The Effectiveness of Exergaming Interventions for Depressive Symptoms and Quality of Life in Old Patients with Dementia: A Systematic Review and Meta-analysis (Preprint)

BACKGROUND Background: Exergame, a novel and promising combination of exercise and video games, has been suggested by previous studies to have an association with depression and quality of life. However, it is evidenced that the effectiveness regarding of depressive symptoms and quality of life in older patients with dementia(OPwD) remain mixed. OBJECTIVE Objective: This systematic review and meta-analysis aimed to quantify the effects of intervening with exergames on depressive symptoms and quality of life in OPwD. METHODS Methods: A comprehensive search of 5 electronic databases was conducted for randomized controlled trials published in English and Chinese from the establishment of the databases to December 1,2024. Eligible studies used exergaming interventions to reduce depression and quality of life in OPwD. In total, 2 independent reviewers screened the retrieved records, extracted data, and evaluated the risk of bias using the Revised Cochrane risk-of-bias tool. Discrepancies were resolved by a third reviewer. Meta-analysis and systematic review were performed using Review Manager 5.4 and Stata 16.0. Setting: Included databases were Web of Science(WoS), PubMed, China National Knowledge Infrastructure(CNKI),WanFang Data(WFD), and VIP Information Databases, searched from the establishment of the databases to December 1, 2024. RESULTS Results: In total, 9 randomized controlled trials (n=494) were screened and included. (1) In terms of improving depressive symptoms, disregarding 1 study that resulted in heterogeneity, the meta-analysis of 5 studies revealed that exergames could significantly alleviate depressive symptoms in OPwD [SMD=−0.97, 95%CI (−1.24 to −0.71), P<0.00001]. Subgroup analysis showed that changes in the number of intervention cycle and intervention frequency had a significant impact in the intervention effect. (2) In terms of improving quality of life, meta-analysis of 6 studies showed that exergames significantly improved the quality of life of older patients [SMD=0.75, 95% CI (0.50 to 1.00), P<0.00001], with a very low heterogeneity level(I²=0%); subgroup analysis showed that the number of intervention weeks, intervention frequency, and intervention method had no significant impact on the effectiveness in improving quality of life. CONCLUSIONS Conclusions: Exergaming intervention shows potential in reducing depressive symptoms and enhancing quality of life (QoL) in older persons with dementia (OPwD). While intervention frequency influences outcomes, QoL improvements appear consistent across variations in cycle, duration, and delivery method. Further research with larger samples and rigorous designs is needed to confirm both short- and long-term benefits and clarify the mechanisms behind specific exergaming protocols. CLINICALTRIAL The methods were preregistered with PROSPERO (International Prospective Register of Systematic Reviews, registration number CRD420251032107, registration on April 14, 2025).