Effectiveness of Exergame Intervention on Depressive Symptoms, Daily Living Activities, and Fear of Falling in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

This systematic review evaluated exergame interventions' efficacy in older adults, focusing on depressive symptoms, activities of daily living (ADLs), and fear of falling. We searched five electronic databases from inception to June 2024. Data were synthesized using the inverse-variance method, reporting standardized mean differences (SMDs) with 95% confidence intervals (CIs). Twenty-four randomized controlled trials (RCTs) with 1,128 participants were included. Exergames significantly improved depressive symptoms (SMD = -0.76, 95% CI: -1.11 to -0.40, p < .001). Meta-regression showed no influence of sample size, health status, intervention duration, gender, or gaming device. No significant effects were found for ADLs (SMD = 0.01, 95% CI: -0.75 to 0.76, p = .988) or fear of falling (SMD = -0.16, 95% CI: -0.40 to 0.08, p = .189). Exergames enhance mental health in older adults but lack clear effects on physical function or fear of falling. High-quality, long-term studies are needed. Exergames offer an engaging intervention to reduce depressive symptoms, complementing mental health therapies. Clinicians should use modern platforms and combine exergames with physical or behavioral interventions to address ADLs and fear of falling.