Non-immersive exergames and remote exercise show the most consistent cognitive benefit for older adults, network meta-analysis finds

A Bayesian network meta-analysis pooled 51 randomised controlled trials (3,673 participants aged 60 and over) comparing four digital physical exercise modalities — immersive virtual reality exercise, non-immersive exergames, remote exercise, and virtual reality exercise combined with cognitive training — against active or no intervention, across three cognitive domains Meta-analysis. Non-immersive exergames most consistently benefited global cognition and executive function. Remote exercise was the only modality to produce a statistically robust improvement in memory function specifically. Certainty of evidence was rated very low for most comparisons, reflecting heterogeneity and reporting-bias concerns across the included trials.

The authors explicitly note that remote exercise and exergame-based interventions are practical options for older adults in rural and resource-limited settings, where supervised in-person group exercise programmes are harder to access.

Given the very-low certainty rating across most comparisons, this evidence base is better suited to informing pilots of digital exercise delivery for older adults with limited access to supervised group programmes than to treating any single modality as an established, guideline-ready intervention. The feasibility and equity of remote delivery for older adults with limited broadband or digital access is not addressed by this evidence and remains a separate implementation question for any service considering it.