Monitoring cognitive load while playing exergames in a four-week intervention for older adults: an explorative EEG study.

Exergaming combines physical and cognitive components in a virtual game and has demonstrated improvements in physical and cognitive functions in older adults. However, methods to monitor cognitive demand during exergaming remain underexplored. This study investigated the sustained cognitive involvement while exergaming during a four-week intervention for older adults, utilizing EEG. The aim is to explore the impact of exergaming on changes in frontal theta power across multiple sessions throughout a four-week intervention in older adults. 21 independently living older adults (mean age 74.80 years ± 0.81; 8 females) completed a 4-week exergaming intervention where they played two different exergames (Puzzle and Fox) at two difficulty levels. Mean power spectral density in the theta band (4–7 Hz) derived from frontal brain regions at sessions 1,2,3,6,9, and 12 during exergaming. Frontal theta was significantly higher during exergaming across all games and difficulty levels compared to the reference movement ( < 0.01). Performance and the theta power change significantly increased over time ( < 0.001), indicating sustained and increasing cognitive engagement. This study is the first to repeatedly measure EEG during an exergaming intervention, confirming frontal theta activity as a robust marker of cognitive involvement. Monitoring players repeatedly during exergaming provides the basis for effective and adaptive interventions. Trial registered at DRKS (DRKS00034786).