Multi-Domain Benefits of Exergaming for Sarcopenia Management in Institutionalized Older Adults: Physical, Psychological, and Social Outcomes.

Abstract

To evaluate the effectiveness of a 12-week exergaming intervention (Nintendo Switch Ring Fit Adventure) on physical, psychological, and social outcomes in institutionalized older adults with sarcopenia. We hypothesized that exergaming would produce concurrent improvements across physical, psychological, and social domains. Pragmatic quasi-experimental study with pre-post design and matched facility pairs, following TREND guidelines. Six long-term care facilities in Taiwan (three intervention and three comparison). Seventy-two institutionalized older adults (36 intervention and 36 comparison) with confirmed sarcopenia per Asian Working Group for Sarcopenia 2019 criteria, aged ≥65 years, with adequate cognitive capacity. The intervention group received thrice-weekly 50-min exergaming sessions over 12 weeks with intensity maintained at Borg rating of perceived exertion of 13-14 (6-20 scale). The comparison group continued routine care. Sarcopenia indicators (muscle mass index, grip strength, and gait speed), functional performance (sit-to-stand and timed up-and-go), and psychosocial outcomes (Geriatric Depression Scale, UCLA Loneliness Scale, Pittsburgh Fatigability Scale, State-Trait Anxiety Inventory, and Pittsburgh Sleep Quality Index). Significant time-by-group interactions (groups changed differently over time) occurred across all domains. Physical: sarcopenia prevalence decreased from 100% to 41.7% (intervention) versus 100% to 94.4% (comparison) (p<0.001); grip strength +26.9% versus -7.4%; and muscle mass index +14.3% versus -5.2%. Psychological: depression decreased 44% versus increased 31%; anxiety decreased 14% versus increased 15%. Social: loneliness decreased 9% versus increased 6%. Adherence reached 94.4% with no adverse events. Exergaming demonstrated clinically meaningful improvements across physical, psychological, and social domains with exceptional adherence, suggesting gaming's unique potential to address sarcopenia's interconnected biopsychosocial nature-a critical advantage for holistic geriatric care in institutional settings.