The (cost-) effectiveness of exergaming in people living with dementia and their informal caregivers: Protocol for a randomized controlled trial

Joeke Van Santen, Rose Marie Dröes, Judith E. Bosmans, Olivier A. Blanson Henkemans, Sjef Van Bommel, Esther Hakvoort, Ronald Valk, Carla Scholten, Joris Wiersinga, Annemieke Van Straten, Franka Meiland*

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Physical activity is linked to benefits such as increased physical fitness, cognition, emotional and social functioning, general health and well-being in older people. Some evidence suggests that this also applies to people living with dementia. However, it can be harder for them to perform physical activities, due to several barriers, such as issues with orientation and balance problems. A relatively new type of physical activity called exergaming may help them overcome these barriers. Exergaming is "physical exercise interactively combined with cognitive stimulation in a gaming environment". The aim of our study is to evaluate the effectiveness and cost-effectiveness of exergaming compared to regular activities in people living with dementia, who attend day-care centres. Additionally, we want to investigate whether the exergaming activity for the person living with dementia, also (indirectly) affects the informal caregiver, as well as which facilitators and barriers to implementation of exergames for this target group exist. Methods: A cluster Randomized Controlled Trial (RCT), with economic and process evaluations alongside will be carried out. In the Netherlands, 24 day-care centres are randomized in the experimental or control group. The study group will consist of 224 dyads (community-dwelling participants with dementia and their informal caregivers), who are interviewed at baseline, and at 3 and 6 months of follow-up. The participant with dementia has to visit the day-care centre for at least two days per week, have a diagnosis of mild to moderate dementia and have an informal caregiver present, who is willing to participate. Societal cost data will be collected during interviews, using healthcare utilization diaries, and from day-care centres. The process evaluation will only involve the experimental group, and will include an online survey, qualitative interviews and focus groups. Discussion: This study will contribute to the evidence base that more effective exercise among people with dementia will result in positive effects on their wellbeing and quality of life. This will motivate people with dementia to be physically active. We also envision that there might be a positive effect on the burden of care experienced by their informal caregivers. Trial registration: This trial was registered at the Netherlands Trial Register (NTR) on December 10, 2015 (number: NTR5537), this publication is based on protocol amendment number 01, issue date 28 December 2018. This includes all items from the World Health Organization Trial Registration Data Set [see Additional file 1].

Original languageEnglish
Article number50
Pages (from-to)1-19
Number of pages19
JournalBMC Geriatrics
Publication statusPublished - 19 Feb 2019


The project received funding from ZonMw/ Alzheimer Nederland (number 733050609) for personnel, material and dissemination costs. ZonMw/ Alzheimer Nederland have peer reviewed the research protocol on which this manuscript is based and have therefore contributed to the design of the study. Additional funding for this was obtained from Stichting Dioraphte (project number 16 02 04 03). Furthermore, this trial was carried out as part of the Marie Curie Innovative Training Network (ITN) (Interdisciplinary Network for Dementia Using Current Technology (INDUCT)) action, H2020-MSCA-ITN-2015, under grant agreement number 676265, therefore funding 3 years of the PhD trajectory of JvS. ZonMw/Alzheimer Nederland, Stichting Dioraphte, and INDUCT have all contributed to the funding to enable the collection, analysis, and interpretation of data and writing of the manuscript. The exergaming equipment is paid for by the day-care centres themselves, however, they can purchase it with a discount from Embedded Fitness B.V. or SilverFit B.V. 1Department of Psychiatry, Amsterdam UMC, location VUmc, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands. 2Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands. 3Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1081, 1081 HV Amsterdam, the Netherlands. 4Child Health, TNO, Schipholweg 77, 2316 ZL Leiden, the Netherlands. 5Sjef van Bommel Management & Support, Stadionweg 53HS, 1077 RZ Amsterdam, the Netherlands. 6Scientific Committee Evean, Waterlandplein 5, 1441 RP Purmerend, the Netherlands. 7HilverZorg – Day-care centre Zonnehoeve, Loosdrechtse Bos 9, 1213 RH Hilversum, the Netherlands. 8Embedded Fitness B.V., Kapelweg 11, 5756 AJ Vlierden, the Netherlands. 9SilverFit B.V., Edisonweg 7, 3442 AC Woerden, the Netherlands. 10Department of Clinical-neuro-and developmental Psychology, Faculty of Behaviour and Movement Sciences, VU University Amsterdam, Van der Boechorststraat 7, Amsterdam, the Netherlands. 11GGZ inGeest Dienst Onderzoek en Innovatie, Oldenaller 1 (room H3.08) Postbus 74077, 1070 BB Amsterdam, The Netherlands.

FundersFunder number
Horizon 2020 Framework Programme676265
Alzheimer NederlandH2020-MSCA-ITN-2015, 733050609


    • Cost effectiveness
    • Dementia
    • Exergaming
    • Physical activity
    • Physical functioning
    • Quality of life
    • Randomized controlled trial


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