Feasibility of Immersive Exergames Using Head-Mounted Displays In Dementia Care: A Pilot Study

Current pharmacological treatments for dementia remain limited, highlighting the importance of complementary non-pharmacological approaches. Serious games and exergames have emerged as promising interventions to promote cognitive stimulation, physical activity, and engagement among People with Dementia (PwD). However, most existing interventions rely on non-immersive delivery platforms, such as tablets or floor-projection systems, which may constrain user engagement and ecological validity. This paper presents a pilot feasibility study exploring the use of culturally adapted exergames delivered through a head-mounted display (HMD) in a daycare context for PwD. Three exergames, previously validated for older adults in a floor-projection format, were adapted to an immersive virtual reality environment and administered over five sessions across two weeks. Feasibility was evaluated through adherence rates, behavioral observation, session-based interviews, and pre- and post-intervention cognitive screening using the Montreal Cognitive Assessment (MoCA). All participants (n = 4) completed the intervention, indicating high adherence and overall acceptability. Behavioral observations and self-reports suggested high engagement, enjoyment, and motivation to participate in the activities. Cognitive outcomes showed heterogeneous patterns, including slight improvements or maintenance of cognitive functioning in most participants, while one participant exhibited reduced tolerance to the HMD. Mild adverse effects, such as dizziness and discomfort, were reported in isolated cases. Overall, the findings indicate that immersive exergames delivered via HMD are feasible and acceptable for PwD in supervised care settings, while also highlighting important usability considerations related to individual tolerance and device comfort. These preliminary results support further longitudinal and controlled studies to assess the long-term clinical impact and de-sign requirements of HMD-based exergaming interventions in dementia care.