PURPOSE: To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD). MATERIALS AND METHODS: Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA. RESULTS: Seven older adults with MNCD in the exergame and 11 in the active control group completed the study (mean age 83.2 +/- 6.5 years; 94.4% female; SPPB score = 7.3 +/- 2.4). Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (eta2 = 0.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise. CONCLUSIONS: The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings. TRIAL REGISTRATION: The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315).

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