OBJECTIVES: This systematic review evaluated exergame interventions' efficacy in older adults, focusing on depressive symptoms, activities of daily living (ADLs), and fear of falling. METHODS: We searched five electronic databases from inception to June 2024. Data were synthesized using the inverse-variance method, reporting standardized mean differences (SMDs) with 95% confidence intervals (CIs). RESULTS: Twenty-four randomized controlled trials (RCTs) with 1,128 participants were included. Exergames significantly improved depressive symptoms (SMD -0.76, 95% CI -1.11 to -0.40, p < 0.0001). Meta-regression showed no influence of sample size, health status, intervention duration, gender, or gaming device. No significant effects were found for ADLs (SMD 0.01, 95% CI -0.75 to 0.76, p = 0.988) or fear of falling (SMD -0.16, 95% CI -0.40 to 0.08, p = 0.189). CONCLUSIONS: Exergames enhance mental health in older adults but lack clear effects on physical function or fear of falling. High-quality, long-term studies are needed.
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