# Neuro-exergaming for the prevention and remediation of decline due to Alzheimer's disease and related dementias: A clinical trial of the interactive Physical and Cognitive Exercise System (iPACES v3)

> **NIH NIH R44** · IPACES, LLC · 2021 · $1,116,991

## Abstract

PROJECT SUMMARY/ABSTRACT
Dementia cases due to Alzheimer's disease (AD) and related dementias are on the rise, and in the absence of
a cure, the devastating impact has led to increased calls for expanded research. Behavioral interventions, such
as exercise, have been noted to enhance brain health and can be useful in the prevention and remediation of
cognitive decline, as in mild cognitive impairment (MCI). Our initial randomized controlled trial (RCT)
investigated exergaming (Anderson-Hanley et al., 2012a), revealed significant cognitive benefit after three
months of pedaling a virtual reality enhanced bike or “cybercycle,” compared with traditional pedaling only.
Results suggest that for the same effort, interactive physical and mental exercise on a cybercycle can yield
greater cognitive benefit than physical exercise alone on a stationary bike. Furthermore, there was a 23%
reduction in risk of conversion to MCI among the cybercyclists. In a follow-up NIA-funded RCT, the Aerobic
and Cognitive Exercise Study (ACES; Anderson-Hanley, 2018a), the PI and collaborators have worked to
replicate and extend this line of research with patients with MCI. However, patients with MCI often declined to
enroll citing travel to the location of the bike as a barrier. This sparked development of a portable, affordable
tablet-based prototype: the interactive Physical and Cognitive Exercise System (iPACES) which can be paired
with an under-table elliptical pedaler for in-home use. Data from in-home pilot trials (v1 & v2) by more than two
dozen older adults pairs, found executive function significantly improved after 3-months of pedaling-to-play in
the iPACES neuro-exergame, and more so than game-only (Anderson-Hanley et al., 2018b; Wall et al., 2018).
The proposed research aims to: 1) enhance long-term exercise with iPACES via adding: a variety of interesting
storyboards (e.g., tourist travel of states and countries), a virtual coach, smart watch notifications to promote
adherence, and integration of tablet assessments with remote data capture, 2) pilot test the updated version of
iPACES, 3) conduct an in-home multi-site clinical trial with 120 MCI-caregiver pairs comparing cognitive and
biomarker outcomes from one-year of iPACES (pedal-to-play) with synchronous, but non-interactive physical
and cognitive exercise (PACE; pedal-while-play), and 4) prepare results for publication and use in
commercialization. Collaborators with wide-ranging expertise, will provide guidance in refining the games for
long-term play, hardening the interface with equipment (e.g., iPad and smart-watch), and interfacing with
reliable and valid unattended electronic assessment of cognition and behaviors. A randomized clinical trial will
evaluate the cognitive and everyday impacts of six months of pedal-to-play iPACES, compared PACE-only,
and use and effect after one year will also be assessed. Results will be prepared for publication and use in
commercialization, as warranted, with the goal...

## Key facts

- **NIH application ID:** 10264165
- **Project number:** 5R44AG071063-02
- **Recipient organization:** IPACES, LLC
- **Principal Investigator:** PAUL J ARCIERO
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,116,991
- **Award type:** 5
- **Project period:** 2020-09-30 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10264165

## Citation

> US National Institutes of Health, RePORTER application 10264165, Neuro-exergaming for the prevention and remediation of decline due to Alzheimer's disease and related dementias: A clinical trial of the interactive Physical and Cognitive Exercise System (iPACES v3) (5R44AG071063-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10264165. Licensed CC0.

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