Falls risk becomes more common with age and is associated with higher rates of disability, mortality, and healthcare costs. Exergames have shown to elicit improvements in prefrontal cortex activity, balance, and postural control of seniors, all of which are associated with fall risk, but it is unknown whether virtual reality (VR) exergames, played using a three-dimensional headset can enhance the effects of cognitive and physiological functioning. Objective: Evaluation of the effects of a

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... duced VR exergame "Falling diamonds" on physical performance, trunk stability and cognition, three attributes linked to falls risk in seniors. Methods: A total of 44 physically active participants aged 60-85 years were randomized to either the immersive VR exergame (n = 14), nonimmersive exergame (n = 15), or control (n = 15). Static balance, leg strength, and gait speed were measured by the Short Physical Performance Battery, trunk stability was assessed using the Prone test and cognition was evaluated by the RehaCom screening software at baseline and follow-up at 9 weeks. Results: The VR exergame group experienced greater improvements in the cognition measures of selective attention control and speed (p = .009, p = .033) more than the exergame group (p = .010) and control (p = .049, p = .004). Conclusions: The evaluation and delivery methods of VR exergame Falling diamonds are feasible, and trial measures, procedures, and intervention are deemed acceptable by participants. Our findings indicate that using a VR exergame to exercise could improve cognition in seniors.