Effectiveness of Gamification on Enjoyment and Satisfaction in Older Adults: Systematic Review and Meta-Analysis.

Background: Sedentary behavior is highly prevalent among older adults, with adherence to exercise being a major challenge. Exercise offers substantial physical, psychological, and social benefits, but enjoyment is a key factor influencing adherence. Technology-based interventions have shown promise in enhancing motivation and participation, demonstrating higher adherence rates than conventional treatments, although challenges such as motivation loss and technological barriers persist. This review evaluates the effectiveness of active video game interventions on enjoyment and satisfaction in older adults. Objective: This systematic review and meta-analysis aims to determine whether active video games are superior to other interventions in generating greater enjoyment or satisfaction in older adults. Methods: PubMed, Cochrane, PEDro, SPORTDiscus, CINAHL, Web of Science, and Scopus databases were searched from inception to September 30, 2024, to identify randomized clinical trials or crossover studies. The primary outcome was enjoyment or satisfaction, assessed using various scales, including the Physical Activity Enjoyment Scale, Intrinsic Motivation Inventory, User Satisfaction Questionnaire, and Likert-type scoring scales. Secondary outcomes included adherence rates and adverse effects. Cochrane Risk of Bias 2 tool was used to evaluate the risk of bias. Results: Five studies were included in the quantitative analysis. The results indicated a significant improvement in enjoyment or satisfaction compared to the control groups (standardized mean difference 0.34, 95% CI 0.05-0.64; P=.02; I2=24%), although the effect size was small. Secondary outcomes could not be analyzed due to insufficient data in the selected studies. Conclusions: Active video game interventions may improve enjoyment and satisfaction in older adults, but the evidence remains of low certainty.