Physical as well as cognitive training interventions improve specific cognitive functions but effects barely generalize on global cognition. Combined physical and cognitive training may overcome this shortcoming as physical training may facilitate the neuroplastic potential which, in turn, may be guided by cognitive training. This study aimed at investigating the benefits of combined training on global cognition while assessing the effect of training dosage and exploring the role of several potential effect modifiers. In this multi-center study, 322 older adults with or without neurocognitive disorders (NCDs) were allocated to a computerized, game-based, combined physical and cognitive training group (n = 237) or a passive control group (n = 85). Training group participants were allocated to different training dosages ranging from 24 to 110 potential sessions. In a pre-post-test design, global cognition was assessed by averaging standardized performance in working memory, episodic memory and executive function tests. The intervention group increased in global cognition compared to the control group, p = 0.002, Cohen’s d = 0.31. Exploratory analysis revealed a trend for less benefits in participants with more severe NCD, p = 0.08 (cognitively healthy: d = 0.54; mild cognitive impairment: d = 0.19; dementia: d = 0.04). In participants without dementia, we found a dose-response effect of the potential number and of the completed number of training sessions on global cognition, p = 0.008 and p = 0.04, respectively. The results indicate that combined physical and cognitive training improves global cognition in a dose-responsive manner but these benefits may be less pronounced in older adults with more severe NCD. The long-lasting impact of combined training on the incidence and trajectory of NCDs in relation to its severity should be assessed in future long-term trials.

FitForAll (FFA) exergaming platform helps elderly to entertain themselves while they do their workout. Motion sensing devices depict user's movement patterns on a game screen. The work described here, highlights the significance of developing human-computer interaction systems focusing on the needs of end-users. Specific design techniques are adopted in order to provide seniors with content that is easily accessible and comprehensible. Some early results of a first prototype are presented. 14 seniors in total, either healthy or with cognitive decline (either mild cognitive impairment or mild dementia) have provided feedback on several aspects of platform usability. An additional evaluation component of the platform that is thoroughly investigated is the affective evaluation of the FFA platform. An important conclusion that stems from the present research is the highly significant predictive value of affective states on usability evaluation, highlighting the important role of the entertaining exergaming environment regarding its usability. Further investigation on the enhancement of seniors' affective experience during game play is of utmost importance to us, as there is strong evidence that dynamic game content adaptation according to one's affective state would result into better training adherence and seniors' reinforcement of motivation.