JMIR Aging

Though exergames attract considerable research interest as tools for preserving cognitive function in older adults, a decade of meta-analytic evidence reveals a persistent gap between theoretical promise and empirical demonstration: exergames rarely outperform conventional motor-cognitive training and do not generate the sustained engagement that preventive benefit requires. These results reflect limitations that are structural: the field focused predominantly on clinical populations rather than primary prevention; training concepts borrowed from rehabilitation protocols rather than grounded in the specific neuroplastic mechanisms of the exergaming medium; and virtual environments that are digitally sophisticated but culturally and esthetically neutral, systematically excluding the stimulation that converging evidence from neuroaesthetics, cultural epidemiology, and narrative neuroscience identifies as a core active ingredient of brain health promotion. To address these limitations simultaneously, this viewpoint introduces Motor-Cognitive Active Gamified Immersive Cultural (MAGIC) exergames, defined as “virtual reality solutions in which motor-cognitive interactions are embedded in artistic content, cultural heritage, or historically situated narrative to exploit optimal neurobiological substrates of the intervention.” Drawing on an integrated theoretical framework, we develop mutually reinforcing mechanistic pillars: multimodal sensorimotor engagement within ecologically valid immersive environments; semantic and narrative activation of memory systems; emotional and autobiographical resonance as a dopaminergic driver of learning consolidation and sustained participation; and the re-engineering of physical effort evaluation from aversive to appetitive through aesthetic pleasure and narrative absorption. A fundamental implication is that in MAGIC exergames, motivation is not engineered through gamification mechanics—it is released by the intrinsic value of inhabiting a culturally meaningful world. We further argue MAGIC exergames correspond to a specific use that is, Cultural Snacking, which consists of the serialization of MAGIC content into brief, narratively open daily episodes of 5 to 10 minutes, designed for 3 to 5 daily consumptions across varied contexts. This dosing architecture is compatible with the motivational profile of healthy older adults who do not identify as patients or trainees. The paper opens perspectives with a design and research agenda structured around three priorities: characterizing MAGIC exergames by the type of motor-cognitive interactions they deliver rather than by the technology platform; conducting mechanistic neuroimaging investigations targeting the specific biomarkers of neuroplastic benefit that creative cultural engagement is expected to produce; and building the intersectoral innovation ecosystem that brings cultural institutions, digital health teams, and older adults together as co-designers. Without waiting for MAGIC-specific trials, we invite the digital medicine, public health, and silver economy communities to recognize that museums, heritage sites, and cultural institutions are potentially the most ecologically valid, intrinsically motivating, and cost-effective substrates for a new generation of brain health exergames that are as meaningful as they are effective. The scientific, institutional, and economic conditions for this convergence already exist.

Immersive virtual reality (VR) is increasingly used for embodied training, but its practical value for older adults depends on whether the experiential benefits can be achieved without unacceptable discomfort or overstated claims about motor learning.

Social disparities in oral health persist, disproportionately affecting Indigenous populations.

The phase angle (PhA) and extracellular water (ECW)–to–total body water (TBW) ratio serve as indicators of cell membrane integrity and body fluid balance in older adults.

Falls and fractures are a major clinical concern for older adults. International clinical guidelines recommend annual fall risk screening for all adults aged 60 years and older. However, existing falls risk–screening algorithms have shown limited sensitivity and specificity in detecting future falls. Emerging health technologies, including wearable sensors, in-silico finite element models (FEMs), and virtual reality (VR) technology, show promise in enhancing fall and fracture risk assessments by providing more personalized objective data to support targeted primary prevention. However, large-scale longitudinal studies are required to evaluate their predictive accuracy and cost-effectiveness for systematic community–based screening.

Digital technology is increasingly being used to deliver interventions and initiatives to support the well-being of older adults. However, few studies have conducted needs assessments to identify the future well-being service requirements of an older adult population and their preferred modes of delivery, whether via digital technology or, in- person, or a combination of both (ie, a hybrid model).

Knee osteoarthritis (KOA) lacks disease-modifying treatment, making early identification of modifiable risk factors in asymptomatic older adults a priority. Patellar tendon stiffness (PTS) and knee extensor strength (KESt) may independently influence KOA development, yet their prognostic value in individuals free of knee symptoms is unestablished.

Alzheimer disease (AD) is a leading cause of dementia, and there is growing interest in scalable approaches for early screening using speech-based tasks. While prior work has demonstrated promising results using either transcript-based language features or acoustic cues, most approaches remain unimodal or rely on simple fusion strategies that do not explicitly consider interactions across modalities.

Early mortality after long-term care facility (LTCF) admission is common; yet, prognostic tools are often derived from Western minimum dataset-based cohorts or require hospital electronic health record linkages that are unavailable at intake in many LTCFs. There is also limited evidence on explainable, admission-feasible machine learning–based prognostication in Asian LTCF settings.

Community exergaming may help older adults remain physically active by combining movement, enjoyment, and social interaction, but less is known about whether observed changes persist after supervised delivery ends in real-world community settings.

Mobility limitations in older adults are associated with an increased physiological cost of walking, reduced functional independence, and elevated fall risk. Conventional wheeled walkers improve stability but lack real-time physiological monitoring and safety feedback. Digital health–enabled assistive devices integrating physiological monitoring and fall detection may enhance mobility performance and safety.

Keep-on-Keep-up Nutrition (KOKU-Nut) is a free, tablet-based digital platform that focuses on increasing physical activity and improving the dietary intake of older adults.