Aging is associated with a decline in physical functions, cognition and brain structure. Considering that human life is based on an inseparable physical-cognitive interplay, combined physical-cognitive training through exergames is a promising approach to counteract age-related impairments. The aim of this study was to assess the effects of an in-home multicomponent exergame training on [i] physical and cognitive functions and [ii] brain volume of older adults compared to a usual care control group. Thirty-seven healthy and independently living older adults aged 65 years and older were randomly assigned to an intervention (exergame training) or a control (usual care) group. Over 16 weeks, the participants of the intervention group absolved three home-based exergame sessions per week (à 30-40 min) including Tai Chi-inspired exercises, dancing and step-based cognitive games. The control participants continued with their normal daily living. Pre-and post-measurements included assessments of physical (gait parameters, functional muscle strength, balance, aerobic endurance) and cognitive (processing speed, short-term attention span, working memory, inhibition, mental flexibility) functions. T1-weighted magnetic resonance imaging was conducted to assess brain volume. Thirty-one participants (mean age = 73.9 ± 6.4 years, range = 65-90 years, 16 female) completed the study. Inhibition and working memory significantly improved postintervention in favor of the intervention group [inhibition: F (1) = 2.537, p = 0.046, n 2 p = 0.11, working memory: F (1) = 5.872, p = 0.015, n 2 p = 0.02]. Two measures of short-term attentional span showed improvements after training in favor of the control group [F (1) = 4.309, p = 0.038, n 2 p = 0.03, F (1) = 8.504, p = 0.004, n 2 p = 0.04]. No significant training effects were evident for physical functions or brain volume. Both groups exhibited a significant decrease in gray matter volume of frontal areas and the hippocampus over time. The findings indicate a positive influence of exergame training Adcock et al. Effects of Exergame Training in Older Adults on executive functioning. No improvements in physical functions or brain volume were evident in this study. Better adapted individualized training challenge and a longer training period are suggested. Further studies are needed that assess training-related structural brain plasticity and its effect on performance, daily life functioning and healthy aging.

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Background: This article describes the case study of a community-based participatory research team that has used a social ecological approach to address significant health disparities in type 2 diabetes among Marshallese living in Arkansas.Methods: A case study approach is used to analyze the activities of the community-based participatory research partnership using a social ecological framework to describe how multiple factors across the social ecology are being addressed simultaneously. Results:In collaboration with the local Marshallese community and local organizations, the interprofessional team implemented interventions at each of the social ecological levels. Conclusion:Efforts to address health disparities should include interventions at multiple social ecological levels. Further, engaging diverse community partners contributes to success by leveraging the contextual and cultural knowledge, practices, and resources of all individuals and organizations involved. Finally, combining a social ecological perspective with a community-based participatory research approach contributes to sustainability of the interventions by engaging the broader community and ensuring the interventions reflect an understanding of and appreciation for the community's culture.

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