A Randomized Controlled Trial of an Enhanced Version of a Cognitive–Behavioral Video Game Intervention Aimed at Promoting Active Aging: Assessments of Perceived Health and Healthy Lifestyle Habits at Pre- and Post-Intervention

<b>Background/Objective:</b> Video games offer an innovative tool for delivering active aging interventions. The objective of this study was to analyze the efficacy of an enhanced version of a cognitive-behavioral intervention to promote active aging, administered through a video game, on perceived health and healthy lifestyle habits. <b>Methods:</b> A total of 556 participants aged 45 or older (74.3% women, mean age of 60.8 [<i>SD</i> = 8.0]) were randomly assigned to a cognitive-behavioral intervention to promote active aging administered via an interactive, multimedia, online, and serious video game with a complementary smartphone app (CBI-V; <i>n</i> = 279) or to a control group receiving non-specific online information (CG; <i>n</i> = 277). Perceived health (General Health, Body Pain, Physical Functioning, Physical Role, Vitality, Social Functioning, Emotional Role, Mental Health, Physical and Mental Summary Indices); healthy habits, including sleep hygiene behaviors, physical activity, and eating habits; dropouts; adherence to the intervention (completed modules; total playtime; time devoted to cognitive training; number of cognitive task attempts and tasks completed between modules); and satisfaction with the intervention were assessed by independent, blind evaluators via an online platform before and after the intervention. <b>Results:</b> At the post-intervention, the CBI-V group obtained significantly better scores in General Health (<i>p</i> < 0.001), Mental Health (<i>p</i> = 0.015), sleep hygiene (<i>p</i> < 0.001), physical activity (<i>p</i> = 0.024), and eating habits (<i>p</i> = 0.001) than the CG. The effect sizes were small (<i>d</i> = -0.188 to 0.334). Clinically significant changes were higher in the CBI-V group than in the CG in General Health (<i>p</i> = 0.029), Physical Function (<i>p</i> = 0.028), Social Function (<i>p</i> = 0.011), Emotional Role (<i>p</i> = 0.008), Mental Health (<i>p</i> = 0.026), Physical Summary Index (<i>p</i> = 0.010), sleep hygiene (<i>p</i> = 0.020), and eating habits (<i>p</i> = 0.019). Participants reported a high level of satisfaction with the intervention, with a mean score of 25.4 (<i>SD</i> = 4.0) out of a maximum of 32 on the intervention satisfaction measure. <b>Conclusions:</b> These findings support the efficacy of a cognitive-behavioral video game intervention in enhancing perceived health and promoting healthy lifestyle habits among people aged 45 and above.