Impact of physical versus digital games on memory and related cognitive performance in older adults: a randomized controlled trial

Age-related memory decline and changes in related cognitive functions are major concerns in later life, with important implications for independence and quality of life. Non-pharmacological strategies, including game-based cognitive interventions, have gained increasing attention. This study aimed to compare the effects of tabletop games and screen games on memory and related cognitive performance in older adults. This parallel-group randomized controlled trial (RCT) was conducted among 60 community-dwelling older adults (≥ 60 years) during the autumn of 2025 in Aran and Bidgol, Isfahan, Iran. Participants were randomly allocated to tabletop games, screen games, and control groups ( n = 20 per group). Those in the two intervention groups received the usual program in addition to 40-minute game sessions twice weekly for 15 sessions, whereas those in the control group received the usual program alone. Memory and related cognitive performance were assessed using the Wechsler Memory Scale, Third Edition (WMS-III), at baseline and immediately after the intervention. Data was analyzed using parametric and non-parametric tests in SPSS version 27. Both intervention groups showed significant gains in total WMS scores (both P < 0.001), whereas the control group showed only a negligible change ( P = 0.037, d = 0.03). At post-test, the two intervention groups had higher total WMS scores than the control group (both P < 0.001), and the screen games group had a higher total score than the tabletop games group ( P = 0.019). Screen games group had higher post-test scores than the control group in all WMS domains except visual memory, whereas tabletop games group showed higher scores than the control group in personal and general information, orientation, and digit span. Both tabletop game and screen game interventions were associated with improvements in memory and related cognitive performance among older adults. Although screen games group yielded a higher post-test total WMS score than tabletop game group, this finding does not establish overall superiority of one format. This intervention may represent potential non-pharmacological approaches for supporting cognitive health in community settings. Iranian Registry of Clinical Trials (IRCT) IRCT20250825066982N1. Date of registration 20/11/2025. Retrospectively registered; ( https://irct.behdasht.gov.ir/trial/86352/pdf ).