Background The population is aging globally. Older people living in long-term care facilities have many functional impairments, such as mobility problems and depression. Digital games and so-called exergames can offer a motivating and entertaining way to maintain older people's physical activity and thus their ability to function. However, previous studies have reported conflicting results about the effects of digital gaming and have focused on community-dwelling older people.

Objective To identify, critically appraise, and synthesize evidence about the effectiveness of digital games on older people's physical, psychological, and social functioning and physical and social activity in long-term care facilities.

Methods Five databases were systematically searched, and relevant studies were screened. Fifteen randomized-controlled trials and quasi-experimental studies (total N = 674) were included in meta-analysis.

Results All digital games used in interventions were exergames. Meta-analysis showed that exergame interventions have a statistically significant large effect on physical functioning [number of studies (N) = 6, standardized mean difference (SMD) = 0.97, p = 0.001] measured by Timed Up and Go or Short Physical Performance Battery and self-assessed physical activity (N = 3, SMD = 1.20, p < 0.001) and medium effect on social functioning (N = 5, SMD = 0.74, p = 0.016) compared to alternative intervention or no intervention. Social activity was not measured in any study.

Conclusions The results are encouraging that exergames effectively increase the functioning and activity of older adults living in long-term facilities. Successful implementation of such activities requires the competence of nursing staff and rehabilitation professionals in digitalization.