Objective: To determine the effects of exer-game balance training on dementia level, quality of life, and self- efficacy in older adults with mild cognitive impairment (MCI), comparing wobble board and stable-surface training. 

Design: Randomized controlled trial. 

Setting: Physiotherapy Department, Railway General Hospital, Rawalpindi, Pakistan. 

Participants: Thirty-two patients with MCI (18 experimental, 14 control) were randomly allocated using sealed envelopes. 

Interventions: The experimental group performed exer-game balance training on a modified wobble board, while controls trained on a Nintendo Wii Fit platform. Both groups completed 24-minute sessions, three times weekly for eight weeks. 

Measures: Outcomes included dementia-related quality of life (DEMQOL), cognition (MoCA), dementia level (CDR), and self-efficacy (General Self-Efficacy Scale), assessed at baseline and eight weeks. 

Results: Both groups showed significant within-group improvements (p≤0.05). Between-group differences were significant for MoCA (p=0.02) and CDR (p=0.05), but not DEMQOL (p=0.46) or self-efficacy (p=0.74). 

Conclusion: Both training modalities effectively improved cognition, dementia level, quality of life, and self- efficacy in older adults with MCI.