Virtual reality(VR)-enhanced exercise combines  physical exercise with computer-simulated environments and interactive videogame features.  In the Cybercycle Study, Cay Anderson-Hanley, from Union College (New York, USA), and colleagues analyzed the effects of VR bicycling in 101 study subjects, ages 58 to 99 years, who lived independently and had indoor access to an exercise bike. Cybercycle participants experienced 3D tours and raced against a "ghost rider," an avatar based on their last best ride. Of 79 participants who completed initial evaluations and training and rode identical recumbent stationary bikes,.63 adults completed the study, averaging three rides per week. Cognitive assessment to evaluate executive functions such as planning, working memory, attention, and problem solving was conducted at enrollment, 1 month later (pre-intervention) and 3 months after (post-intervention). Blood plasma was tested to measure whether a change in brain-derived neurotrophic growth factor (BDNF) indicated possible neuroplasticity, a mechanism of change that could link exercise to cognition. The team found that virtual-reality enhanced interactive exercise – in this case, 'cybercycling' two to three times per week for 3 months, yielded greater cognitive benefit, and conferred added protection against mild cognitive impairment (MCI), as compared to traditional exercise alone. The study authors conclude that: “simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline.”