iPACES LLC is developing an innovative solution that utilizes Neuro-Exergaming to address the challenges of Alzheimer’s disease and related dementias (ADRDs). Dementia cases are on the rise, and in the absence of a cure, the devastating impact has led to increased calls for expanded research. Behavioral interventions, such as exercise, have been noted to enhance brain health and can be useful in the prevention and remediation of cognitive decline, as in mild cognitive impairment (MCI). iPACES LLC aims to develop the next iteration of Neuro-Exergaming for the prevention and remediation of decline due to ADRDs through a clinical trial of the interactive Physical and Cognitive Exercise System (iPACES v3). Thanks to the grant awarded to iPACES LLC by the National Institute on Aging under the auspices of the Small Business Innovation Research (SBIR) program and National Institutes of Health (NIH), this clinical trial has been made possible. During this current clinical trial, iPACES LLC aims to enhance long-term exercise as a treatment by adding a variety of interesting and stimulating Neuro-Exergames to promote adherence, coupled with the integration of assessments with remote data capture and updated versions of the game. The research will be conducted in an in-home clinical trial with MCI-caregiver pairs. We aim to compare cognitive and biomarker outcomes from one-year of treatment intervention with one-year of synchronous, but non-interactive physical and cognitive exercise. We hope to follow this investigation with preparation of results for publication and use in commercialization.