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Funghi G, Meli C, Cavagna A, Bisoffi L, Zappini F, Papagno C, Dodich A. The Social and Cognitive Online Training (SCOT) project: A digital randomized controlled trial to promote socio-cognitive well-being in older adults. Arch Gerontol Geriatr 2024; 122:105405. [PMID: 38531149 DOI: 10.1016/j.archger.2024.105405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES Effective prevention programs targeting risk factors for cognitive decline in the elderly are recommended given the progressive increase in the aging of the general population. The Social and Cognitive Online Training (SCOT) project is a randomized, controlled, parallel clinical trial designed to prevent the age-related decline in executive and social functions. METHODS The study included 60 cognitively healthy older adults (age = 71.8±5.3, education = 12.3±3.7, MoCA = 25.1±2.4). Participants underwent a baseline clinical and neuropsychological assessment and were then assigned to either an experimental group (SCOT) or a non-specific cognitive training group (CON). Both 8-week digital interventions included two individual cognitive training sessions and one group meeting per week. Post-intervention assessment evaluated the efficacy of the training on specific outcome measures: the Tower of London for executive functioning, the Ekman-60 Faces test, and the Mini-Social cognition & Emotional Assessment battery for social cognition. A measure of loneliness was included as an exploratory outcome. RESULTS Baseline demographic and neuropsychological characteristics were balanced between SCOT (n = 29) and CON (n = 28) groups. Pre-post-intervention analyses showed improvements in executive functioning and social cognition in both groups, without significant interaction effects. Exploratory post-hoc analyses stratifying the SCOT group by training performance showed significant post-training improvements in executive functioning, emotion recognition, and cognitive theory of mind for high-performing participants. DISCUSSION Results provide preliminary evidence for the beneficial effects of SCOT training, particularly for those who performed best during the training. The SCOT training could represent a new intervention to promote socio-cognitive well-being in the context of active ageing and dementia prevention.
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Affiliation(s)
- Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Arianna Cavagna
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Lisa Bisoffi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Zappini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy.
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Chuderski A, Chinta SR. Transcranial alternating current stimulation barely enhances working memory in healthy adults: A meta-analysis. Brain Res 2024; 1839:149022. [PMID: 38801916 DOI: 10.1016/j.brainres.2024.149022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Working memory (WM) is a pivotal neural mechanism for cognitive function and ability. Transcranial alternating current stimulation (tACS) was used to improve WM by entraining key brain rhythms. We submitted to meta-analysis 143 effects of tACS on WM performance, found in 42 reports published between 2014 and 2023, encompassing a total of 1386 healthy adults stimulated. The overall effect size of 134 interventions intended to improve WM equaled Hedges' g = 0.076 [0.039, 0.113]. However, after correcting for a significant publication bias this effect size dropped to zero. By contrast, 9 interventions distorting the brain synchronization using antiphase tACS reliably decreased WM performance, with Hedges' g = -0.266, [-0.458, -0.074]. Individuating the targeted frequency band was the only reliable moderator. The disparity between our null outcome and moderately positive tACS effects estimated by previous meta-analyses resulted from our inclusion of the most recent studies mostly reporting negligible effects. Our results suggest that current tACS protocols barely enhance WM in healthy adults. More research is needed to develop effective methods for WM stimulation.
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Sandoval-Lentisco A, López-Nicolás R, Tortajada M, López-López JA, Sánchez-Meca J. Transparency in Cognitive Training Meta-analyses: A Meta-review. Neuropsychol Rev 2024:10.1007/s11065-024-09638-2. [PMID: 38639881 DOI: 10.1007/s11065-024-09638-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/10/2024] [Indexed: 04/20/2024]
Abstract
Meta-analyses often present flexibility regarding their inclusion criteria, outcomes of interest, statistical analyses, and assessments of the primary studies. For this reason, it is necessary to transparently report all the information that could impact the results. In this meta-review, we aimed to assess the transparency of meta-analyses that examined the benefits of cognitive training, given the ongoing controversy that exists in this field. Ninety-seven meta-analytic reviews were included, which examined a wide range of populations with different clinical conditions and ages. Regarding the reporting, information about the search of the studies, screening procedure, or data collection was detailed by most reviews. However, authors usually failed to report other aspects such as the specific meta-analytic parameters, the formula used to compute the effect sizes, or the data from primary studies that were used to compute the effect sizes. Although some of these practices have improved over the years, others remained the same. Moreover, examining the eligibility criteria of the reviews revealed a great heterogeneity in aspects such as the training duration, age cut-offs, or study designs that were considered. Preregistered meta-analyses often specified poorly how they would deal with the multiplicity of data or assess publication bias in their protocols, and some contained non-disclosed deviations in their eligibility criteria or outcomes of interests. The findings shown here, although they do not question the benefits of cognitive training, illustrate important aspects that future reviews must consider.
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Affiliation(s)
| | - Rubén López-Nicolás
- Department Basic Psychology and Methodology, University of Murcia, Murcia, Spain
| | - Miriam Tortajada
- Department Basic Psychology and Methodology, University of Murcia, Murcia, Spain
| | | | - Julio Sánchez-Meca
- Department Basic Psychology and Methodology, University of Murcia, Murcia, Spain
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Moret B, Kolasinska AB, Nucci M, Campana G, Zini F, Gaspari M, Stablum F. Cognitive benefits of the attentional vs exergame training in older adults. Aging Ment Health 2024; 28:531-541. [PMID: 37395120 DOI: 10.1080/13607863.2023.2228220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE The present study aimed at comparing the effectiveness of an Attentional Computerized Cognitive Training and a commercial Exergame Training. METHODS Eighty-four healthy older adults took part in the study. They were randomly assigned to one of the following conditions: Attentional Computerized Cognitive Training (ATT-CCT), Exergame Training (EXERG-T), or passive Control Group (CG). Participants assigned to the experimental groups underwent 8 laboratory-based sessions-lasting approximately 45 min each-of the respective training activity. A battery of cognitive tests was assessed before, after, and 3 months following the intervention phase. RESULTS The results showed that just the ATT-CCT improved participants' performance, specifically within attention, processing speed, verbal learning and memory. While both intervention groups revealed improved memory self-perception and decreased self-reported absent-mindedness, only the benefits following the ATT-CCT proved to be stable over time. CONCLUSIONS The results suggested that our ATT-CCT may be an effective tool for enhancing cognitive abilities in older healthy adults.
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Affiliation(s)
- Beatrice Moret
- Department of General Psychology, University of Padova, Padova, Italy
| | | | - Massimo Nucci
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
| | - Floriano Zini
- Faculty of Computer Science, Free University of Bozen-Bolzano, Bolzano, Italy
| | - Mauro Gaspari
- Department of Computer Science and Engineering, University of Bologna, Bologna, Italy
| | - Franca Stablum
- Department of General Psychology, University of Padova, Padova, Italy
- Human Inspired Technology Research Centre, University of Padova, Padova, Italy
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Daniels K, Bonnechère B. Harnessing digital health interventions to bridge the gap in prevention for older adults. Front Public Health 2024; 11:1281923. [PMID: 38259780 PMCID: PMC10800474 DOI: 10.3389/fpubh.2023.1281923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Affiliation(s)
- Kim Daniels
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Center, Hasselt University, Diepenbeek, Belgium
| | - Bruno Bonnechère
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Center, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, Diepenbeek, Belgium
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Asada T, Tanaka M, Araki W, Jon Lebowitz A, Kakuma T. Efficacy and Concurrent Validity of Computerized Brain Training Based on Everyday Living (BTEL) Based on Instrumental Activities of Living for Cognitively Healthy Old Individuals: A Preliminary Study. J Alzheimers Dis 2024; 99:549-558. [PMID: 38701140 DOI: 10.3233/jad-231165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Interventions to prevent or attenuate cognitive decline and dementia in older adults are becoming increasingly important. Recently, cognitive training exercise can be via computer or mobile technology for independent or home use. Recent meta-analysis has reported that Computerized Cognitive Training (CCT) is effective at enhancing cognitive function in healthy older and Alzheimer's disease adults, although little is known about individual characteristics of each computerized program. Objective We developed a new CCT named Brain Training Based on Everyday Living (BTEL) to enhance cognitive capacity for Instrumental Activities of Daily Living (IADL). We aim to evaluate the efficacy of the BTEL among cognitively healthy old individuals and to explore its concurrent validity and construct concept. Methods We conducted a double-blind study where 106 individuals aged 65 years and older (intervened = 53, control = 53) worked on the active and placebo tasks three times a week over three months (clinical trial: UMIN000048730). The main results were examined using ANCOVA and calculating correlation coefficients. Results We found no effect on total score of the three tests; however, there was significant effect for the BTEL on: recognition in MMSE, and immediate recall in HDSR. The tasks are associated with prefrontal cortex. In addition, correlations indicated that each BTEL domain had some validity as a cognitive assessment tool. Different from previous CCT, we determined the neuropsychological characteristics of specific cognitive tasks of the BTEL to a certain degree. Conclusions We found modest efficacy of the BTEL in cognitively healthy old individuals and confirmed its concurrent validity and the conceptual construct.
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Affiliation(s)
- Takashi Asada
- Memory Clinic Ochanomizu, Tokyo, Japan
- Tokyo Medical and Dental University, Tokyo, Japan
| | - Mieko Tanaka
- Brain Functions Laboratory, Inc., Yokohama, Japan
| | | | - Adam Jon Lebowitz
- Department of General Education, Jichi Medical University, Tochigi, Japan
| | - Tatsuyuki Kakuma
- Biostatistics Center, Kurume University School of Medicine, Fukuoka, Japan
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Park J, Wiese LAK, Holt J. Online Chair Yoga and Digital Learning for Rural Underserved Older Adults at Risk for Alzheimer's Disease and Related Dementias. Clin Gerontol 2023:1-17. [PMID: 37941382 DOI: 10.1080/07317115.2023.2277333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVES We evaluated the feasibility and preliminary efficacy of a home-based online chair yoga (OCY) program for racially and ethnically diverse rural community-dwelling older adults. METHODS We randomly assigned participants to OCY or a computer brain game (CBG). After a computer literacy training led by high school students, participants engaged in remotely supervised OCY or CBG in twice-weekly 45-minute sessions for 12 weeks. Outcome data (pain interference, cognitive function, mobility, computer skills) were collected at baseline, post-intervention, and 3-month follow-up. RESULTS A total of 32 eligible residents with mean age of 71 years participated in this intervention study. The interventions were feasible (100% recruitment rate, 96.8% retention rate, 100% safety rate). There were significant improvements in pain interference, cognitive function, mobility, and computer skills from baseline to follow-up among participants in both OCY and CBG but no significant differences in outcomes between groups. CONCLUSIONS Preliminary results indicated that the CBG was as effective as online OCY in clinical outcomes in these participants. However, this should be confirmed in future studies. CLINICAL IMPLICATIONS This telehealth-based intervention is feasible for older adults in rural and digitally underserved communities and could provide a strategy for delivering health-promoting interventions for home-bound older adults at risk for Alzheimer's disease and related dementias (ADRD) and connect caregivers to online resources.
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Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Lisa Ann Kirk Wiese
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Janet Holt
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
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Liang C, Subramaniam P, Mohd Ridzwan Goh NS, Kok Wai T, Moustafa AA. Digital Device Use, Risk of Cognitive Impairment, and Cognition in Healthy Older Adults: The Role of Cognitive Reserve. Healthcare (Basel) 2023; 11:2822. [PMID: 37957967 PMCID: PMC10649017 DOI: 10.3390/healthcare11212822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/15/2023] [Accepted: 09/01/2023] [Indexed: 11/15/2023] Open
Abstract
Neuroprotective factors are essential to successful ageing. As such, digital device use was proposed as an easily accessible and stimulating available cognitive activity to enhance brain function. Nonetheless, there was a lack of studies inspecting the connection between digital device use and cognitive reserve, the risk of cognitive impairment, and cognition. This study aims to investigate the potential mediator and moderator of the association between digital device use, cognitive reserve, the risk of cognitive impairment, and cognition among healthy older adults. A quantitative cross-sectional study was conducted to investigate the relationship between digital device use and cognitive reserve, the risk of cognitive impairment, and cognition. A total of 210 healthy older adults were recruited through purposive sampling. The results obtained from this study revealed that there was a significant difference in cognitive reserve and cognition between healthy older adults who use a digital device for communication purpose only and who use a digital device for multiple purposes. A significant relationship was also found between cognitive reserve, the risk of cognitive impairment, and cognition. Although digital device use was found to be significantly associated with cognitive reserve and cognition, it was not significantly associated with the risk of cognitive impairment. Cognitive reserve partially mediated the relationship between digital device use and cognition, supporting the notion that cognitive reserve acts as an underlying mechanism in the relationship between digital device use and cognition. Hence, digital device use was suggested to be a good daily intervention for healthy older adults to build on their cognitive reserve and potentially protect their cognition from declining. Nevertheless, relying on digital device use alone is not sufficient, and other activities should be explored to enhance cognitive reserve among healthy older adults.
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Affiliation(s)
- Carolyn Liang
- Clinical Psychology Programme, Centre of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (C.L.); (N.S.M.R.G.)
| | - Ponnusamy Subramaniam
- Clinical Psychology Programme, Centre of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (C.L.); (N.S.M.R.G.)
- Centre for Health Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nurul Syasya Mohd Ridzwan Goh
- Clinical Psychology Programme, Centre of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia; (C.L.); (N.S.M.R.G.)
- Centre for Health Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Tay Kok Wai
- Centre for Health Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jln Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Department of Psychology and Counseling, Faculty of Arts and Social Science, Tunku Abdul Rahman University, Kampar 31900, Perak, Malaysia
| | - Ahmed A. Moustafa
- Center for Data Analytics, School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, QLD 4226, Australia;
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Smith ET, Basak C. A game-factors approach to cognitive benefits from video-game training: A meta-analysis. PLoS One 2023; 18:e0285925. [PMID: 37531408 PMCID: PMC10395941 DOI: 10.1371/journal.pone.0285925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/04/2023] [Indexed: 08/04/2023] Open
Abstract
This current study is a meta-analysis conducted on 63 studies on video-game based cognitive interventions (118 investigations, N = 2,079), which demonstrated a moderate and significant training effect on overall gains in cognition, g = 0.25, p < .001. Significant evidence of transfer was found to overall cognition, as well as to attention/perception and higher-order cognition constructs. Examination of specific gameplay features however showed selective and differential transfer to these outcome measures, whereas the genre labels of "action", "strategy", "casual", and "non-casual" were not similarly predictive of outcomes. We therefore recommend that future video-game interventions targeting cognitive enhancements should consider gameplay feature classification approach over existing genre classification, which may provide more fruitful training-related benefits to cognition.
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Affiliation(s)
- Evan T. Smith
- Center for Vital Longevity, University of Texas at Dallas, Dallas, Texas, United States of America
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, United States of America
| | - Chandramallika Basak
- Center for Vital Longevity, University of Texas at Dallas, Dallas, Texas, United States of America
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, United States of America
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Abd-Alrazaq A, Abuelezz I, Al-Jafar E, Denecke K, Househ M, Aziz S, Ahmed A, Aljaafreh A, AlSaad R, Sheikh J. The performance of serious games for enhancing attention in cognitively impaired older adults. NPJ Digit Med 2023; 6:122. [PMID: 37422507 PMCID: PMC10329640 DOI: 10.1038/s41746-023-00863-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 06/15/2023] [Indexed: 07/10/2023] Open
Abstract
Attention, which is the process of noticing the surrounding environment and processing information, is one of the cognitive functions that deteriorate gradually as people grow older. Games that are used for other than entertainment, such as improving attention, are often referred to as serious games. This study examined the effectiveness of serious games on attention among elderly individuals suffering from cognitive impairment. A systematic review and meta-analyses of randomized controlled trials were carried out. A total of 10 trials ultimately met all eligibility criteria of the 559 records retrieved. The synthesis of very low-quality evidence from three trials, as analyzed in a meta-study, indicated that serious games outperform no/passive interventions in enhancing attention in cognitively impaired older adults (P < 0.001). Additionally, findings from two other studies demonstrated that serious games are more effective than traditional cognitive training in boosting attention among cognitively impaired older adults. One study also concluded that serious games are better than traditional exercises in enhancing attention. Serious games can enhance attention in cognitively impaired older adults. However, given the low quality of the evidence, the limited number of participants in most studies, the absence of some comparative studies, and the dearth of studies included in the meta-analyses, the results remain inconclusive. Thus, until the aforementioned limitations are rectified in future research, serious games should serve as a supplement, rather than a replacement, to current interventions.
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Israa Abuelezz
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | | | - Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Science, Bern, Switzerland
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ali Aljaafreh
- Department of Management Information Systems, School of Business, Mutah University, Karak, Jordan
| | - Rawan AlSaad
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Javaid Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Kukkohovi S, Siira H, Arolaakso S, Miettunen J, Elo S. The effectiveness of digital gaming on the functioning and activity of older people living in long-term care facilities: a systematic review and meta-analysis. Aging Clin Exp Res 2023:10.1007/s40520-023-02459-y. [PMID: 37338731 PMCID: PMC10363061 DOI: 10.1007/s40520-023-02459-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023]
Abstract
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.
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Affiliation(s)
- Saara Kukkohovi
- GeroNursing Centre, Research Unit of Health Science and Technology, University of Oulu, Oulu, Finland.
| | - Heidi Siira
- GeroNursing Centre, Research Unit of Health Science and Technology, University of Oulu, Oulu, Finland
| | | | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Satu Elo
- Oulu University of Applied Sciences, Oulu, Finland
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Ishibashi GA, Santos GD, Moreira APB, Verga CER, Silva GAD, Ordonez TN, Moraes LCD, Lessa PP, Brucki SMD, Silva TBLD. Effects of cognitive interventions with video games on cognition in healthy elderly people: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:484-491. [PMID: 37257469 DOI: 10.1055/s-0043-1764413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Currently, studies using video games as an intervention to improve cognitive functions in the elderly are on the rise. OBJECTIVE To investigate and evaluate the effects of cognitive interventions using video games on cognition in healthy elderly people published in the last ten years. METHODS A systematic review involving a qualitative analysis carried out between July and September 2021on the SciELO, LILACS and MEDLINE databases.. RESULTS A total of 262 articles were identified in the initial search. After exclusion of duplicates, analysis of titles/abstracts and of the full text, a final total of 9 studies were included in the review. The objectives of the studies included investigating the effects on cognition of cognitive training (CT) programs using video games compared to programs using entertainment games or to low-intensity CT games. Despite the growing number of studies, many of them were focused on cognitive rehabilitation in elderly people with some degree of cognitive impairment, and few involved training among healthy elderly people. CONCLUSION According to the studies analyzed, the interventions involving CT with video games promoted significant improvements in processing speed and working memory, but no improvements in executive functions.
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Affiliation(s)
- Graciela Akina Ishibashi
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Instituto Supera de Educação, São José dos Campos SP, Brazil
| | - Gabriela Dos Santos
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Ana Paula Bagli Moreira
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Cássia Elisa Rossetto Verga
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Guilherme Alves da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Tiago Nascimento Ordonez
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Luiz Carlos de Moraes
- Instituto Supera de Educação, São José dos Campos SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Patrícia Prata Lessa
- Instituto Supera de Educação, São José dos Campos SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
| | - Thais Bento Lima da Silva
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil
- Universidade de São Paulo, Escola de Artes Ciências e Humanidades, Grupo de Estudos de Treinamento Cognitivo, São Paulo SP, Brazil
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brazil
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13
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Bonnechère B, Klass M. Cognitive Computerized Training for Older Adults and Patients with Neurological Disorders: Do the Amount and Training Modality Count? An Umbrella Meta-Regression Analysis. Games Health J 2023; 12:100-117. [PMID: 36920851 DOI: 10.1089/g4h.2022.0120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Numerous applications have been created to train cognition and challenge the brain, a process known as computerized cognitive training (CCT). Despite potential positive results, important questions remain unresolved: the appropriate training duration, the efficacy of CCT depending on its type (commercial or developed in-house for the rehabilitation of specific patients) and delivery mode (at-home or on-site), and the patients most likely to benefit such intervention. This study aims to perform an umbrella meta-analysis and meta-regression to determine if the type of CCT, the delivery mode, the amount of training, and participants' age at inclusion influence the improvement of the cognitive function. To do so, we performed a umbrella meta-analysis. One hundred studies were included in this analysis representing 6407 participants. Statistical improvements were found for the different conditions after the training. We do not find statistical difference between the type of intervention or the delivery mode. No dose-response relationship between the total amount of training and the improvement of cognitive functions was found. CCT is effective in improving cognitive function in patients suffering from neurological conditions and in healthy aging. There is therefore an urgent need for health care systems to recognize its therapeutic potential and to evaluate at a larger scale their integration into the clinical pipeline as preventive and rehabilitation tool.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.,Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
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14
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Ha JY, Park HJ. Effects of mobile-based cognitive interventions for the cognitive function in the community-dwelling older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 104:104829. [PMID: 36215779 DOI: 10.1016/j.archger.2022.104829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/24/2022] [Accepted: 09/30/2022] [Indexed: 02/07/2023]
Abstract
Cognitive interventions that can be operated using mobile gadgets could facilitate the maintenance and improvement in the cognitive function of the community-dwelling elderly. The aims of this study was to estimate influences for mobile-based cognitive interventions in the community-dwelling elderly. A systematic literature search were conducted using various databases such as the Cochrane Library, PubMed, the Excerpta Medica Database, and Cumulative Index to Nursing and Allied Health Literature. Published articles up to August 2021 were searched without period limit. Integrated and analyzed RCTs' results that identified the effects of mobile-based cognitive interventions on the cognitive function of community-dwelling older adults with normal cognitive function. A meta-analysis was performed by RevMan 5.3 version. The methodological quality was assessed by the Cochrane Collaboration risk of bias tool. Registered with PROSPERO, the registration number is CRD42021268788. Overall, 6 randomized controlled trials identified from 400 articles were included in meta-analysis. The mobile-based cognitive interventions were found to have a significant effect on the short-term memory [standardized mean difference(SMD)= 0.22; 95% confidence interval (CI)=0.13,0.32; p<.001; I²=0%], working memory (SMD=0.70; 95% CI=0.02,1.37; p=.040; I²=81%), reasoning (SMD=0.27; 95% CI=0.11,0.42; p<.001; I²=25%), and executive function (SMD=0.62; 95% CI=0.09,1.16; p=.020; I²=0%). Finally, Egger's regression test and a funnel plot were conducted to examine publication bias; however, there was no significant bias. The mobile-based cognitive interventions had significantly affirmative effect on the older adults' executive function, reasoning, short-term memory, and working memory. Such programs may be employed as a supportive or an alternative method for improving their cognitive functions.
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Affiliation(s)
- Ju-Young Ha
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, South Korea
| | - Hyo-Jin Park
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, South Korea.
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15
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Wu Y, Zang M, Wang B, Guo W. Does the combination of exercise and cognitive training improve working memory in older adults? A systematic review and meta-analysis. PeerJ 2023; 11:e15108. [PMID: 37065695 PMCID: PMC10100799 DOI: 10.7717/peerj.15108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/01/2023] [Indexed: 04/18/2023] Open
Abstract
Background Cognitive functioning is dependent on working memory and a decline in working memory is the main cause of cognitive aging. Many studies have suggested that physical exercise or cognitive intervention can effectively improve working memory in the elderly. However, it is still unknown whether a combination of exercise and cognitive training (CECT) is more effective than either intervention alone. The present systematic review and meta-analysis were undertaken to evaluate the effect of CECT on working memory in the elderly. Methods The review was registered in the International Prospective Systematic Review (PROSPERO, CRD42021290138). Systematic searches were conducted on Web of Science, Elsevier Science, PubMed and Google Scholar. The data were extracted according to the PICOS framework. Comprehensive meta-analysis (CMA) software was used to perform the meta-analysis, moderator analysis and publication bias testing. Results The current meta-analysis included 21 randomized controlled trials (RCT). Results showed that CECT had a significantly greater impact on working memory in older adults compared to no intervention groups (SMD = 0.29, 95% CI [0.14-0.44], p < 0.01), with no significant difference between CECT and exercise (SMD = 0.16, 95% CI [-0.04-0.35], p = 0.12) or cognitive intervention alone (SMD = 0.08, 95% CI [-0.13-0.30], p = 0.44). Furthermore, the positive effect of CECT was moderated by intervention frequency and cognitive state. Conclusions The CECT can effectively improve working memory of older adults, but the effect of CECT compared to single intervention needs to be further explored.
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Affiliation(s)
- Yiqing Wu
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Ming Zang
- College of Electrical Engineering, Chuzhou Polytechnic, Chuzhou, China
| | - Biye Wang
- College of Physical Education, Yangzhou University, Yangzhou, China
- Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, China
| | - Wei Guo
- College of Physical Education, Yangzhou University, Yangzhou, China
- Institute of Sports, Exercise and Brain, Yangzhou University, Yangzhou, China
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16
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A systematic review and meta-analysis of randomized controlled trials on the effect of serious games on people with dementia. Ageing Res Rev 2022; 82:101740. [PMID: 36191740 DOI: 10.1016/j.arr.2022.101740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/27/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND An increase in dementia prevalence has been accompanied by increasing interest in new rehabilitation methods, such as serious games. Serious games hold the potential to postpone functional and cognitive declines in people with dementia by increasing their independence and engagement; however, the efficacy of serious games remains underexplored. This review was conducted to quantify the effects of serious games in people with dementia, including several newly published trials, with the hopes of contributing to evidence-based practice by offering support for clinical decision-making. METHODS Only randomized controlled trials (RCTs) assessing the impacts of game-based intervention programs compared with conventional therapy on cognitive function, instrumental and non-instrumental activities of daily living, or depression among people with dementia were included in this review. Meta-analyses were performed to determine the pooled standardized mean difference (SMD) of each outcome using a random-effects model. RESULTS The final search identified 12 studies that met our criteria. Overall, serious games were found to improve cognitive function (pooled SMD: 0.34; 95% CI: 0.07-0.61) and alleviated depression (pooled SMD: -0.131; 95% CI: -1.85 to -0.77) in people with dementia. CONCLUSIONS Serious games improve cognitive function and reduce depression in people with dementia. Future studies in this field should aim to evaluate and determine the long-term effect of these games.
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17
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Abd-alrazaq A, Abuelezz I, Alsaad R, Al-jafar E, Ahmed A, Aziz S, Nashwan A, Sheikh J. Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis (Preprint).. [DOI: 10.2196/preprints.43607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis.
OBJECTIVE
This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment.
METHODS
Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate.
RESULTS
Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (<i>P</i>=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (<i>P</i>=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (<i>P</i>=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; <i>P</i>=.03) and conventional cognitive training (2/11, 18%; <i>P</i><.001) in enhancing nonverbal learning.
CONCLUSIONS
Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods.
CLINICALTRIAL
PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa
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18
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Schaefer SY, Hooyman A, Haikalis NK, Essikpe R, Lohse KR, Duff K, Wang P. Efficacy of Corsi Block Tapping Task training for improving visuospatial skills: a non-randomized two-group study. Exp Brain Res 2022; 240:3023-3032. [PMID: 36227343 PMCID: PMC9558013 DOI: 10.1007/s00221-022-06478-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022]
Abstract
Even though impaired visuospatial abilities can negatively affect daily functioning, there are very few training programs that attempt to improve visuospatial abilities. The purpose of this study was to examine if a single training session with a computerized version of the Corsi Block Tapping Task could improve mental rotation skills. Fifty-three young adults were assigned to one of two groups: (1) control group (mean age = 21.4; 10 females), who had 20 min of rest after their baseline assessment, or (2) training group (mean age = 21.5; 17 females), who had 20 min of training on the Corsi Block Tapping Task after their baseline assessment. The primary outcome was reaction time on a computer-based mental rotation task, and it was assessed both before and after the rest or training. There was a significant interaction between time (pre vs. post) and group (control vs. training) on mental rotation performance (p = 0.04), with the training group performing on average 124 ms faster on accurate trials than the control group at post-test. This preliminary study suggested that improving mental rotation may be feasible through targeted cognitive training. Future studies will consider multiple sessions of Corsi Block Tapping Task training to maximize training benefits (i.e., dose-response), as well as longer term retention in cognitively intact and impaired individuals.
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Affiliation(s)
- Sydney Y Schaefer
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA.
| | - Andrew Hooyman
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Nicole K Haikalis
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Randy Essikpe
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
| | - Keith R Lohse
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | - Kevin Duff
- Center for Alzheimer's Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
| | - Peiyuan Wang
- School of Biological and Health Systems Engineering, Arizona State University, 501 E. Tyler Mall, MC 9709, Tempe, AZ, 85287-9709, USA
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19
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Leung C, Wong KC, So WWY, Tse ZCK, Li D, Cao Y, Shum DHK. The application of technology to improve cognition in older adults: A review and suggestions for future directions. Psych J 2022; 11:583-599. [PMID: 35675967 PMCID: PMC9543085 DOI: 10.1002/pchj.565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 02/01/2023]
Abstract
The rapidly increasing worldwide population of older adults, along with the increasing prevalence of cognitive impairment and dementia in this population, is a growing health‐care problem. As such, advances in technology‐based cognitive interventions and games are playing an increasingly key role in preserving and improving older adults' cognitive function, especially during the COVID‐19 pandemic when opportunities for face‐to‐face activities or training are few. In this paper, we summarize from previous studies systematic reviews and meta‐analyses on the various types of technology used in cognitive interventions (namely, computerized cognitive training, virtual‐reality interventions and robot‐assisted interventions) and the empirical evidence on the effects of these technologies on global and specific cognitive functions in healthy and clinical populations of older adults (e.g., older adults with mild cognitive impairment or dementia). We also describe older adults' perceptions, experiences and acceptance of these technologies. Finally, we discuss the limitations, challenges and future avenues of research in this field.
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Affiliation(s)
- Carole Leung
- Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Kai Chun Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Winnie W Y So
- Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Zita C K Tse
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Duo Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Yuan Cao
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - David H K Shum
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.,Mental Health Research Centre, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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20
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White BK, Martin A, White J. Gamification and older adults: Opportunities for gamification to support health promotion initiatives for older adults in the context of COVID-19. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022:100528. [PMID: 35815240 PMCID: PMC9257427 DOI: 10.1016/j.lanwpc.2022.100528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has increased reliance on digital service delivery, including the delivery of health promotion initiatives. Health promotion interventions need to carefully consider user engagement. Gamification is a strategy used to engage and motivate people, and evidence shows overall cautious positive results in the use of gamification for older people across a range of health areas although more evidence is needed. Gamification has been used as a strategy in COVID-19 related initiatives and there is potential to build on the evidence to further develop gamification initiatives for those living in the Western Pacific region to impact positively on healthy behaviours and health outcomes.
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Affiliation(s)
- Becky K White
- Reach Health Promotion Innovations, Perth, Western Australia
- Curtin University, Perth, Western Australia
| | - Annegret Martin
- Reach Health Promotion Innovations, Perth, Western Australia
| | - James White
- Reach Health Promotion Innovations, Perth, Western Australia
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21
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Makmee P, Wongupparaj P. Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults. INTERVENCION PSICOSOCIAL 2022; 31:133-144. [PMID: 37361011 PMCID: PMC10268555 DOI: 10.5093/pi2022a10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 06/28/2023]
Abstract
With the rapid growth of the older population globally, it is anticipated that age-related cognitive decline in the prodromal phase and more severe pathological decline will increase. Moreover, currently, no effective treatment options for the disease exist. Thus, early and timely prevention actions are promising and prior strategies to preserve cognitive functions by preventing symptomatology from increasing the age-related deterioration of the functions in healthy older adults. This study aims to develop the virtual reality-based cognitive intervention for enhancing executive functions (EFs) and examine the EFs after training with the virtual reality-based cognitive intervention in community-dwelling older adults. Following inclusion/exclusion criteria, 60 community-dwelling older adults aged 60-69 years were involved in the study and randomly divided into passive control and experimental groups. Eight 60 min virtual reality-based cognitive intervention sessions were held twice a week and lasted for 1 month. The EFs (i.e., inhibition, updating, and shifting) of the participants were assessed by using standardized computerized tasks, i.e., Go/NoGo, forward and backward digit span, and Berg's card sorting tasks. Additionally, a repeated-measure ANCOVA and effect sizes were applied to investigate the effects of the developed intervention. The virtual reality-based intervention significantly improved the EFs of older adults in the experimental group. Specifically, the magnitudes of enhancement were observed for inhibitory as indexed by the response time, F(1) = 6.95, p < .05, ηp2 = .11, updating as represented by the memory span, F(1) = 12.09, p < .01, ηp2 = .18, and the response time, F(1) = 4.46, p = .04, ηp2 = .07, and shifting abilities as indexed by the percentage of correct responses, F(1) = 5.30, p = .03, ηp2 = .09, respectively. The results indicated that the simultaneous combined cognitive-motor control as embedded in the virtual-based intervention is safe and effective in enhancing EFs in older adults without cognitive impairment. Nevertheless, further studies are required to investigate the benefits of these enhancements to motor functions and emotional aspects relating to daily living and the well-being of older populations in communities.
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Affiliation(s)
- Pattrawadee Makmee
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
| | - Peera Wongupparaj
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
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22
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The Impact of COVID-19 Infection on Cognitive Function and the Implication for Rehabilitation: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137748. [PMID: 35805406 PMCID: PMC9266128 DOI: 10.3390/ijerph19137748] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/20/2022] [Accepted: 06/23/2022] [Indexed: 12/11/2022]
Abstract
There is mounting evidence that patients with severe COVID-19 disease may have symptoms that continue beyond the acute phase, extending into the early chronic phase. This prolonged COVID-19 pathology is often referred to as ‘Long COVID’. Simultaneously, case investigations have shown that COVID-19 individuals might have a variety of neurological problems. The accurate and accessible assessment of cognitive function in patients post-COVID-19 infection is thus of increasingly high importance for both public and individual health. Little is known about the influence of COVID-19 on the general cognitive levels but more importantly, at sub-functions level. Therefore, we first aim to summarize the current level of evidence supporting the negative impact of COVID-19 infection on cognitive functions. Twenty-seven studies were included in the systematic review representing a total of 94,103 participants (90,317 COVID-19 patients and 3786 healthy controls). We then performed a meta-analysis summarizing the results of five studies (959 participants, 513 patients) to quantify the impact of COVID-19 on cognitive functions. The overall effect, expressed in standardized mean differences, is −0.41 [95%CI −0.55; −0.27]. To prevent disability, we finally discuss the different approaches available in rehabilitation to help these patients and avoid long-term complications.
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23
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Esmaeilzadeh S, Kumpulainen S, Pesola AJ. Strength-Cognitive Training: A Systemic Review in Adults and Older Adults, and Guidelines to Promote "Strength Exergaming" Innovations. Front Psychol 2022; 13:855703. [PMID: 35712202 PMCID: PMC9197110 DOI: 10.3389/fpsyg.2022.855703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Despite functional and cognitive benefits, few adults and older adults do strength training twice per week with sufficient intensity. Exercise-based active video games (exergaming) may amplify the cognitive benefits of exercise and increase adherence and motivation toward training. However, the benefits of a well-defined and monitored dose of strength training, executed simultaneously or sequentially with a cognitive element, has received little attention. In this study we have two aims: First, to systematically gather the available evidence; second, to suggest possible ways to promote strength exergaming innovations. Methods We systematically reviewed randomized controlled trials using simultaneous or sequent combined strength and cognitive training or strength exergaming to improve cognitive or functional outcomes in adults and older adults. Results After screening 1,785 studies (Google Scholar, ACM Digital Library, IEEE Xplore Library, PsycARTICLES, Scopus, Cochrane Library and PubMed) we found three eligible studies. Of the two studies using sequent strength and cognitive training, one showed improved functionality, but the other showed negative effects on cognition. The third study using simultaneous intervention, reported a positive influence on both cognition and function, when compared with either strength training alone or a control group. Moderate level of evidence was showed on GRADE analysis. Conclusion The existing little evidence suggests that strength and cognitive training improves cognition and function in adults and older adults. The following suggestions may help to promote further innovation: (1) ensure minimal dosage of strength training (30-60 min, 2 × /week), (2) use machine-based strength training devices to control volume and intensity (to prevent cognitive components from interfering with strength training), (3) include power training by using cognitive tasks requiring rapid reactions, and (4) add cognitive memory tasks (to extend the cognitive benefits of strength training per se), and (5) include motivational exergame elements to increase adherence.
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Affiliation(s)
- Samad Esmaeilzadeh
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Susanne Kumpulainen
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Arto J Pesola
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
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24
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Li W, Yue L, Xiao S. Association Between Internet Use, Cognitive Function, and Globus Pallidus Volumes: A Study Among the Elderly in Chinese Communities. Front Public Health 2022; 10:886974. [PMID: 35646776 PMCID: PMC9130581 DOI: 10.3389/fpubh.2022.886974] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 01/15/2023] Open
Abstract
Background Previous studies have linked internet use with several beneficial outcomes for brain health, but there is little data on this among older Chinese. Objective The goal of this study was to explore the association between internet use and cognitive impairment and to explore the possible mechanisms by which internet use prevents cognitive decline. Methods The current study consisted of two cohorts: one from the China Longitudinal Aging Study (CLAS), which included 610 older adults with mild cognitive impairment (MCI), 192 with dementia, and 2,218 healthy older adults; the second cohort included 39 healthy adults from the Shanghai brain health foundation (SHBHF2016001), who underwent T1 cranial magnetic resonance imaging at baseline, from which their volumes of the hippocampus, amygdala, and globus pallidus were calculated. Moreover, they were also followed up for 1 year. Through standardized questionnaires, detailed general demographic information and internet use information was obtained. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline, and their overall cognitive function was assessed by the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results In cohort 1, after controlling age, gender, smoker, tea drinker, take exercise, diabetes, and hypertension, we found that internet use was associated with MCI (P = 0.015, OR = 0.478, 95% CI: 0.264~0.867), but not for dementia (P = 0.205, OR = 0.393, 95% CI: 0.093~1.665). In cohort 2, we found that the globus pallidus volume of internet users was significantly larger than that of non-users, and the MMSE change score was lower (P < 0.05). The results of partial correlation analysis (controlled for sex, age and education) showed that the change of MMSE value was positively correlated with the volume of left globus pallidus (r = 0.547, P = 0.004). Conclusions Internet use might be a protective factor for mild cognitive impairment among the Chinese elderly, and it may prevent a decline in cognitive decline by affecting the volume of the globus pallidus.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Abd-alrazaq A, Abuelezz I, Hassan A, AlSammarraie A, Alhuwail D, Irshaidat S, Abu Serhan H, Ahmed A, Alabed Alrazak S, Househ M. Artificial Intelligence-Driven Serious Games in Healthcare: A Scoping Review (Preprint). JMIR Serious Games 2022; 10:e39840. [DOI: 10.2196/39840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/11/2022] [Accepted: 10/11/2022] [Indexed: 11/07/2022] Open
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Abd-alrazaq A, Abuelezz I, Hassan A, Alsammarraie A, Alhuwail D, Irshaidat S, Abu Serhan H, Ahmed A, Alabed Alrazak S, Househ M. Artificial Intelligence-Driven Serious Games in Healthcare: A Scoping Review (Preprint).. [DOI: 10.2196/preprints.39840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Artificial Intelligence (AI)-driven serious games have been used in healthcare to offer a customizable and immersive experience. Summarizing the features of the current AI-driven serious games is very important to explore how they have been developed and used and their current state in order to plan on how to leverage them in the current and future healthcare needs.
OBJECTIVE
The current study aimed to explore the features of AI-driven serious games in healthcare as reported by previous research.
METHODS
We carried out a scoping review to achieve the above-mentioned objective. The most popular databases in information technology and health fields (e.g., MEDLINE and IEEE Xplore) were searched using keywords related to serious games and AI. These terms were selected based on the target intervention (i.e., AI) and the target disease (i.e., COVID-19). Two reviewers independently performed the study selection process. Three reviewers independently used Microsoft Excel to extract data from the included studies. A narrative approach was used for data synthesis.
RESULTS
The search process returned 1470 records. Of these records, 46 met all eligibility criteria. 60 different serious games were found in the included studies. Motor impairment was the most common health condition targeted by these serious games. Serious games in most of the studies were used for rehabilitation. The serious games in the majority of the included studies can be played by only single player. Most serious games were played on standalone devices (offline games). The most common genres of serious games were role-playing games, puzzle games, and platformer games. Unity was the most prominent game engine used to develop serious games. Personal computers (PCs) were the most common platforms used to play serious games. The most common algorithms used in the included studies were Support Vector Machine (SVM), Convolutional Neural Network (CNN), Artificial Neural Networks (ANN), and Random Forest (RF). The most common purposes of AI were the detection of disease and the evaluation of user's performance. The dataset size ranged from 36 to 795,600, with an average of about 52,124. The most common validation techniques used in the included studies were K-fold cross-validation and training test split validation. Accuracy was the most commonly used metric to evaluate the performance of AI models.
CONCLUSIONS
The last decade witnessed an increase in the development of AI-driven serious games for healthcare purposes and targeting various health conditions and leveraging multiple AI algorithms; this rising trend is expected to continue for years to come. While the evidence uncovered in this study shows promising applications of AI-driven serious games, larger and more rigorous, diverse, and robust studies may be needed to examine the efficacy and effectiveness of AI-driven serious games in different populations with different health conditions.
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Safaei A, Rahmanian M, Oraki M, Zinchenko A. Video Game Play Does Not Improve Spatial Skills When Controlling for Speed-Accuracy Trade-Off: Evidence From Mental-Rotation and Mental-Folding Tasks. Percept Mot Skills 2022; 129:488-512. [PMID: 35395926 DOI: 10.1177/00315125221078982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Researchers have been divided on the efficacy of computerized cognitive training (CCT) for enhancing spatial abilities, transfer of training, and improving malleability of skills. In this study, we assessed the effects of puzzle video game training on subsequent mental rotation (MR) and mental folding (MF) performance among adults with no cognitive impairment. We assessed participants at baseline with the Shepard-Metzler MR test followed by the differential aptitude test: space relations MF test (i.e., far transfer). We ranked participants' skills on these pre-tests and used a matching technique to form two skill groups from which we then randomly assigned members of each skill group either to an experimental group or a wait-list control group. The experimental group played two puzzle video games closely related to two-dimensional and three-dimensional MR tasks during 4-week training sessions (total of 12 hour of video games). Post-training, participants completed the MR and MF tests again. Two months later, we re-assessed only the experimental group's spatial skills to explore the sustainability of the trained performance. In addition to response times (RT) and error scores (ES), reported separately, we combined these variables into rate correct scores (RCS) to form an integrated measure of potential speed-accuracy trade-offs (SAT). As a result, we did not find significant improvements in MR performance from CCT engagement, nor did participants show a transfer of skills obtained by practicing MR-related puzzle games to a MF task. Based on the current findings, we urge caution when proposing a game-based intervention as a training tool to enhance spatial abilities. We argue that separately interpreting individual test measures can be misleading, as they only partially represent performance. In contrast, composite scores illuminate underlying cognitive strategies and best determine whether an observed improvement is attributable to enhanced capacities or individual heuristics and learned cognitive shortcuts.
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Affiliation(s)
- Ali Safaei
- Faculty of Psychology, 125635Payame Noor University, Tehran, Iran
| | | | - Mohammad Oraki
- Faculty of Psychology, 125635Payame Noor University, Tehran, Iran
| | - Artyom Zinchenko
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
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Bonnechère B. [Brain training games: An effective tool in the fight against cognitive decline]. Med Sci (Paris) 2022; 38:294-295. [PMID: 35333167 DOI: 10.1051/medsci/2022015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Bruno Bonnechère
- REVAL rehabilitation research center, Faculty of rehabilitation sciences, Université Hasselt, Agoralaan Gebouw A, 3590 Diepenbeek, Belgique
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Wei J, Hou J, Mu T, Sun J, Li S, Wu H, Su B, Zhang T. Evaluation of Computerized Cognitive Training and Cognitive and Daily Function in Patients Living With HIV: A Meta-analysis. JAMA Netw Open 2022; 5:e220970. [PMID: 35238931 PMCID: PMC8895263 DOI: 10.1001/jamanetworkopen.2022.0970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
IMPORTANCE In the era of antiretroviral therapy (ART), the incidence of HIV-associated neurocognitive disorder (HAND) has not yet been controlled. With the exception of ART, there is no beneficial pharmacologic treatment. However, some studies have reported that computerized cognitive training (CCT) programs may improve cognitive function among people living with HIV. OBJECTIVE To examine the association between CCT programs and 8 domains measuring cognitive function (7 domains) and daily function (1 domain) among people living with HIV. DATA SOURCES Records from the Cochrane Library, PsycINFO, PubMed, and Web of Science were searched from database inception to December 15, 2020. Supplementary searches to identify missing studies were conducted in Google Scholar using updated search terms from database inception to November 18, 2021. STUDY SELECTION Studies that compared changes before and after a CCT intervention among people living with HIV were included. Search terms were a combination of words associated with HIV (eg, people living with HIV, HIV, and/or AIDS) and cognitive training (eg, cognitive intervention, nonpharmacology intervention, computer game, video game, computerized training, cognitive exercise, cognitive stimulation, and/or cognitive enhancement). Studies were included if they (1) used CCT as the primary intervention or combined CCT with other types of interventions; (2) used placebo, passive control conditions, traditional cognitive training, or single training tasks as control conditions; (3) reported changes between baseline and posttraining; (4) included participants 18 years or older; and (5) were randomized clinical trials (RCTs). Studies were excluded if they (1) were not associated with HIV, (2) were research protocols or feedback reports, (3) were case reports, or (4) did not report findings for domains of interest. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Random-effects models were used to quantitatively synthesize the existing data. MAIN OUTCOMES AND MEASURES Primary outcomes were the meta-synthesized changes in each domain after CCT. RESULTS Among 1245 records identified, 1043 were screened after removal of duplicates. Of those, 1019 records were excluded based on titles and abstracts, and 24 full-text articles were assessed for eligibility. After exclusions, 12 eligible RCTs were selected for inclusion in the meta-analysis. These RCTs involved 596 total participants, with 320 individuals in the CCT group (mean age, 47.5-59.7 years; 0%-94% female; 8.3-14.2 years of education) and 276 individuals in the control group (mean age, 44.2-60.0 years; 19%-90% female; 9.0-14.9 years of education). The average HIV inhibition ratio (the proportion of participants who achieved virological suppression) ranged from 30% to 100%, and the CD4+ T-cell count ranged from 471 to 833 cells/μL. The time since training ranged from 3 to 24 weeks. After receipt of CCT, function significantly improved in 6 of the 8 domains: abstraction and executive function (standardized mean difference [SMD], 0.58; 95% CI, 0.26-0.91; P < .001), attention and working memory (SMD, 0.62; 95% CI, 0.33-0.91; P < .001), memory (SMD, 0.59; 95% CI, 0.20-0.97; P = .003), motor skills (SMD, 0.50; 95% CI, 0.24-0.77; P < .001), speed of information processing (SMD, 0.65; 95% CI, 0.37-0.94; P < .001), and daily function (SMD, 0.44; 95% CI, 0.02-0.86; P = .04). Sensory and perceptual skills (SMD, 0.06; 95% CI, -0.36 to 0.48; P = .78) and verbal and language skills (SMD, 0.46; 95% CI, -0.07 to 0.99; P = .09) did not significantly improve after CCT. CONCLUSIONS AND RELEVANCE This meta-analysis of RCTs found that CCT programs were associated with improvements in cognitive and daily function among people living with HIV. Future studies are needed to design optimal specific training programs and use implementation science to enable the transformation of CCT from a scientific research tool to a real-world clinical intervention.
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Affiliation(s)
- Jiaqi Wei
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tingting Mu
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jun Sun
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Shuang Li
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bin Su
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Tong Zhang
- Beijing Key Laboratory for HIV/AIDS Research, Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
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Tapia JL, Puertas FJ, Duñabeitia JA. Study Protocol for a Randomized Controlled Trial Assessing the Effectiveness of Personalized Computerized Cognitive Training for Individuals With Insomnia. Front Behav Neurosci 2022; 16:779990. [PMID: 35296055 PMCID: PMC8919067 DOI: 10.3389/fnbeh.2022.779990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
Insomnia is a frequent and heightened pathology in the general population of developed countries, and its condition generally leads to health discomfort and performance drop in daily and work-related tasks. As current pharmacological treatments for insomnia do not always seem sufficient to mitigate impairment, contemporary cognitive approaches might shed light on developing complementary therapies for this population. We propose a cognitive stimulation intervention program based on the importance of cognitive abilities as precipitating and maintenance variables of sleep disturbances. A full phase I-II-III clinical trial is proposed in which the first two studies will serve to assess the safety of the intervention and to identify the maximum tolerated time of the computerized cognitive training (phase I) and the minimum effective number of training sessions (phase II) in the absence of adverse events or side effects. Next, a phase-III double-blind randomized controlled trial design will be set. Sixty individuals with insomnia aged 25 to 55 years will enroll in a home-based personalized computerized cognitive stimulation program for a total time of 8 weeks, training 5 days per week. Sixty insomnia patients matched in a variety of factors will constitute the active control group, where the orthogonal activities will not be cognitively demanding. Sleep, cognitive, emotional, and quality of life variables will be measured before and immediately after training. A linear mixed model and hierarchical regression analysis will be used to investigate intervention effects. The results derived from this study will be precious for future research and treatment in cognitive performance and clinical pathologies. Clinical Trial Registration: [https://clinicaltrials.gov/], identifier [NCT05050292].
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Affiliation(s)
- Jose Luis Tapia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Antonio de Nebrija, Madrid, Spain
| | - Francisco Javier Puertas
- Unidad Sueño, Hospital Universitario de la Ribera-FISABIO, Valencia, Spain
- Facultad de Medicina, Universidad Católica de Valencia, Valencia, Spain
| | - Jon Andoni Duñabeitia
- Centro de Investigación Nebrija en Cognición (CINC), Universidad Antonio de Nebrija, Madrid, Spain
- AcqVA Aurora Center, The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Jon Andoni Duñabeitia,
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Abd-alrazaq A, Ahmed A, Alali H, Aldardour AM, Househ M. The effectiveness of serious games in improving processing speed among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint).. [DOI: 10.2196/preprints.36754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Cognitive processing speed is known to decline by age. Processing speed refers to the time that an individual takes from receiving a stimulus to reacting to it. Serious games, which are video games employed for training and educational purposes, have the potential in improving processing speed. Numerous systematic reviews have summarized the evidence about the effectiveness of serious games in improving processing speed, but they are undermined by some limitations.
OBJECTIVE
This study aims to pool the evidence about the effectiveness of serious games in improving processing speed among elderly people with cognitive impairment.
METHODS
A systematic review of randomized controlled trials (RCTs) was undertaken. Two search sources were used in this review: 8 electronic databases as well as backward and forward reference list checking. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, and appraised the risk of bias and quality of the evidence. Evidence from the included studies was synthesized using a narrative and statistical approach (i.e., meta-analysis), as appropriate.
RESULTS
Out of 548 publications identified, 16 RCTs eventually met all eligibility criteria. Very low-quality evidence from 8 RCTs and 6 RCTs showed no statistically significant effect of serious games on the processing speed as compared with no or passive interventions groups (P=0.77) and conventional exercises (P=0.58), respectively. A subgroup analysis showed that both types of serious games (cognitive training games (P=0.26) and exergames (P=0.88)) are as effective as conventional exercises in improving processing speed.
CONCLUSIONS
There is no superiority of serious games over no or passive interventions and conventional exercises in improving processing speed among older adults with cognitive impairment. Yet, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Therefore, until more robust evidence is published, serious games should be offered or used as an adjunct to existing interventions. Further trials should be undertaken to investigate the effect of serious games that target specifically processing speed rather than cognitive abilities in general.
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Abd-Alrazaq A, Ahmed A, Alali H, Aldardour AM, Househ M. The effectiveness of serious games on the cognitive processing speed among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint). JMIR Serious Games 2022; 10:e36754. [PMID: 36083623 PMCID: PMC9508673 DOI: 10.2196/36754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/23/2022] [Accepted: 04/07/2022] [Indexed: 12/22/2022] Open
Abstract
Background Human cognitive processing speed is known to decline with age. Human cognitive processing speed refers to the time that an individual takes from receiving a stimulus to reacting to it. Serious games, which are video games used for training and educational purposes, have the potential to improve processing speed. Numerous systematic reviews have summarized the evidence regarding the effectiveness of serious games in improving processing speed, but they are undermined by some limitations. Objective This study aimed to examine the effectiveness of serious games on the cognitive processing speed of an older adult population living with cognitive impairment. Methods A systematic review of randomized controlled trials (RCTs) was conducted. Two search sources were used in this review: 8 electronic databases and backward and forward reference list checking. A total of 2 reviewers independently checked the eligibility of the studies, extracted data from the included studies, and appraised the risk of bias and quality of the evidence. Evidence from the included studies was synthesized using a narrative and statistical approach (ie, meta-analysis), as appropriate. Results Of the 548 publications identified, 16 (2.9%) RCTs eventually met all eligibility criteria. Very-low-quality evidence from 50% (8/16) and 38% (6/16) of the RCTs showed no statistically significant effect of serious games on processing speed compared with no or passive intervention groups (P=.77) and conventional exercises (P=.58), respectively. A subgroup analysis showed that both types of serious games (cognitive training games: P=.26; exergames: P=.88) were as effective as conventional exercises in improving processing speed. Conclusions There is no superiority of serious games over no or passive interventions and conventional exercises in improving processing speed among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of the evidence, the small sample size in most of the included studies, and the paucity of studies included in the meta-analyses. Therefore, until more robust evidence is published, serious games should be offered or used as an adjunct to existing interventions. Further trials should be undertaken to investigate the effect of serious games that specifically target processing speed rather than cognitive abilities in general. Trial Registration PROSPERO CRD42022301667; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=301667
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Haitham Alali
- Health Management Department, Faculty of Medical and Health Sciences, Liwa College of Technology, Abu Dhabi, United Arab Emirates
| | | | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Abd-alrazaq A, Alhuwail D, Ahmed A, Househ M. Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis (Preprint).. [DOI: 10.2196/preprints.36123] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
BACKGROUND
Executive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses.
OBJECTIVE
This study aims to investigate the effectiveness of serious games for improving executive functions among older adults with cognitive impairment.
METHODS
A systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies.
RESULTS
Of 548 publications identified, 16 RCTs were eventually included in this review. Of the 16 studies, 14 studies were included in 6 meta-analyses. Our meta-analyses showed that serious games are as effective as no or passive interventions at improving executive functions (<i>P</i>=.29). Surprisingly, conventional exercises were more effective than serious games at improving executive functions (<i>P</i>=.03). Our subgroup analysis showed that both types of serious games (cognitive training games, <i>P</i>=.08; exergames, <i>P</i>=.16) are as effective as conventional exercises at improving executive functions. No difference was found between adaptive serious games and nonadaptive serious games for improving executive functions (<i>P</i>=.59).
CONCLUSIONS
Serious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by health care providers nor used by patients for improving executive functions among older adults with cognitive impairment. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.
CLINICALTRIAL
PROSPERO CRD42021272757; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272757
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Abd-Alrazaq A, Alhuwail D, Ahmed A, Househ M. The effectiveness of serious games in improving executive functions among older adults with cognitive impairment: A systematic review and meta-analysis (Preprint). JMIR Serious Games 2022; 10:e36123. [PMID: 35877166 PMCID: PMC9361143 DOI: 10.2196/36123] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 12/17/2022] Open
Abstract
Background Executive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses. Objective This study aims to investigate the effectiveness of serious games for improving executive functions among older adults with cognitive impairment. Methods A systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies. Results Of 548 publications identified, 16 RCTs were eventually included in this review. Of the 16 studies, 14 studies were included in 6 meta-analyses. Our meta-analyses showed that serious games are as effective as no or passive interventions at improving executive functions (P=.29). Surprisingly, conventional exercises were more effective than serious games at improving executive functions (P=.03). Our subgroup analysis showed that both types of serious games (cognitive training games, P=.08; exergames, P=.16) are as effective as conventional exercises at improving executive functions. No difference was found between adaptive serious games and nonadaptive serious games for improving executive functions (P=.59). Conclusions Serious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by health care providers nor used by patients for improving executive functions among older adults with cognitive impairment. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment. Trial Registration PROSPERO CRD42021272757; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272757
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, College of Life Sciences, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Gasteiger N, Ahn HS, Gasteiger C, Lee C, Lim J, Fok C, Macdonald BA, Kim GH, Broadbent E. Robot-Delivered Cognitive Stimulation Games for Older Adults. ACM TRANSACTIONS ON HUMAN-ROBOT INTERACTION 2021. [DOI: 10.1145/3451882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Cognitive stimulation games delivered on robots may be able to improve cognitive functioning and delay decline in older adults. However, little is known about older adults’ in-depth opinions of robot-delivered games, as current research primarily focuses on technical development and one-off use. This article explores the usability, acceptability, and perceptions of community-dwelling older adults towards cognitive games delivered on a robot that incorporated movable interactive blocks. Semi-structured interviews were conducted with participants at the end of a 12-week cognitive stimulation games intervention delivered entirely on robots. Participants were 10 older adults purposively sampled from two retirement villages. A framework analysis approach was used to code data to predefined themes related to technology acceptance (perceived benefits, satisfaction, and preference), and usability (effectiveness, efficiency, and satisfaction). Results indicated that cognitive games delivered on a robot may be a valuable addition to existing cognitive stimulation activities. The robot was considered easy to use and useful in improving cognitive functioning. Future developments should incorporate interactive gaming tools, the use of social anthropomorphic robots, contrasting colour schemes to accommodate macular degeneration, and cultural-specific imagery and language. This will help cater to the preferences and age-related health needs of older adults, to ultimately enhance usability and acceptability.
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Affiliation(s)
- Norina Gasteiger
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Ho Seok Ahn
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland, New Zealand
| | - Chiara Gasteiger
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Christopher Lee
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland, New Zealand
| | - Jongyoon Lim
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland, New Zealand
| | - Christine Fok
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Bruce A. Macdonald
- Department of Electrical, Computer and Software Engineering, The University of Auckland, Auckland, New Zealand
| | - Geon Ha Kim
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University, College of Medicine, Seoul, South Korea
| | - Elizabeth Broadbent
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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Manser P, de Bruin ED. Making the Best Out of IT: Design and Development of Exergames for Older Adults With Mild Neurocognitive Disorder - A Methodological Paper. Front Aging Neurosci 2021; 13:734012. [PMID: 34955806 PMCID: PMC8698204 DOI: 10.3389/fnagi.2021.734012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/03/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Utilizing information technology (IT) systems, for example in form of computerized cognitive screening or exergame-based (also called active videogames) training, has gained growing interest for supporting healthy aging and to detect, prevent and treat neurocognitive disorders (NCD). To ameliorate the effectiveness of exergaming, the neurobiological mechanisms as well as the most effective components for exergame-based training remain to be established. At the same time, it is important to account for the end-users' capabilities, preferences, and therapeutic needs during the design and development process to foster the usability and acceptance of the resulting program in clinical practice. This will positively influence adherence to the resulting exergame-based training program, which, in turn, favors more distinct training-related neurobiological effects. Objectives and Methods: This methodological paper describes the design and development process of novel exergame-based training concepts guided by a recently proposed methodological framework: The 'Multidisciplinary Iterative Design of Exergames (MIDE): A Framework for Supporting the Design, Development, and Evaluation of Exergames for Health' (Li et al., 2020). Case Study: A step-by-step application of the MIDE-framework as a specific guidance in an ongoing project aiming to design, develop, and evaluate an exergame-based training concept with the aim to halt and/or reduce cognitive decline and improve quality of life in older adults with mild neurocognitive disorder (mNCD) is illustrated. Discussion and Conclusion: The development of novel exergame-based training concepts is greatly facilitated when it is based on a theoretical framework (e.g., the MIDE-framework). Applying this framework resulted in a structured, iterative, and evidence-based approach that led to the identification of multiple key requirements for the exergame design as well as the training components that otherwise may have been overlooked or neglected. This is expected to foster the usability and acceptance of the resulting exergame intervention in "real life" settings. Therefore, it is strongly recommended to implement a theoretical framework (e.g., the MIDE-framework) for future research projects in line with well-known checklists to improve completeness of reporting and replicability when serious games for motor-cognitive rehabilitation purposes are to be developed.
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Affiliation(s)
- Patrick Manser
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Eling D de Bruin
- Movement Control and Learning - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,OST - Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
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Abd-Alrazaq A, Alhuwail D, Al-Jafar E, Ahmed A, Shuweihdi F, Reagu SM, Househ M. The effectiveness of serious games in improving memory among the elderly with cognitive impairment: A systematic review and meta-analysis (Preprint). JMIR Serious Games 2021; 10:e35202. [PMID: 35943792 PMCID: PMC9399845 DOI: 10.2196/35202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/10/2022] [Accepted: 05/13/2022] [Indexed: 12/17/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Dari Alhuwail
- Information Science Department, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | | | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
| | | | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Abd-alrazaq A, Alhuwail D, Al-jafar E, Ahmed A, Reagu SM, Househ M. The effectiveness of serious games in improving memory among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint).. [DOI: 10.2196/preprints.35202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Memory, one of the main cognitive functions, is known to decline by age. Serious games have been used for improving memory among the elderly. The effectiveness of serious games in improving memory has been investigated by several systematic reviews; however, they are limited by design and methodological weaknesses.
OBJECTIVE
This study aims to assess the effectiveness of serious games in improving memory among the elderly with cognitive impairment.
METHODS
A systematic review of randomized controlled trials (RCTs) was carried out. The search sources included searching 8 databases, screening reference lists of the included studies and relevant reviews, and checking studies that cited the included studies. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence appraisal. Extracted data were synthesized using a narrative approach and a statistical approach (i.e., meta-analysis), as appropriate.
RESULTS
Out of 466 citations retrieved, 18 studies met the eligibility criteria of this review. Of those, 15 RCTs were eventually included in 10 meta-analyses. We found that serious games are more effective than no or passive interventions in improving non-verbal memory (P=0.002) and working memory (P=0.02), but not verbal memory (P=0.13). The review also showed that serious games are more effective than conventional exercises in improving verbal memory (P=0.004), but not for non-verbal memory (P=0.12) and working memory (P=0.49). Serious games were as effective as conventional cognitive activities in improving verbal memory (P=0.07), non-verbal memory (P=0.94), and working memory (P=0.08) among the elderly with cognitive impairment. Lastly, the effect of adaptive serious games on working memory was comparable to non-adaptive serious games (P=0.08).
CONCLUSIONS
Serious games have the potential to improve verbal, non-verbal, and working memory among elderly people with cognitive impairment. However, our findings should be interpreted cautiously given that most meta-analyses were based on a few studies (≤3) and judged to have a low quality of evidence. Therefore, serious games should be offered as supplemental to existing proven and safe interventions, rather than a complete substitute until further, more robust evidence is available. Future studies should investigate the short and long-term effects of serious games on memory and other cognitive abilities among people from different age groups with or without cognitive impairment.
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Moore AL, Miller TM, Ledbetter C. Remote vs. In-person Delivery of LearningRx One-on-One Cognitive Training During the COVID-19 Pandemic: A Non-inferiority Study. Front Psychol 2021; 12:749898. [PMID: 34777146 PMCID: PMC8586525 DOI: 10.3389/fpsyg.2021.749898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
The COVID-19 pandemic challenged in-person delivery of cognitive training. Some clinics pivoted to remote delivery for those impacted by lockdowns, illness, or fear of exposure to the virus. However, it was unknown if remote delivery using teleconferencing technology was as effective as in-person delivery. The current study compared the outcomes of remote delivery to in-person delivery of ThinkRx cognitive training during 2020. The sample included 381 child and adult clients from 18 cognitive training centers. One group (n = 178, mean age = 12.3) received traditional in-person delivery of cognitive training. The second group (n = 203, mean age = 11.7) received remote delivery of one-on-one cognitive training via Zoom teleconferencing. Each client was assessed before and after the intervention using the Woodcock Johnson IV Tests of Cognitive Abilities. Clients completed an average of 112 h of cognitive training delivered by a clinician in 90-min sessions 3 or 4 days per week. Paired samples t-tests revealed significant differences from pretest to post-test across all constructs for both groups. After Bonferroni correction, MANOVA revealed no significant difference in changes scores between the two intervention groups on any of the subtests. With very small effect sizes, linear regression analyses indicated that age was a significant predictor of change in working memory and processing speed for the in-person group, and a significant predictor of change in overall IQ score for the teletherapy group. Non-inferiority analyses indicated remote delivery is not inferior to in-person delivery on the primary outcome measure of overall IQ score along with processing speed, fluid reasoning, long-term memory, and visual processing. Although in-person training results were slightly higher than remote training results, the current study reveals remote delivery of cognitive training during COVID-19 was a viable alternative to in-person delivery of cognitive training with little practical differences based on the age of client.
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Affiliation(s)
- Amy Lawson Moore
- Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States
| | - Terissa Michele Miller
- Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States
| | - Christina Ledbetter
- Department of Psychology, Gibson Institute of Cognitive Research, Colorado Springs, CO, United States.,Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA, United States
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Ownby RL, Kim J. Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial. Front Aging Neurosci 2021; 13:766311. [PMID: 34867291 PMCID: PMC8634723 DOI: 10.3389/fnagi.2021.766311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
Objective: HIV infection is associated with impaired cognition, and as individuals grow older, they may also experience age-related changes in mental abilities. Previous studies have shown that computer-based cognitive training (CCT) and transcranial direct current stimulation (tDCS) may be useful in improving cognition in older persons. This study evaluated the acceptability of CCT and tDCS to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed. Methods: In a single-blind randomized study, 46 individuals with HIV-associated mild neurocognitive disorder completed neuropsychological assessments and six 20-min training sessions to which they had been randomly assigned to one of the following conditions: (1) CCT with active tDCS; (2) CCT with sham tDCS, or (3) watching educational videos with sham tDCS. Immediately after training and again 1 month later, participants completed follow-up assessments. Outcomes were evaluated via repeated measures mixed effects models. Results: Participant ratings of the intervention were positive. Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention. Conclusion: Both CCT and tDCS were highly acceptable to older persons with HIV infection. CCT and tDCS may improve cognitive in affected individuals. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03440840].
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Affiliation(s)
- Raymond L. Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
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Abd-Alrazaq A, Alajlani M, Alhuwail D, Toro CT, Giannicchi A, Ahmed A, Makhlouf A, Househ M. The effectiveness and safety of serious games in improving cognitive abilities among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint). JMIR Serious Games 2021; 10:e34592. [PMID: 35266877 PMCID: PMC8949701 DOI: 10.2196/34592] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 12/13/2022] Open
Abstract
Background Cognitive impairment is a mental disorder that commonly affects elderly people. Serious games, which are games that have a purpose other than entertainment, have been used as a nonpharmacological intervention for improving cognitive abilities. The effectiveness and safety of serious games for improving cognitive abilities have been investigated by several systematic reviews; however, they are limited by design and methodological weaknesses. Objective This study aims to assess the effectiveness and safety of serious games for improving cognitive abilities among elderly people with cognitive impairment. Methods A systematic review of randomized controlled trials (RCTs) was conducted. The following 8 electronic databases were searched: MEDLINE, Embase, CINAHL, PsycINFO, ACM Digital Library, IEEE Xplore, Scopus, and Google Scholar. We also screened reference lists of the included studies and relevant reviews, as well as checked studies citing our included studies. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence appraisal. We used a narrative and statistical approach, as appropriate, to synthesize the results of the included studies. Results Fifteen studies met the eligibility criteria among 466 citations retrieved. Of those, 14 RCTs were eventually included in the meta-analysis. We found that, regardless of their type, serious games were more effective than no intervention (P=.04) and conventional exercises (P=.002) for improving global cognition among elderly people with cognitive impairment. Further, a subgroup analysis showed that cognitive training games were more effective than no intervention (P=.05) and conventional exercises (P<.001) for improving global cognition among elderly people with cognitive impairment. Another subgroup analysis demonstrated that exergames (a category of serious games that includes physical exercises) are as effective as no intervention and conventional exercises (P=.38) for improving global cognition among elderly people with cognitive impairment. Although some studies found adverse events from using serious games, the number of adverse events (ie, falls and exacerbations of pre-existing arthritis symptoms) was comparable between the serious game and control groups. Conclusions Serious games and specifically cognitive training games have the potential to improve global cognition among elderly people with cognitive impairment. However, our findings remain inconclusive because the quality of evidence in all meta-analyses was very low, mainly due to the risk of bias raised in the majority of the included studies, high heterogeneity of the evidence, and imprecision of total effect sizes. Therefore, psychologists, psychiatrists, and patients should consider offering serious games as a complement and not a substitute to existing interventions until further more robust evidence is available. Further studies are needed to assess the effect of exergames, the safety of serious games, and their long-term effects.
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Affiliation(s)
- Alaa Abd-Alrazaq
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Mohannad Alajlani
- Warwick Manufacturing Group, Institute of Digital Healthcare, University of Warwick, Warwick, United Kingdom
| | - Dari Alhuwail
- Information Science Department, College of Life Sciences, Kuwait University, Kuwait, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait, Kuwait
| | - Carla T Toro
- Warwick Manufacturing Group, Institute of Digital Healthcare, University of Warwick, Warwick, United Kingdom
| | - Anna Giannicchi
- Behavioral Health Services and Policy Research Department, New York State Psychiatric Institute, New York, NY, United States
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ahmed Makhlouf
- Ambulance Service, Hamad Medical Corporation, Doha, Qatar
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
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Abd-alrazaq A, Alajlani M, Alhuwail D, Toro CT, Giannicchi A, Ahmed A, Makhlouf A, Househ M. The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis (Preprint).. [DOI: 10.2196/preprints.34592] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND
Cognitive impairment is a mental disorder that commonly affects elderly people. Serious games, which are games that have a purpose other than entertainment, have been used as a nonpharmacological intervention for improving cognitive abilities. The effectiveness and safety of serious games for improving cognitive abilities have been investigated by several systematic reviews; however, they are limited by design and methodological weaknesses.
OBJECTIVE
This study aims to assess the effectiveness and safety of serious games for improving cognitive abilities among elderly people with cognitive impairment.
METHODS
A systematic review of randomized controlled trials (RCTs) was conducted. The following 8 electronic databases were searched: MEDLINE, Embase, CINAHL, PsycINFO, ACM Digital Library, IEEE Xplore, Scopus, and Google Scholar. We also screened reference lists of the included studies and relevant reviews, as well as checked studies citing our included studies. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence appraisal. We used a narrative and statistical approach, as appropriate, to synthesize the results of the included studies.
RESULTS
Fifteen studies met the eligibility criteria among 466 citations retrieved. Of those, 14 RCTs were eventually included in the meta-analysis. We found that, regardless of their type, serious games were more effective than no intervention (<i>P</i>=.04) and conventional exercises (<i>P</i>=.002) for improving global cognition among elderly people with cognitive impairment. Further, a subgroup analysis showed that cognitive training games were more effective than no intervention (<i>P</i>=.05) and conventional exercises (<i>P</i><.001) for improving global cognition among elderly people with cognitive impairment. Another subgroup analysis demonstrated that exergames (a category of serious games that includes physical exercises) are as effective as no intervention and conventional exercises (<i>P</i>=.38) for improving global cognition among elderly people with cognitive impairment. Although some studies found adverse events from using serious games, the number of adverse events (ie, falls and exacerbations of pre-existing arthritis symptoms) was comparable between the serious game and control groups.
CONCLUSIONS
Serious games and specifically cognitive training games have the potential to improve global cognition among elderly people with cognitive impairment. However, our findings remain inconclusive because the quality of evidence in all meta-analyses was very low, mainly due to the risk of bias raised in the majority of the included studies, high heterogeneity of the evidence, and imprecision of total effect sizes. Therefore, psychologists, psychiatrists, and patients should consider offering serious games as a complement and not a substitute to existing interventions until further more robust evidence is available. Further studies are needed to assess the effect of exergames, the safety of serious games, and their long-term effects.
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Bonnechère B, Rintala A, Spooren A, Lamers I, Feys P. Is mHealth a Useful Tool for Self-Assessment and Rehabilitation of People with Multiple Sclerosis? A Systematic Review. Brain Sci 2021; 11:brainsci11091187. [PMID: 34573208 PMCID: PMC8466296 DOI: 10.3390/brainsci11091187] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/30/2021] [Accepted: 09/02/2021] [Indexed: 12/19/2022] Open
Abstract
The development of mobile technology and mobile Internet offers new possibilities in rehabilitation and clinical assessment in a longitudinal perspective for multiple sclerosis management. However, because the mobile health applications (mHealth) have only been developed recently, the level of evidence supporting the use of mHealth in people with multiple sclerosis (pwMS) is currently unclear. Therefore, this review aims to list and describe the different mHealth available for rehabilitation and self-assessment of pwMS and to define the level of evidence supporting these interventions for functioning problems categorized within the International Classification of Functioning, Disability and Health (ICF). In total, 36 studies, performed with 22 different mHealth, were included in this review, 30 about rehabilitation and six for self-assessment, representing 3091 patients. For rehabilitation, most of the studies were focusing on cognitive function and fatigue. Concerning the efficacy, we found a small but significant effect of the use of mHealth for cognitive training (Standardized Mean Difference (SMD) = 0.28 [0.12; 0.45]) and moderate effect for fatigue (SMD = 0.61 [0.47; 0.76]). mHealth is a promising tool in pwMS but more studies are needed to validate these solutions in the other ICF categories. More replications studies are also needed as most of the mHealth have only been assessed in one single study.
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Affiliation(s)
- Bruno Bonnechère
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- Correspondence:
| | - Aki Rintala
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, FI-15210 Lahti, Finland;
| | - Annemie Spooren
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
| | - Ilse Lamers
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- University MS Center Hasselt-Pelt, B-3500 Hasselt, Belgium
| | - Peter Feys
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium; (A.S.); (I.L.); (P.F.)
- University MS Center Hasselt-Pelt, B-3500 Hasselt, Belgium
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Isernia S, Cabinio M, Di Tella S, Pazzi S, Vannetti F, Gerli F, Mosca IE, Lombardi G, Macchi C, Sorbi S, Baglio F. Diagnostic Validity of the Smart Aging Serious Game: An Innovative Tool for Digital Phenotyping of Mild Neurocognitive Disorder. J Alzheimers Dis 2021; 83:1789-1801. [PMID: 34459394 DOI: 10.3233/jad-210347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Smart Aging Serious Game (SASG) is an ecologically-based digital platform used in mild neurocognitive disorders. Considering the higher risk of developing dementia for mild cognitive impairment (MCI) and vascular cognitive impairment (VCI), their digital phenotyping is crucial. A new understanding of MCI and VCI aided by digital phenotyping with SASG will challenge current differential diagnosis and open the perspective of tailoring more personalized interventions. OBJECTIVE To confirm the validity of SASG in detecting MCI from healthy controls (HC) and to evaluate its diagnostic validity in differentiating between VCI and HC. METHODS 161 subjects (74 HC: 37 males, 75.47±2.66 mean age; 60 MCI: 26 males, 74.20±5.02; 27 VCI: 13 males, 74.22±3.43) underwent a SASG session and a neuropsychological assessment (Montreal Cognitive Assessment (MoCA), Free and Cued Selective Reminding Test, Trail Making Test). A multi-modal statistical approach was used: receiver operating characteristic (ROC) curves comparison, random forest (RF), and logistic regression (LR) analysis. RESULTS SASG well captured the specific cognitive profiles of MCI and VCI, in line with the standard neuropsychological measures. ROC analyses revealed high diagnostic sensitivity and specificity of SASG and MoCA (AUCs > 0.800) in detecting VCI versus HC and MCI versus HC conditions. An acceptable to excellent classification accuracy was found for MCI and VCI (HC versus VCI; RF: 90%, LR: 91%. HC versus MCI; RF: 75%; LR: 87%). CONCLUSION SASG allows the early assessment of cognitive impairment through ecological tasks and potentially in a self-administered way. These features make this platform suitable for being considered a useful digital phenotyping tool, allowing a non-invasive and valid neuropsychological evaluation, with evident implications for future digital-health trails and rehabilitation.
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Affiliation(s)
- Sara Isernia
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | - Monia Cabinio
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy.,Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Stefania Pazzi
- Consorzio di Bioingegneria e Informatica Medica (CBIM), Pavia, Italy
| | | | - Filippo Gerli
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | | | - Gemma Lombardi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy
| | - Sandro Sorbi
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan-Florence, Italy.,Universitá degli Studi di Firenze, NEUROFARBA, Firenze, Italy
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Pallavicini F, Pepe A, Mantovani F. Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review. JMIR Ment Health 2021; 8:e28150. [PMID: 34398795 PMCID: PMC8406113 DOI: 10.2196/28150] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/26/2021] [Accepted: 05/22/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games. OBJECTIVE The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play). METHODS A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")]. RESULTS A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety. CONCLUSIONS Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety. TRIAL REGISTRATION International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.
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Affiliation(s)
- Federica Pallavicini
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education "Riccardo Massa", University of Milano Bicocca, Milano, Italy
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Harrington K, Craven MP, Wilson ML, Landowska A. Using Patient and Public Involvement to Elicit Opinion on Cognitive Training Games and Assessment Technologies for Dementia (Preprint). JMIR Serious Games 2021; 10:e32489. [PMID: 35723912 PMCID: PMC9253969 DOI: 10.2196/32489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/22/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022] Open
Abstract
Background Cognitive training and assessment technologies offer the promise of dementia risk reduction and a more timely diagnosis of dementia, respectively. Cognitive training games may help reduce the lifetime risk of dementia by helping to build cognitive reserve, whereas cognitive assessment technologies offer the opportunity for a more convenient approach to early detection or screening. Objective This study aims to elicit perspectives of potential end users on factors related to the acceptability of cognitive training games and assessment technologies, including their opinions on the meaningfulness of measurement of cognition, barriers to and facilitators of adoption, motivations to use games, and interrelationships with existing health care infrastructure. Methods Four linked workshops were conducted with the same group, each focusing on a specific topic: meaningful improvement, learning and motivation, trust in digital diagnosis, and barriers to technology adoption. Participants in the workshops included local involvement team members acting as facilitators and those recruited via Join Dementia Research through a purposive selection and volunteer sampling method. Group activities were recorded, and transcripts were analyzed using thematic analysis with a combination of a priori and data-driven themes. Using a mixed methods approach, we investigated the relationships between the categories of the Capability, Opportunity, and Motivation–Behavior change model along with data-driven themes by measuring the φ coefficient between coded excerpts and ensuring the reliability of our coding scheme by using independent reviewers and assessing interrater reliability. Finally, we explored these themes and their relationships to address our research objectives. Results In addition to discussions around the capability, motivation, and opportunity categories, several important themes emerged during the workshops: family and friends, cognition and mood, work and hobbies, and technology. Group participants mentioned the importance of functional and objective measures of cognitive change, the social aspect of activities as a motivating factor, and the opportunities and potential shortcomings of digital health care provision. Our quantitative results indicated at least moderate agreement on all but one of the coding schemes and good independence of our coding categories. Positive and statistically significant φ coefficients were observed between several coding themes between categories, including a relatively strong positive φ coefficient between capability and cognition (0.468; P<.001). Conclusions The implications for researchers and technology developers include assessing how cognitive training and screening pathways would integrate into existing health care systems; however, further work needs to be undertaken to address barriers to adoption and the potential real-world impact of cognitive training and screening technologies. International Registered Report Identifier (IRRID) RR2-10.1007/978-3-030-49065-2_4
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Affiliation(s)
- Kyle Harrington
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, Nottingham, United Kingdom
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
| | - Michael P Craven
- NIHR MindTech MedTech Co-operative, Institute of Mental Health, Nottingham, United Kingdom
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, Nottingham, United Kingdom
| | - Max L Wilson
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
- Mixed Reality Lab, School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Aleksandra Landowska
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
- Mixed Reality Lab, School of Computer Science, University of Nottingham, Nottingham, United Kingdom
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Nguyen L, Murphy K, Andrews G. A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychol Rev 2021; 32:601-630. [PMID: 34251578 DOI: 10.1007/s11065-021-09515-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/15/2021] [Indexed: 12/31/2022]
Abstract
The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI). Seven programs were identified: BrainGymmer, BrainHQ, CogMed, CogniFit, Dakim, Lumosity, and MyBrainTrainer. Analyses yielded small, significant near-transfer effects for both healthy and MCI samples. Far-transfer was not observed for the MCI sample, whereas a small, significant effect was found for subjective but not objective measures of far-transfer in the healthy sample. Analyses of individual domains (combining near-and far-transfer outcomes) yielded significant transfer to executive-functioning, memory, and processing-speed in healthy older adults. After adjusting for publication bias, only the effect size for processing speed remained significant. Transfer to attention, objective everyday functioning, fluid-intelligence, and visuospatial domains was not significant. Thus, whilst "brain training" may be suitable for enjoyment and entertainment purposes, there is currently insufficient empirical evidence to support that such training can improve memory, general cognition, or everyday functioning. This area of research is still in its infancy and warrants further investigation to provide more substantial evidence regarding the efficacy of this rapidly expanding industry.
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Affiliation(s)
- Lan Nguyen
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia.
| | - Karen Murphy
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
| | - Glenda Andrews
- School of Applied Psychology, Griffith University, Griffith University, Gold Coast, QLD 4222, Australia
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48
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Bonnechère B, Klass M, Langley C, Sahakian BJ. Brain training using cognitive apps can improve cognitive performance and processing speed in older adults. Sci Rep 2021; 11:12313. [PMID: 34112925 PMCID: PMC8192763 DOI: 10.1038/s41598-021-91867-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
Managing age-related decrease of cognitive function is an important public health challenge, especially in the context of the global aging of the population. Over the last years several Cognitive Mobile Games (CMG) have been developed to train and challenge the brain. However, currently the level of evidence supporting the benefits of using CMG in real-life use is limited in older adults, especially at a late age. In this study we analyzed game scores and the processing speed obtained over the course of 100 sessions in 12,000 subjects aged 60 to over 80 years. Users who trained with the games improved regardless of age in terms of scores and processing speed throughout the 100 sessions, suggesting that old and very old adults can improve their cognitive performance using CMG in real-life use.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium. .,Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK.
| | - Malgorzata Klass
- Laboratory of Applied Biology and Neurophysiology, ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Christelle Langley
- Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Barbara Jacquelyn Sahakian
- Department of Psychiatry and Behavioural and Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0SZ, UK
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49
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Bonnechère B, Sahakian BJ. Can Mobile Technology Help Prevent the Burden of Dementia in Low- and Mid-Income Countries? Front Public Health 2020; 8:554938. [PMID: 33282809 PMCID: PMC7689265 DOI: 10.3389/fpubh.2020.554938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/08/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Bruno Bonnechère
- Department of Psychiatry and Behavioural, Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom.,Public Health School, Université Libre de Bruxelles, Brussels, Belgium
| | - Barbara J Sahakian
- Department of Psychiatry and Behavioural, Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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