After prolonged stay in an intensive care unit (ICU) patients often complain about cognitive impairments that affect health-related quality of life after discharge. The aim of this proof-of-concept study was to test the feasibility and effects of controlled visual and acoustic stimulation in a virtual reality (VR) setup in the ICU. The VR setup consisted of a head-mounted display in combination with an eye tracker and sensors to assess vital signs. The stimulation consisted of videos featuring natural scenes and was tested in 37 healthy participants in the ICU. The VR stimulation led to a reduction of heart rate (p = 0. 049) and blood pressure (p = 0.044). Fixation/saccade ratio (p < 0.001) was increased when a visual target was presented superimposed on the videos (reduced search activity), reflecting enhanced visual processing. Overall, the VR stimulation had a relaxing effect as shown in vital markers of physical stress and participants explored less when attending the target. Our study indicates that VR stimulation in ICU settings is feasible and beneficial for critically ill patients.

Despite growing interest in developing ecological assessment of difficulties in patients with Alzheimer’s disease new methods assessing the cognitive difficulties related to functional activities are missing. To complete current evaluation, the use of Serious Games can be a promising approach as it offers the possibility to recreate a virtual environment with daily living activities and a precise and complete cognitive evaluation. The aim of the present study was to evaluate the usability and the screening potential of a new ecological tool for assessment of cognitive functions in patients with Alzheimer’s disease. Eighteen patients with Alzheimer’s disease and twenty healthy controls participated to the study. They were asked to complete six daily living virtual tasks assessing several cognitive functions: three navigation tasks, one shopping task, one cooking task and one table preparation task following a one-day scenario. Usability of the game was evaluated through a questionnaire and through the analysis of the computer interactions for the two groups. Furthermore, the performances in terms of time to achieve the task and percentage of completion on the several tasks were recorded. Results indicate that both groups subjectively found the game user friendly and they were objectively able to play the game without computer interactions difficulties. Comparison of the performances between the two groups indicated a significant difference in terms of percentage of achievement of the several tasks and in terms of time they needed to achieve the several tasks. This study suggests that this new Serious Game based assessment tool is a user-friendly and ecological method to evaluate the cognitive abilities related to the difficulties patients can encounter in daily living activities and can be used as a screening tool as it allowed to distinguish Alzheimer’s patient’s performance from healthy controls.

BackgroundIn recent computerized cognitive training studies, video games have emerged as a promising tool that can benefit cognitive function and well-being. Whereas most video game training studies have used first-person shooter (FPS) action video games, subsequent studies found that older adults dislike this type of game and generally prefer casual video games (CVGs), which are a subtype of video games that are easy to learn and use simple rules and interfaces. Like other video games, CVGs are organized into genres (eg, puzzle games) based on the rule-directed interaction with the game. Importantly, game genre not only influences the ease of interaction and cognitive abilities CVGs demand, but also affects whether older adults are willing to play any particular genre. To date, studies looking at how different CVG genres resonate with older adults are lacking.ObjectiveThe aim of this study was to investigate how much older adults enjoy different CVG genres and how favorably their CVG characteristics are rated.MethodsA total of 16 healthy adults aged 65 years and above playtested 7 CVGs from 4 genres: casual action, puzzle, simulation, and strategy video games. Thereafter, they rated casual game preference and acceptance of casual game characteristics using 4 scales from the Core Elements of the Gaming Experience Questionnaire (CEGEQ). For this, participants rated how much they liked the game (enjoyment), understood the rules of the game (game-play), learned to manipulate the game (control), and make the game their own (ownership).ResultsOverall, enjoyment and acceptance of casual game characteristics was high and significantly above the midpoint of the rating scale for all CVG genres. Mixed model analyses revealed that ratings of enjoyment and casual game characteristics were significantly influenced by CVG genre. Participants’ mean enjoyment of casual puzzle games (mean 0.95 out of 1.00) was significantly higher than that for casual simulation games (mean 0.75 and 0.73). For casual game characteristics, casual puzzle and simulation games were given significantly higher game-play ratings than casual action games. Similarly, participants’ control ratings for casual puzzle games were significantly higher than that for casual action and simulation games. Finally, ownership was rated significantly higher for casual puzzle and strategy games than for casual action games.ConclusionsThe findings of this study show that CVGs have characteristics that are suitable and enjoyable for older adults. In addition, genre was found to influence enjoyment and ratings of CVG characteristics, indicating that puzzle games are particularly easy to understand, learn, and play, and are enjoyable. Future studies should continue exploring the potential of CVG interventions for older adults in improving cognitive function, everyday functioning, and well-being. We see particular potential for CVGs in people suffering from cognitive impairment due to dementia or brain injury.