Effectiveness of Serious Games for Visuospatial Abilities in Elderly Population with Cognitive Impairment: A Systematic Review and Meta-Analysis

Abd‐Alrazaq, Alaa; Abuelezz, Israa; Hassan, Asma; Khalifa, Mohamed; Ahmed, Arfan; Aldardour, Ahmad; Al-Jafar, Eiman; Alam, Tanvir; Shah, Zubair; Househ, Mowafa

doi:10.3233/shti220673

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…For Google Scholar, only the initial 10 pages, which is equivalent to the first 100 results, were taken into account for this review since it does not provide as powerful search tools as other databases, and it typically retrieves many publications automatically sorted according to their relevance. We limited our search in these databases to studies published from 2010 onward because, first, video games have significantly been developed in the last decade, and, second, previous reviews did not find any study published on similar topics before 2012 12 , 14 , 17 . Backward reference list checking was carried out by screening the reference lists of included publications and related reviews.…”

Section: Methodsmentioning

confidence: 99%

“…The experimental findings were compiled and categorized according to the comparator, which consisted of no interventions or passive interventions, traditional cognitive training, standard exercises, and other serious games. In alignment with other reviews, meta-analyses were conducted using Review Manager (RevMan 5.4) when two or more studies from the same comparator provided sufficient data (that is, the number of participants in each intervention group, mean, standard deviation) 12 , 14 , 17 . Studies evaluated to carry a high risk of bias were excluded from the meta-analyses.…”

Section: Methodsmentioning

confidence: 99%

“…Serious games are defined as interactive games designed for education, simulation, or training purposes, as opposed to games that are purely used for entertainment purposes. They have proven effective in enhancing various cognitive abilities among older individuals [12][13][14][15][16][17] . Exergames and cognitive training games are prevalent categories within the realm of serious games.…”

Section: Introductionmentioning

confidence: 99%

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The performance of serious games for enhancing attention in cognitively impaired older adults

Abd‐Alrazaq

Abuelezz

Al-Jafar³

et al. 2023

npj Digit. Med.

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The performance of serious games for enhancing attention in cognitively impaired older adults

Abd‐Alrazaq

Abuelezz

Al-Jafar³

et al. 2023

npj Digit. Med.

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“…Serious games refer to participative electronic games that are designed for goals other than entertainment, such as therapeutic rehabilitation; education; prevention of, for example, cognitive impairments; and training. Serious games have also been used to improve several cognitive functions such as memory [ 14 ], processing speed [ 15 ], executive functions [ 16 ], language processing [ 17 ], visuospatial skills [ 18 ], and global cognition [ 19 ]. Common types of serious games are exergames and cognitive training games.…”

Section: Introductionmentioning

confidence: 99%

Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis

Abd‐Alrazaq¹,

Abuelezz²,

AlSaad³

et al. 2023

J Med Internet Res

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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 (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.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 (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.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. Trial Registration PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa

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“…Accordingly, healthcare digital serious games have been designed to engage and train brain regions that are responsible for everyday functioning including executive functions, domains of memory, and processing. The experimental studies on serious games specifically adapted to people with neurodegenerative disorders show that physical games can positively affect the players with mild Alzheimer's disease and mild cognitive impairment [ 10 , 11 ] such as attention and memory [ 12 ] and visual-spatial abilities [ 13 ]. In addition, these serious games can have a positive impact on mental health, for instance, to prevent or treat anxiety and depression [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Development and Evaluation of an Artificial Intelligence–Based Cognitive Exercise Game: A Pilot Study

Eun

Kim

2022

Journal of Environmental and Public Health

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Recently, cognitive serious games have successfully been employed to train cognitive abilities in elderly people with mild cognitive impairment, Alzheimer’s disease, and related disorders. However, despite the continuous rehabilitation game design and its applications, the existing cognitive exercise games fall short of user interaction and personalized elements with regard to difficult levels, which leads to users leaving early and losing interests during the gameplay. In this regard, the purpose of the study was to design and develop the serious game inclusive of playful elements for user motivation, the web-based mobile application system for easy accessibility, and Artificial Intelligence– (AI–) based difficulty level adjustment system for prevention from earlier leaving out in the middle of the play so that the elderly users can feel entertaining and immersed into the cognitive game voluntarily. This study was designed as an eight-week pilot experiment with thirty-seven participants in their 60s to 80s for the game’s usability assessment purpose. Results of the study showed that the AI-based cognitive exercise game was acceptable, interesting, and motivating for the elderly people and the test results before and after the eight-week training suggest a relationship between longer the training on the game and lower cognitive assessment scores including geriatric quality of life scale, geriatric depression scale, and Korean version of mini-mental state examination (MMSE). These correlations demonstrate the potential value of serious games in clinical assessment of cognitive status for the elderly users with varying cognitive ability. Based on these results, the elderly-centered serious game with playful element can be potentially used in clinical settings, allowing the cognitive training to be more enjoyable and more medically effective. Given these promising results, a more focused study can extend to the game system or additional game tools or features to be explored that solely target the elderly by applying AI and advanced visualization devices.

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Effectiveness of Serious Games for Visuospatial Abilities in Elderly Population with Cognitive Impairment: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 12 publications

The performance of serious games for enhancing attention in cognitively impaired older adults

The performance of serious games for enhancing attention in cognitively impaired older adults

Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis

Development and Evaluation of an Artificial Intelligence–Based Cognitive Exercise Game: A Pilot Study

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