Physical Training In-Game Metrics for Cognitive Assessment: Evidence from Extended Trials with the Fitforall Exergaming Platform

Abstract

Conventional clinical cognitive assessment has its limitations, as evidenced by the environmental shortcomings of various neuropsychological tests conducted away from an older person’s everyday environment. Recent research activities have focused on transferring screening tests to computerized forms, as well as on developing short screening tests for screening large populations for cognitive impairment. The purpose of this study was to present an exergaming platform, which was widely trialed (116 participants) to collect in-game metrics (built-in game performance measures). The potential correlation between in-game metrics and cognition was investigated in-depth by scrutinizing different in-game metrics. The predictive value of high-resolution monitoring games was assessed by correlating it with classical neuropsychological tests; the area under the curve (AUC) in the receiver operating characteristic (ROC) analysis was calculated to determine the sensitivity and specificity of the method for detecting mild cognitive impairment (MCI). Classification accuracy was calculated to be 73.53% when distinguishing between MCI and normal subjects, and 70.69% when subjects with mild dementia were also involved. The results revealed evidence that careful design of serious games, with respect to in-game metrics, could potentially contribute to the early and unobtrusive detection of cognitive decline.

A Novel Game-Based Intelligent Test for Detecting Elderly Cognitive Function Impairment

“…Konstantinidis et al presented a new platform, and the classification accuracy was calculated to be 73.53% when distinguishing between MCI and normal subjects and 70.69% when subjects with mild dementia were also involved. The results revealed evidence that careful design of serious games concerning in-game metrics could potentially contribute to the early and unobtrusive detection of cognitive decline [ 21 ].…”

Visualization and Interaction Technologies in Serious and Exergames for Cognitive Assessment and Training: A Survey on Available Solutions and Their Validation

“…Consoles with monitor and projectors [8], [9], [15], [23], [145]- [159] 19 PC and mobile [3], [21], [32], [33], [48], [144], [160]- [168] 15 Not specified [49], [169] 2…”

“…Immersive HMDs [6], [14], [17], [20], [27], [29], [35], [42], [46], [47], [52], [174] Touchful devices comprise the widely diffused tools for gaming (N=181) and physiotherapic devices (N=17), e.g. treadmills, cycle-ergometers and pressure sensitive plates, which are particularly suitable for rehabilitation programs aimed at improving motor skills in subjects with age-related disorders [15], [50], [88], [94], [111], [146]- [149], [203], [208], major neurocognitive disorders (MNCD) [23], stroke [115], [151] and multiple sclerosis (MS) [22] patients. In general, touchful interfaces ensure stability, reliability and effectiveness.…”

Digital Biomarkers for Well-being Through Exergame Interactions: Exploratory Study

“…The exergame platform of Long Lasting Memories Care has proven to significantly improve strength, flexibility, endurance, and balance in older adults [ 20 ]. Furthermore, a previous study conducted by Konstantinidis et al [ 21 ] demonstrated the value of in-game metrics generated from body movement interactions with the exergame for detecting cognitive decline, and the study by Anagnostopoulou et al [ 22 ] demonstrated evidence of improving the functional architecture of the brain in adults with Down syndrome.…”

“…SG targeting the improvement of the physical capacity of the player, as the one addressed in this study, are called exergames and can open up a new category of outcome assessment. Exergames are a promising tool for measuring and assessing unobtrusively physical health [ 19 , 21 ] and focus mainly on fall risk assessment by correlating typical in-game metrics of exergames, such as movement time and response time, with a test battery or standardized assessment tests of fall risk [ 29 ]. The study by Aguilar et al [ 30 ] assessed the effect of 6 weeks of unsupervised home-based SG intervention on dynamic postural control.…”