Recommendations for the Use of Serious Games in Neurodegenerative Disorders: 2016 Delphi Panel

Abstract

The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer’s disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients’ treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician.

Recommendations for the Design of Serious Games in Neurodegenerative Diseases

“…The cognitive decline found in older adults with AD or MCI questions the usability of the VG designed for “healthy players” ( Ben-Sadoun et al, 2015 ). For this reason, there is a recent interest among professionals to design specific VG (called Serious Games [SG]) adapted to these populations ( Robert et al, 2014 ; Manera et al, 2017 ), in order to slow down the cognitive decline associated with normal and pathological aging ( Mader et al, 2012 ; Anguera et al, 2013 ; Kim et al, 2016 ).…”

Mirror neurons and their relationship with neurodegenerative disorders

“…The possibility to exploit the motor resonance to stimulate cognitive function in the frame of rehabilitation of neurodegenerative pathologies appears fascinating because it could represent a therapeutic solution that does not exist yet. Specific drugs have still not been approved for the MCI phase and pharmacotherapy effects are extremely limited in AD (Petersen et al, ; Raina et al, ); cognitive stimulation and serious game trainings have positive but limited effects (Hill et al, ; Manera et al, ; Woods, Aguirre, Spector, & Orrell, ) probably because of training performed in artificial environment and developing specific skills not transferable to daily normal life activities. No substantial pharmacological therapy is available for ALS/FTD.…”

Current Cognition Tests, Potential Virtual Reality Applications, and Serious Games in Cognitive Assessment and Non-Pharmacological Therapy for Neurocognitive Disorders

“…Furthermore, as mentioned previously, some individuals experience motion sickness from virtual environments, and the discomfort may limit or prevent their use of therapeutic VR [ 51 ]; though the aforementioned studies note that participants largely tolerated and enjoyed VR systems, sample sizes were relatively small; larger studies with more rigorously explained inclusion and exclusion criteria are necessary for further analysis of the prevalence of tolerability issues. Furthermore, serious games in general are considered to be most adapted to those with more mild NCDs, rather than those with AD and major NCDs; those with major NCDs also require the assistance of a caregiver more so than those with mild NCDs [ 95 ].…”