The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis
<h3>Background</h3><p dir="ltr">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 abiliti...
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2022
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| _version_ | 1864513517954007040 |
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| author | Alaa Abd-alrazaq (17058018) |
| author2 | Mohannad Alajlani (9392676) Dari Alhuwail (6497858) Carla T Toro (18441099) Anna Giannicchi (18441102) Arfan Ahmed (17541309) Ahmed Makhlouf (17632179) Mowafa Househ (9154124) |
| author2_role | author author author author author author author |
| author_facet | Alaa Abd-alrazaq (17058018) Mohannad Alajlani (9392676) Dari Alhuwail (6497858) Carla T Toro (18441099) Anna Giannicchi (18441102) Arfan Ahmed (17541309) Ahmed Makhlouf (17632179) Mowafa Househ (9154124) |
| author_role | author |
| dc.creator.none.fl_str_mv | Alaa Abd-alrazaq (17058018) Mohannad Alajlani (9392676) Dari Alhuwail (6497858) Carla T Toro (18441099) Anna Giannicchi (18441102) Arfan Ahmed (17541309) Ahmed Makhlouf (17632179) Mowafa Househ (9154124) |
| dc.date.none.fl_str_mv | 2022-03-10T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.2196/34592 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/The_Effectiveness_and_Safety_of_Serious_Games_for_Improving_Cognitive_Abilities_Among_Elderly_People_With_Cognitive_Impairment_Systematic_Review_and_Meta-Analysis/25688763 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Psychology Cognitive and computational psychology serious games cognitive training exergames mild cognitive impairment Alzheimer disease dementia global cognition systematic review meta-analysis |
| dc.title.none.fl_str_mv | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">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.</p><h3>Objective</h3><p dir="ltr">This study aims to assess the effectiveness and safety of serious games for improving cognitive abilities among elderly people with cognitive impairment.</p><h3>Methods</h3><p dir="ltr">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.</p><h3>Results</h3><p dir="ltr">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.</p><h3>Conclusions</h3><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: JMIR Serious Games<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.2196/34592" target="_blank">https://dx.doi.org/10.2196/34592</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_4c633860bad5511d01d6a0c777a2c845 |
| identifier_str_mv | 10.2196/34592 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25688763 |
| publishDate | 2022 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-AnalysisAlaa Abd-alrazaq (17058018)Mohannad Alajlani (9392676)Dari Alhuwail (6497858)Carla T Toro (18441099)Anna Giannicchi (18441102)Arfan Ahmed (17541309)Ahmed Makhlouf (17632179)Mowafa Househ (9154124)Biomedical and clinical sciencesClinical sciencesPsychologyCognitive and computational psychologyserious gamescognitive trainingexergamesmild cognitive impairmentAlzheimer diseasedementiaglobal cognitionsystematic reviewmeta-analysis<h3>Background</h3><p dir="ltr">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.</p><h3>Objective</h3><p dir="ltr">This study aims to assess the effectiveness and safety of serious games for improving cognitive abilities among elderly people with cognitive impairment.</p><h3>Methods</h3><p dir="ltr">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.</p><h3>Results</h3><p dir="ltr">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.</p><h3>Conclusions</h3><p dir="ltr">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.</p><h2>Other Information</h2><p dir="ltr">Published in: JMIR Serious Games<br>License: <a href="https://creativecommons.org/licenses/by/4.0/" target="_blank">https://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.2196/34592" target="_blank">https://dx.doi.org/10.2196/34592</a></p>2022-03-10T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.2196/34592https://figshare.com/articles/journal_contribution/The_Effectiveness_and_Safety_of_Serious_Games_for_Improving_Cognitive_Abilities_Among_Elderly_People_With_Cognitive_Impairment_Systematic_Review_and_Meta-Analysis/25688763CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/256887632022-03-10T03:00:00Z |
| spellingShingle | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis Alaa Abd-alrazaq (17058018) Biomedical and clinical sciences Clinical sciences Psychology Cognitive and computational psychology serious games cognitive training exergames mild cognitive impairment Alzheimer disease dementia global cognition systematic review meta-analysis |
| status_str | publishedVersion |
| title | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| title_full | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| title_fullStr | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| title_short | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| title_sort | The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities Among Elderly People With Cognitive Impairment: Systematic Review and Meta-Analysis |
| topic | Biomedical and clinical sciences Clinical sciences Psychology Cognitive and computational psychology serious games cognitive training exergames mild cognitive impairment Alzheimer disease dementia global cognition systematic review meta-analysis |