Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
<h3>Background</h3><p dir="ltr">Executive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for sp...
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2022
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| _version_ | 1864513517971832832 |
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| author | Alaa Abd-alrazaq (17058018) |
| author2 | Dari Alhuwail (6497858) Arfan Ahmed (17541309) Mowafa Househ (9154124) |
| author2_role | author author author |
| author_facet | Alaa Abd-alrazaq (17058018) Dari Alhuwail (6497858) Arfan Ahmed (17541309) Mowafa Househ (9154124) |
| author_role | author |
| dc.creator.none.fl_str_mv | Alaa Abd-alrazaq (17058018) Dari Alhuwail (6497858) Arfan Ahmed (17541309) Mowafa Househ (9154124) |
| dc.date.none.fl_str_mv | 2022-07-25T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.2196/36123 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Effectiveness_of_Serious_Games_for_Improving_Executive_Functions_Among_Older_Adults_With_Cognitive_Impairment_Systematic_Review_and_Meta-analysis/25679871 |
| 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 executive functions mild cognitive impairment Alzheimer disease dementia systematic reviews meta-analysis |
| dc.title.none.fl_str_mv | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults 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">Executive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses.</p><h3>Objective</h3><p dir="ltr">This study aims to investigate the effectiveness of serious games for improving executive functions among older adults with cognitive impairment.</p><h3>Methods</h3><p dir="ltr">A systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies.</p><h3>Results</h3><p dir="ltr">Of 548 publications identified, 16 RCTs were eventually included in this review. Of the 16 studies, 14 studies were included in 6 meta-analyses. Our meta-analyses showed that serious games are as effective as no or passive interventions at improving executive functions (P=.29). Surprisingly, conventional exercises were more effective than serious games at improving executive functions (P=.03). Our subgroup analysis showed that both types of serious games (cognitive training games, P=.08; exergames, P=.16) are as effective as conventional exercises at improving executive functions. No difference was found between adaptive serious games and nonadaptive serious games for improving executive functions (P=.59).</p><h3>Conclusions</h3><p dir="ltr">Serious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by health care providers nor used by patients for improving executive functions among older adults with cognitive impairment. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.</p><h3>Trial Registration</h3><p dir="ltr">PROSPERO CRD42021272757; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272757</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/10.2196/36123" target="_blank">https://dx.doi.org/10.2196/36123</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_8a04a5a2acfed603c074b78069fb9044 |
| identifier_str_mv | 10.2196/36123 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25679871 |
| publishDate | 2022 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysisAlaa Abd-alrazaq (17058018)Dari Alhuwail (6497858)Arfan Ahmed (17541309)Mowafa Househ (9154124)Biomedical and clinical sciencesClinical sciencesPsychologyCognitive and computational psychologyserious gamescognitive trainingexergamesexecutive functionsmild cognitive impairmentAlzheimer diseasedementiasystematic reviewsmeta-analysis<h3>Background</h3><p dir="ltr">Executive functions are one of the known cognitive abilities that decline with age. They are the high-order cognitive processes that enable an individual to concentrate, plan, and take action. Serious games, which are games developed for specific purposes other than entertainment, could play a positive role in improving executive functions. Several systematic reviews have pooled the evidence about the effectiveness of serious games in improving executive functions; however, they are limited by some weaknesses.</p><h3>Objective</h3><p dir="ltr">This study aims to investigate the effectiveness of serious games for improving executive functions among older adults with cognitive impairment.</p><h3>Methods</h3><p dir="ltr">A systematic review of randomized controlled trials (RCTs) was conducted. To retrieve relevant studies, 8 electronic databases were searched. Further, reference lists of the included studies and relevant reviews were screened, and we checked studies that cited our included studies. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, assessed the risk of bias, and appraised the quality of the evidence. We used a narrative and statistical approach, as appropriate, to synthesize results of the included studies.</p><h3>Results</h3><p dir="ltr">Of 548 publications identified, 16 RCTs were eventually included in this review. Of the 16 studies, 14 studies were included in 6 meta-analyses. Our meta-analyses showed that serious games are as effective as no or passive interventions at improving executive functions (P=.29). Surprisingly, conventional exercises were more effective than serious games at improving executive functions (P=.03). Our subgroup analysis showed that both types of serious games (cognitive training games, P=.08; exergames, P=.16) are as effective as conventional exercises at improving executive functions. No difference was found between adaptive serious games and nonadaptive serious games for improving executive functions (P=.59).</p><h3>Conclusions</h3><p dir="ltr">Serious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. However, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Accordingly, until more robust evidence is available, serious games should not be offered by health care providers nor used by patients for improving executive functions among older adults with cognitive impairment. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.</p><h3>Trial Registration</h3><p dir="ltr">PROSPERO CRD42021272757; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272757</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/10.2196/36123" target="_blank">https://dx.doi.org/10.2196/36123</a></p>2022-07-25T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.2196/36123https://figshare.com/articles/journal_contribution/Effectiveness_of_Serious_Games_for_Improving_Executive_Functions_Among_Older_Adults_With_Cognitive_Impairment_Systematic_Review_and_Meta-analysis/25679871CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/256798712022-07-25T03:00:00Z |
| spellingShingle | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults 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 executive functions mild cognitive impairment Alzheimer disease dementia systematic reviews meta-analysis |
| status_str | publishedVersion |
| title | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis |
| title_full | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis |
| title_fullStr | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis |
| title_full_unstemmed | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis |
| title_short | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis |
| title_sort | Effectiveness of Serious Games for Improving Executive Functions Among Older Adults 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 executive functions mild cognitive impairment Alzheimer disease dementia systematic reviews meta-analysis |