Are Video Games Effective to Promote Cognition and Everyday Functional Capacity in Mild Cognitive Impairment/Dementia Patients? A Meta-Analysis of Randomized Controlled Trials

Article type: Research Article

Authors: Ferreira-Brito, Filipa^a | Ribeiro, Filipa^b | Aguiar de Sousa, Diana^c | Costa, João^{d; e; f; g} | Caneiras, Cátia^{h; i} | Carriço, Luís^j | Verdelho, Ana^{a; g; k}

Affiliations: [a] Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [b] Center for Interdisciplinary Research in Health, Instituto de Ciências da Saúde, Universidade Católica Portuguesa, Lisbon, Portugal | [c] Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisboa, Lisbon, Portugal | [d] Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [e] Centro Colaborador Português da Rede Cochrane Iberoamericana, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [f] Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [g] Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [h] Laboratório de Investigação em Microbiologia na Saúde Ambiental (EnviHealthMicro Lab), Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal | [i] Healthcare Department, Nippon Gases Portugal, Vila Franca de Xira, Portugal | [j] LASIGE, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal | [k] Neurology Service, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal

Correspondence: [*] Correspondence to: Filipa Ferreira-Brito, Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, Ed. Egas Moniz, Piso 0, Ala C, 1649-028 Lisboa, Portugal. Tel.: +351 916048808; E-mail: filipa.brito@campus.ul.pt.

Abstract: Background:Mild cognitive impairment (MCI) and dementia are associated with increased age. MCI is a clinical entity described as a transitional state between normal cognition and dementia. Video games (VGs) can potentially promote cognition and functional capacity since multiple cognitive domains are recruited during gameplay. However, there is still a lack of consensus regarding the efficacy of VGs as therapeutic tools, particularly in neurodegenerative diseases. Objective:We aimed to analyze the impact of VGs on cognition and functional capacity outcomes in MCI/dementia patients. Methods:We conducted a systematic review and meta-analysis study (PROSPERO [CRD42021229445]). PubMed, Web of Science, Epistemonikos, CENTRAL, and EBSCO electronic databases were searched for RCT (2000-2021) that analyzed the impact of VGs on cognitive and functional capacity outcomes in MCI/dementia patients. Results:Nine studies were included (n = 409 participants), and Risk of Bias (RoB2) and quality of evidence (GRADE) were assessed. Data regarding attention, memory/learning, visual working memory, executive functions, general cognition, functional capacity, quality of life were identified, and pooled analyses were conducted. An effect favoring VGs interventions was observed on Mini-Mental State Examination (MMSE) score (MD = 1.64, 95%CI 0.60 to 2.69). Conclusion:Although promising, the effects observed should be interpreted with caution since serious methodological shortcomings were identified in the studies included. Nonetheless, the effect observed is higher than the minimum clinically important difference (1.4 points) established to MMSE. Future studies on the current topic urge. Recommendations for the design and conduction of cognitive RCT studies are presented.

Keywords: Cognition, dementia, independent living, mhealth, mild cognitive impairment, telerehabilitation, video games

DOI: 10.3233/JAD-210545

Journal: Journal of Alzheimer's Disease, vol. 84, no. 1, pp. 329-341, 2021