Video games to monitor cognitive ability in people prone to Alzheimer’s disease

Simple computer games may allow better tracking of cognitive ability in people early in the progression to Alzheimer’s disease, subjective cognitive decline, an early clinical marker that may indicate early development of the progression of this pathology.

This approach not only makes it possible to continuously monitor people’s cognition, but, based on the results, treatments and follow-up could also be personalized.

This is established by a new study, in which the Integrated Pharmacology and Systems Neuroscience Research Group of the Hospital del Mar Research Institute and the BBBRC (Barcelona Beta Brain Research Center), a research center of the Pasqual Maragall Foundation, have collaborated. as well as the Network Biomedical Research Center for Physiopathology of Obesity and Nutrition (CIBEROBN), in Spain.

The study has validated these tools based on data from 56 people participating in the PENSA Study, which evaluates the efficacy in the prevention of cognitive decline of an intervention based on lifestyle habits, diet, physical activity, cognitive stimulation and cognitive training during twelve months.

In the cognitive training component, the participants played a panel of 36 games designed by the company NeuronUP, which were distributed throughout the month in three weekly 30-minute sessions.

For twelve months, the participants played the same games, but the degree of difficulty varied depending on the performance of each participant.

Data obtained from six computerized cognitive stimulation games that trained executive abilities, including planning ability, working memory, mental flexibility, attention, and inhibition, were analyzed.

From these data it has been possible to control very carefully and precisely the evolution of their cognitive performance.

Unlike the traditional approach that limits one to waiting at least 6 months between cognitive assessments, with this new tool cognition can be assessed monthly without the learning effects observed in the traditional approach appearing. In addition, these tools are twice as sensitive as traditional tests for measuring changes in cognitive ability in stages prior to the onset of Alzheimer’s disease.

Artistic recreation of a logic video game on a screen and a person reflected in it. (Illustration: Amazings/NCYT)

innovative tool

This is the first time that a tool of this type has been validated to monitor people at risk of dementia or Alzheimer’s. “It is a very innovative way of evaluating people’s cognition on a continuum,” explains Rafael de la Torre, a researcher at the Hospital del Mar Research Institute and CIBEROBN and principal investigator of the PENSA study. “Its great advantage is that we avoid the learning effect that occurs with other assessment systems and we solve one of the challenges in being able to monitor cognitive ability in real time,” adds Natalia Soldevila, co-author of the study and researcher at the Hospital del Instituto de Investigación Hospital del Sea.

Normally, the evaluation of the participants in a study of this type is done at three specific moments. At the beginning, to know its initial state, in the middle of the investigation, to see the evolution, and at the end, to determine the effect of the evaluated interventions. With the use of computerized cognitive stimulation games, monitoring capacity is greatly improved. In addition, they provide other advantages, as explained by Laura Forcano, a researcher at the Hospital del Mar Research Institute and CIBEROBN and co-author of the study. “In the traditional tests there are no levels, it is always the same difficulty. In games, the degree of difficulty is adjusted to the basal performance of each individual. Once the person has reached the maximum level of it, we can precisely measure the cognitive changes ”, she details. In addition, the fact that they play at home, in a familiar environment, also eliminates the stress factor of the usual tests, which have to be carried out in a clinical or research environment.

In this sense, the use of a tool like this “not only allows us to see the general evolution of how our participants’ cognition has evolved, but also allows us to carry out personalized medicine in terms of seeing who responds and who does not respond to the intervention.” . The acquisition of so many repeated measurements makes it possible to trace trajectories and see who follows a better trajectory and who does not, and study the reasons” adds Natalia Soldevila. In a case of application in a patient or participant in a study, it can allow adapting the treatment to her response without having to wait for the end of the investigation. In the study, this could be verified in four of the participants, in whom no improvement in their cognitive ability was observed.

From a clinical point of view, “the NeuronUP (NUP) is a cognitive stimulation and rehabilitation tool that has been validated for the first time to assess cognition, specifically executive functions, longitudinally to detect subtle changes. Having this type of tool will be essential to evaluate the effectiveness of interventions to prevent cognitive deterioration”, assesses Oriol Grau, neurologist and coordinator of the Clinical Research Group and Risk Factors for Neurodegenerative Diseases of the Hospital del Mar Research Institute and Head of the Clinical Research Group and Risk Factors for Degenerative Diseases at the Barcelona Beta Brain Research Center.

All participants in the PENSA study have been physically fit people between the ages of 60 and 80. To be included, they had to perceive some memory problems that they hadn’t noticed in a while and be carriers of the APOE4 allele. 129 volunteers have participated, who were offered a personalized action plan based on lifestyle habits and health indicators.

The study is titled “Intensive assessment of executive functions derived from performance in cognitive training games”. And it has been published in the academic journal iScience. (Source: CIBEROBN / Hospital del Mar Research Institute)