RESUMO
Spatial cognition is known to decline with aging. However, little is known about whether training can reduce or eliminate age-related deficits in spatial memory. We investigated whether a custom-designed video game involving spatial navigation, obstacle avoidance, and balance control would improve spatial memory in older adults. Specifically, 56 healthy adults aged 65 to 84 years received 10 sessions of multicomponent video game training, based on a virtual cityscape, over 5 weeks. Participants were allocated to one of three training conditions: the main intervention, the "CityQuest" group (n = 19), and two control groups, spatial navigation without obstacle avoidance ("Spatial Navigation-only" group, n = 21) and obstacle avoidance without spatial navigation ("Obstacles-only" group, n = 15). Performance on object recognition, egocentric and allocentric spatial memory (incorporating direction judgment tasks and landmark location tasks, respectively), navigation strategy preference, and executive functioning was assessed in pre- and post-intervention sessions. The results showed an overall benefit on performance in a number of spatial memory measures and executive function for participants who received spatial navigation training, particularly the CityQuest group, who also showed significant improvement on the landmark location task. However, there was no evidence of a shift from egocentric to allocentric strategy preference. We conclude that spatial memory in healthy older participants is amenable to improvement with training over a short term. Moreover, technology based on age-appropriate, multicomponent video games may play a key role in cognitive training in older adults.
RESUMO
Recently there has been a growing interest in employing serious games (SGs) for the assessment and rehabilitation of elderly people with mild cognitive impairment (MCI), Alzheimer's disease (AD), and related disorders. In the present study we examined the acceptability of 'Kitchen and cooking' - a SG developed in the context of the EU project VERVE (http://www.verveconsortium.eu/) - in these populations. In this game a cooking plot is employed to assess and stimulate executive functions (such as planning abilities) and praxis. The game is installed on a tablet, to be flexibly employed at home and in nursing homes. Twenty one elderly participants (9 MCI and 12 AD, including 14 outpatients and 7 patients living in nursing homes, as well as 11 apathetic and 10 non-apathetic) took part in a 1-month trail, including a clinical and neuropsychological assessment, and 4-week training where the participants were free to play as long as they wanted on a personal tablet. During the training, participants met once a week with a clinician in order to fill in self-report questionnaires assessing their overall game experience (including acceptability, motivation, and perceived emotions). The results of the self reports and of the data concerning game performance (e.g., time spent playing, number of errors, etc) confirm the overall acceptability of Kitchen and cooking for both patients with MCI and patients with AD and related disorders, and the utility to employ it for training purposes. Interestingly, the results confirm that the game is adapted also to apathetic patients.