Cognitive screening of older adults using serious games: An empirical study.

Abstract Objective The goal of the research is to develop three serious games using design for the older adult population, in order to evaluate the cognitive performance of older adults. Simultaneously, the games provide information about the cognitive performance of players with neurocognitive pathology that can be used by health care professionals in clinical monitoring. Subjects and methods Two groups of adults aged 50 years or more participated in the study. Group 1 was composed of 52 subjects with high cognitive performance attending a cultural academy and a senior university. Group 2 consisted in 51 patients with cognitive impairment recruited in the Old Age Psychiatric Unit of a university hospital. Each participant played the game and was assessed with a widely-used and well validated neuropsychological instrument (Montreal Cognitive Assessment – MoCA). Concurrent validity was tested for each cognitive domain with Spearman correlation coefficient. Results Groups 1 (Senior University) and 2 (Hospital) differed in relation to average age (64.8 vs. 76.5), proportion of female gender (80% vs. 74.1%), educational level and occupation. Subjects in Group 1 scored higher in all assessed cognitive domains and in total MoCA score (24.3 vs. 13.5). The overall game performance was better in Group 1 with the Maximum Level and Group 2 the Maximum Level correlated with all cognitive domains except for abstraction. Conclusions The research provides a useful case study in the development of Serious Games for cognitive screening, which can be used independently by players, repeatedly, as cognitive exercise. Thus, these Serious Games are relevant tools that can be used as a stimulus supplement (exercises) and continuous evaluation (normative tables) of the evolution of the players (older adult population), offering useful information (collecting and choosing the data to be analyzed) for follow-up by professionals involved in patient care.