Effect of digital game intervention on cognitive functions in older adults: a multiple baseline single case experimental design study

Abstract

Background: Residents in nursing homes are prone to cognitive decline affecting memory, visuospatial cognition, and executive functions. Cognitive decline can lead to dementia, necessitating prioritized intervention.

Methods: The current study aimed to investigate whether an intervention using a digital game was effective for preserving and improving the cognitive function of residents in nursing homes. An intervention study was conducted using a single-case AB design with multiple baselines. The participants in the study were five older adults aged 65 and over who do not play digital games regularly. The study ran for 15 weeks, including a baseline (phase A) and an intervention phase (phase B). Phase A had five baselines (5 to 9 weeks) with random participant assignment. In phase B, participants engaged in a digital game (Space Invaders) individually. Cognitive function was assessed as the outcome, measured using the Brain Assessment (performed on a tablet through the Internet) at 16 measurement points. Four of five participants (two female and two male) were included in the analysis, using visual inspection and Bayesian statistics with multi-level modeling.

Results: Visual inspection of the graphs revealed cognitive function score improvements after the intervention for most layers in terms of memory of numbers, memory of words, mental rotation test (visuospatial ability), and total scores in the Brain Assessment. These effects were also significant in the analysis by multi-level modeling.

Conclusions: The results suggest that the use of digital games may be effective for preserving and improving cognitive function among residents of nursing home.

Trial registration: This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000048677; public title: Effect of a Digital Game Intervention for Cognitive Functions in Older People; registration date: August 30, 2022).

Keywords: Bayesian analysis; Cognitive functions; Digital game; Nursing home; Single-case design.

Fig. 1

Assigning participants to each layer. Participants 1, 2, 4, and 5 underwent the Brain Assessment once a week, for a total of 16 times, including the first time. The time required to conduct the Brain Assessment was 10 min each time (five tasks each requiring 2 min). Participants 1, 2, 4, and 5 underwent digital intervention for 27, 21, 18, and 30 sessions, respectively, for 30 to 60 min, three times a week during phase B. Participant 3 left the study midway through the study, so only underwent Brain Assessment a total of eight times, including the first time, and did not undergo the digital intervention

Fig. 2

Progress of each Brain Assessment item (memory of numbers, memory of words, and MRT) score. The left side of the vertical line represents phase A, while the right side represents phase B. MRT, mental rotation test

Fig. 3

Progress of each Brain Assessment item (N-back test, judgment, and total) score. The left side of the vertical line represents phase A, while the right side represents phase B