Efficacy of Gamification of Cognitive Training for OlderAdults with Mild Cognitive Impairment

• Main Authors: Yi-Chen Tsai, 蔡宜蓁
• Other Authors: Hui-Fen Mao
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/9wkukx

碩士 === 國立臺灣大學 === 職能治療研究所 === 106 === Backgrounds: Persons with mild cognitive impairment (MCI) are at high risk for dementia. Cognitive-based intervention, such as game-based cognitive training for persons with MCI to prevent their further deterioration, is crucial in clinical practice. However, there was no sufficient evidence to support the efficacy of game-based cognitive training for persons with MCI. There was also no study to compare the effects of cognitive training between different formats of the intervention, individual and group. Aims: The purpose of this study was to investigate the efficacy of a board game-based cognitive training program on the enhancement of cognitive functions, namely attention, memory and executive function. We also compared the efficacy between group versus individual format. Methods：This was a single-blind, quasi-experimental study. The subjects included 18 older adults with a confirmed MCI from a neurologist. The participants were assigned either a group- or individual-based intervention. Both groups received a 12-session cognitive training program (1.5 hours for each session, twice a week). The primary outcomes included the general cognitive function (Montreal Cognitive Assessment-Taiwan Version), selective/divided attention (Test of Everyday Attention), immediate/delayed visual memory(Contextual Memory Test), immediate/delayed verbal memory (The Rivermead Behavior Memory Test-Third Edition), processing speed (Symbol Digit Modalities Test), inhibition (Stroop Color and Word Test), visual spatial working memory (Cambridge Neuropsychological Test Automated Battery-Spatial working memory), and emotional state(Geriatric Depression Scale). Outcomes were assessed pre- and post-test. The nonparametric statistics were used by Wilcoxon Signed Ranked Test (within group analysis) and Mann-Whitney U Test or Chi-Squared (between group analysis). Results：The results showed significant improvement for all subjects in overall cognitive function, selective attention, delayed visual memory and immediate/delayed verbal memory after the intervention. Subjects in individual format showed significant within-group improvement in overall cognitive function, delayed verbal memory, inhibition, and visual space working memory. While subjects in group format improved significantly only in visual spatial working memory. However, there was no significant between-group difference of the changes on all outcome measures. Furthermore, subjects with low cognitive function (Clinical Dementia Rating – Sum of Boxes≧3) had significantly improved visual space working memory after training in individual training format , whereas subjects with high cognitive function has only significant improvement in the emotional state after the group training. Conclusions：The present study showed that applying a 12-session board-game cognitive training for older adults with MCI had positive effects on cognitive function enhancement, especially in general cognition and memory. With equal time of intervention, compared with group format, the individual format provide more opportunities for practices, can be more tailored to individuals’ needs, and might result in better outcomes. Future studies need larger samples to validate this.