The Effectiveness of Serious Games in Improving Memory Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis

Alaa Abd‐Alrazaq; Alhuwail, Dari; Al-Jafar, Eiman; Ahmed, Arfan; Shuweihdi, Farag; Reagu, Shuja; Househ, Mowafa · 2022 · OpenAlex-citations

DOI: 10.2196/35202

archive: archived pipeline: cataloged verified

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Summary

This systematic review and meta-analysis addresses the effectiveness of serious games in improving memory among older adults with cognitive impairment, such as mild cognitive impairment, Alzheimer disease, or dementia. Motivated by the global increase in aging populations and the prevalence of cognitive decline, the study aimed to pool findings from existing randomized controlled trials (RCTs) to draw definitive conclusions. Previous reviews were limited by outdated searches, inclusion of non-RCTs, or narrow scopes focusing on specific game types or memory domains. This study sought to fill these gaps by evaluating all types of serious games against various comparators and assessing verbal, nonverbal, and working memory outcomes. The researchers conducted a systematic search of eight bibliographic databases and Google Scholar, identifying 618 citations. After rigorous screening, 18 RCTs published between 2012 and 2021 met the eligibility criteria. These studies involved older adults (mean age 74.5 years) recruited from clinical and community settings. Interventions primarily consisted of cognitive training games (89%) and exergames (11%) delivered via computers, tablets, or VR headsets. Data were synthesized using narrative methods and multilevel meta-analyses to account for dependency among effect sizes. The analysis compared serious games against no intervention, passive interventions, conventional exercises, and conventional cognitive activities. Risk of bias and evidence quality were assessed using the Cochrane RoB 2 tool and GRADE approach, respectively. The meta-analysis revealed that serious games were significantly more effective than no or passive interventions in improving nonverbal memory (standardized mean difference [SMD] 0.46, P=.02) and working memory (SMD 0.31, P=.04), but not verbal memory. When compared to conventional exercises, serious games significantly improved verbal memory (SMD 0.46, P=.003) but showed no significant difference for nonverbal or working memory. Serious games were found to be as effective as conventional cognitive activities for all three memory types, with no statistically significant differences observed. Additionally, adaptive serious games showed comparable effects on working memory to nonadaptive games. The authors conclude that serious games have potential for improving memory in older adults with cognitive impairment. However, they caution that most meta-analyses were based on few studies (≤3) and yielded low-quality evidence. Consequently, serious games should currently be offered as a supplement to, rather than a substitute for, proven interventions. The study highlights the need for future robust research investigating short- and long-term effects across diverse age groups and cognitive statuses.

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