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Games are typically designed for entertainment, but “serious games” have become popular for training, wellness and other important applications. And there is a need for serious gaming for the older adults. With our increasing aging population comes corresponding increases in age-related conditions associated with impaired cognitive status, and gaming can be applied for cognitive assessments.

AGE-WELL researcher Mark Chignell

“Individuals with cognitive impairments may benefit from playing serious games, which can potentially assess a variety of factors associated with cognitive decline in dementia,” says Mark Chignell, a psychologist and professor in the department of mechanical and industrial engineering, University of Toronto. He is a lead researcher who works with AGE-WELL, a Canadian network of scientists, older adults, caregivers, partner organizations and future leaders. He presented his findings about therapeutic gaming at the AGE-WELL conference held in Vancouver last fall.

When individuals are active and stimulated, serious gaming can help by slowing down or furthering cognitive decline. “We know it is important to measure cognitive status— much can be lost in day- to-day living to the point where you can no longer plan and organize,” he says, adding that this is the biggest concern for aging in place.

In Ontario, for instance, there is only a 14-month life expectancy in long-term care homes with people who already have complex problems. Unfortunately, most of these patients cannot benefit from gaming. But people with dementia account for half of that population, and they are prime candidates for serious gaming.

A doctor at Sunnybrook Hospital first came up with the idea of using the “whack-a-mole” game to help with elderly patients in ER who risk developing delirium. The patients were given the game to hit the moles.

“We found a correlation with game scores and traditional cognitive tests, such as giving a patient a pencil and paper to spell the word ‘world’ backwards and to draw a clock face,” explains Chignell. “Patients found it easier to play the game and it was more enjoyable. It can be played multiple times, which can be easily done when they have to wait several hours in ER.”

Chignell particularly sees a need to screen for dementia.  His team has a version of the game on tablets, which has already been used in Canadian ERs and they have trials to validate it.

Though fun to play, games can have serious benefits.
Photo: Flickr/Creative Commons, Thomas Hawk.

Whack-a-mole is being tweaked to benefit those in long-term care homes as well. Chignell found that people with dementia sometimes don’t do well using touch screens so his team developed six colour-coded push buttons to correspond with the mole, which is a hole on the screen that makes a whacky sound when the mole gets hit.  “And apologies to the Save-the-Mole Society,” he says with a chuckle.

He is currently working with a cognitive neuroscientist and plans to create the mole game with different versions, such as a memory test. “We can create other versions,” he notes. “One of the issues we address is that we want individuals to play the game as often as possible. So we have added buttons to watch videos, like your own personal video channel. The mole game comes up now and then so you have to play it to get back to the video of your choice.”

Chignell’s plan is to give out 100 free tablets by mid 2019 and he has also started a project in New Brunswick. The goal is to put all the data on a confidential website where family members and staff can review and assess the status of a person.

“If we could have a way of measuring how well people are doing cognitively – based on them playing games – it will shift our focus away from medical conditions like bed sores and on to the things they need to maintain their human status.”

As Peter Drucker, known as the inventor of modern business management, once said, “You cannot manage what you can’t measure.”