PDF(Pubmed)
Abstract：
BACKGROUND: Serious games (SGs) are nonpharmacological interventions that are widely applied among older adults. To date, no evidence has been published regarding the effect of digital SGs on cognitive ability, daily behavioral capacity, or depression in older adults with Alzheimer\'s disease (AD) and mild cognitive impairment (MCI).
OBJECTIVE: This study aimed to assess the effect of SGs on older adults with AD and MCI by summarizing and pooling the results of previous studies.
METHODS: This meta-analysis examined the effectiveness of digital SGs in improving cognitive ability, enhancing daily behavioral capacity, and alleviating depression in older adults with AD and MCI. We searched the following databases up to December 31, 2023, to identify relevant high-quality randomized controlled trials (RCTs): PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Stata 15.1 and Review Manager 5.3 were used to screen the 14 studies, extract data, code the data, and perform meta-analysis. Mean differences and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Eligibility criteria were developed in accordance with the Population, Intervention, Comparison, Outcomes, and Study Design framework: (1) population (older adults with AD and MCI), (2) intervention (digital SG intervention), (3) comparison (digital SG intervention vs routine health care), (4) outcomes (cognitive ability, daily behavioral capacity, and depression), and (5) study or research design (RCT). Sensitivity analysis was performed, and a funnel plot was constructed.
RESULTS: From January 2017 to December 2023, we enrolled 714 individuals across 14 RCTs, with 374 (52.4%) in the severe game group using digital SGs and 340 (47.6%) in the control group using traditional methods. The results of our meta-analysis indicated that using digital SGs in older adults with AD and MCI is more effective than traditional training methods in several key areas. Specifically, digital SG therapy significantly increased cognitive ability, as found in the Mini-Mental State Examination (SMD 2.11, 95% CI 1.42-2.80; P<.001) and the Montreal Cognitive Assessment (SMD 2.75, 95% CI 1.98-3.51; P<.001), significantly increased daily behavioral capacity (SMD 0.53, 95% CI 0.06-0.99; P=.03), and significantly reduced depression (SMD -2.08, 95% CI -2.94 to -1.22; P<.001) in older adults with AD and MCI. No publication bias was detected based on the results of Begg and Egger tests.
CONCLUSIONS: Digital SGs offer a viable and effective nonpharmacological approach for older adults with AD and MCI, yielding better results compared to traditional formats. However, caution is warranted in interpreting these findings due to limited RCTs, small sample sizes, and low-quality meta-analyzed evidence.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews: CRDCRD42023486090; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486090.
OBJECTIVE: This study aimed to assess the effect of SGs on older adults with AD and MCI by summarizing and pooling the results of previous studies.
METHODS: This meta-analysis examined the effectiveness of digital SGs in improving cognitive ability, enhancing daily behavioral capacity, and alleviating depression in older adults with AD and MCI. We searched the following databases up to December 31, 2023, to identify relevant high-quality randomized controlled trials (RCTs): PubMed, Embase, Web of Science, Scopus, and Cochrane Library. Stata 15.1 and Review Manager 5.3 were used to screen the 14 studies, extract data, code the data, and perform meta-analysis. Mean differences and standardized mean differences (SMDs) with 95% CIs were used to calculate continuous variables. The Cochrane risk-of-bias assessment tool was used to evaluate the risk of bias. Eligibility criteria were developed in accordance with the Population, Intervention, Comparison, Outcomes, and Study Design framework: (1) population (older adults with AD and MCI), (2) intervention (digital SG intervention), (3) comparison (digital SG intervention vs routine health care), (4) outcomes (cognitive ability, daily behavioral capacity, and depression), and (5) study or research design (RCT). Sensitivity analysis was performed, and a funnel plot was constructed.
RESULTS: From January 2017 to December 2023, we enrolled 714 individuals across 14 RCTs, with 374 (52.4%) in the severe game group using digital SGs and 340 (47.6%) in the control group using traditional methods. The results of our meta-analysis indicated that using digital SGs in older adults with AD and MCI is more effective than traditional training methods in several key areas. Specifically, digital SG therapy significantly increased cognitive ability, as found in the Mini-Mental State Examination (SMD 2.11, 95% CI 1.42-2.80; P<.001) and the Montreal Cognitive Assessment (SMD 2.75, 95% CI 1.98-3.51; P<.001), significantly increased daily behavioral capacity (SMD 0.53, 95% CI 0.06-0.99; P=.03), and significantly reduced depression (SMD -2.08, 95% CI -2.94 to -1.22; P<.001) in older adults with AD and MCI. No publication bias was detected based on the results of Begg and Egger tests.
CONCLUSIONS: Digital SGs offer a viable and effective nonpharmacological approach for older adults with AD and MCI, yielding better results compared to traditional formats. However, caution is warranted in interpreting these findings due to limited RCTs, small sample sizes, and low-quality meta-analyzed evidence.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews: CRDCRD42023486090; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=486090.
摘要：
背景：严重游戏（SGs）是非药物干预措施，广泛应用于老年人。迄今为止,没有证据表明数字SGs对认知能力的影响，日常行为能力，患有阿尔茨海默病（AD）和轻度认知障碍（MCI）的老年人或抑郁症。
目的：本研究旨在通过总结和汇集先前研究的结果来评估SGs对患有AD和MCI的老年人的影响。
方法：这项荟萃分析检查了数字SGs在提高认知能力方面的有效性，增强日常行为能力，减轻患有AD和MCI的老年人的抑郁症。我们搜索了截至2023年12月31日的以下数据库，以确定相关的高质量随机对照试验（RCT）：PubMed，Embase,WebofScience,Scopus,科克伦图书馆Stata15.1和ReviewManager5.3用于筛选14项研究，提取数据，对数据进行编码，并进行荟萃分析。使用95%CI的平均差和标准化平均差(SMD)来计算连续变量。使用Cochrane偏差风险评估工具评估偏差风险。资格标准是根据人口制定的，干预,比较,结果，和研究设计框架：（1）人群（患有AD和MCI的老年人），（2）干预（数字SG干预），（3）比较（数字SG干预与常规医疗保健），(4)结果(认知能力，日常行为能力，和抑郁)，（5）研究或研究设计（RCT）。进行了敏感性分析，并构建了漏斗图。
结果：从2017年1月到2023年12月，我们在14个RCT中招募了714名个人，在使用数字SGs的严重游戏组中有374（52.4％），在使用传统方法的对照组中有340（47.6％）。我们的荟萃分析结果表明，在几个关键领域中，在患有AD和MCI的老年人中使用数字SGs比传统的培训方法更有效。具体来说,数字SG治疗显著提高了认知能力，如简易精神状态检查（SMD2.11，95％CI1.42-2.80；P<.001）和蒙特利尔认知评估（SMD2.75，95％CI1.98-3.51；P<.001），日常行为能力显著增加（SMD0.53，95%CI0.06-0.99；P=0.03），在患有AD和MCI的老年人中，抑郁显著降低（SMD-2.08，95%CI-2.94至-1.22；P<.001）。根据Begg和Egger测试的结果，未检测到发表偏倚。
结论：数字SGs为患有AD和MCI的老年人提供了一种可行且有效的非药物治疗方法，与传统格式相比，效果更好。然而,由于RCT有限，在解释这些发现时需要谨慎，小样本量，和低质量的荟萃分析证据。
背景：PROSPERO国际系统评价前瞻性注册：CRDCRD42023486090;https://www.crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=486090。
目的：本研究旨在通过总结和汇集先前研究的结果来评估SGs对患有AD和MCI的老年人的影响。
方法：这项荟萃分析检查了数字SGs在提高认知能力方面的有效性，增强日常行为能力，减轻患有AD和MCI的老年人的抑郁症。我们搜索了截至2023年12月31日的以下数据库，以确定相关的高质量随机对照试验（RCT）：PubMed，Embase,WebofScience,Scopus,科克伦图书馆Stata15.1和ReviewManager5.3用于筛选14项研究，提取数据，对数据进行编码，并进行荟萃分析。使用95%CI的平均差和标准化平均差(SMD)来计算连续变量。使用Cochrane偏差风险评估工具评估偏差风险。资格标准是根据人口制定的，干预,比较,结果，和研究设计框架：（1）人群（患有AD和MCI的老年人），（2）干预（数字SG干预），（3）比较（数字SG干预与常规医疗保健），(4)结果(认知能力，日常行为能力，和抑郁)，（5）研究或研究设计（RCT）。进行了敏感性分析，并构建了漏斗图。
结果：从2017年1月到2023年12月，我们在14个RCT中招募了714名个人，在使用数字SGs的严重游戏组中有374（52.4％），在使用传统方法的对照组中有340（47.6％）。我们的荟萃分析结果表明，在几个关键领域中，在患有AD和MCI的老年人中使用数字SGs比传统的培训方法更有效。具体来说,数字SG治疗显著提高了认知能力，如简易精神状态检查（SMD2.11，95％CI1.42-2.80；P<.001）和蒙特利尔认知评估（SMD2.75，95％CI1.98-3.51；P<.001），日常行为能力显著增加（SMD0.53，95%CI0.06-0.99；P=0.03），在患有AD和MCI的老年人中，抑郁显著降低（SMD-2.08，95%CI-2.94至-1.22；P<.001）。根据Begg和Egger测试的结果，未检测到发表偏倚。
结论：数字SGs为患有AD和MCI的老年人提供了一种可行且有效的非药物治疗方法，与传统格式相比，效果更好。然而,由于RCT有限，在解释这些发现时需要谨慎，小样本量，和低质量的荟萃分析证据。
背景：PROSPERO国际系统评价前瞻性注册：CRDCRD42023486090;https://www.crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=486090。
