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Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis

BACKGROUND: Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic review...

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Autores principales: Abd-alrazaq, Alaa, Abuelezz, Israa, AlSaad, Rawan, Al-Jafar, Eiman, Ahmed, Arfan, Aziz, Sarah, Nashwan, Abdulqadir, Sheikh, Javaid
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134019/
https://www.ncbi.nlm.nih.gov/pubmed/37043277
http://dx.doi.org/10.2196/43607
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author Abd-alrazaq, Alaa
Abuelezz, Israa
AlSaad, Rawan
Al-Jafar, Eiman
Ahmed, Arfan
Aziz, Sarah
Nashwan, Abdulqadir
Sheikh, Javaid
author_facet Abd-alrazaq, Alaa
Abuelezz, Israa
AlSaad, Rawan
Al-Jafar, Eiman
Ahmed, Arfan
Aziz, Sarah
Nashwan, Abdulqadir
Sheikh, Javaid
author_sort Abd-alrazaq, Alaa
collection PubMed
description BACKGROUND: Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis. OBJECTIVE: This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment. METHODS: Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate. RESULTS: Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning. CONCLUSIONS: Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods. TRIAL REGISTRATION: PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa
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spelling pubmed-101340192023-04-28 Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis Abd-alrazaq, Alaa Abuelezz, Israa AlSaad, Rawan Al-Jafar, Eiman Ahmed, Arfan Aziz, Sarah Nashwan, Abdulqadir Sheikh, Javaid J Med Internet Res Review BACKGROUND: Learning disabilities are among the major cognitive impairments caused by aging. Among the interventions used to improve learning among older adults are serious games, which are participative electronic games designed for purposes other than entertainment. Although some systematic reviews have examined the effectiveness of serious games on learning, they are undermined by some limitations, such as focusing on older adults without cognitive impairments, focusing on particular types of serious games, and not considering the comparator type in the analysis. OBJECTIVE: This review aimed to evaluate the effectiveness of serious games on verbal and nonverbal learning among older adults with cognitive impairment. METHODS: Eight electronic databases were searched to retrieve studies relevant to this systematic review and meta-analysis. Furthermore, we went through the studies that cited the included studies and screened the reference lists of the included studies and relevant reviews. Two reviewers independently checked the eligibility of the identified studies, extracted data from the included studies, and appraised their risk of bias and the quality of the evidence. The results of the included studies were summarized using a narrative synthesis or meta-analysis, as appropriate. RESULTS: Of the 559 citations retrieved, 11 (2%) randomized controlled trials (RCTs) ultimately met all eligibility criteria for this review. A meta-analysis of 45% (5/11) of the RCTs revealed that serious games are effective in improving verbal learning among older adults with cognitive impairment in comparison with no or sham interventions (P=.04), and serious games do not have a different effect on verbal learning between patients with mild cognitive impairment and those with Alzheimer disease (P=.89). A meta-analysis of 18% (2/11) of the RCTs revealed that serious games are as effective as conventional exercises in promoting verbal learning (P=.98). We also found that serious games outperformed no or sham interventions (4/11, 36%; P=.03) and conventional cognitive training (2/11, 18%; P<.001) in enhancing nonverbal learning. CONCLUSIONS: Serious games have the potential to enhance verbal and nonverbal learning among older adults with cognitive impairment. However, our findings remain inconclusive because of the low quality of evidence, the small sample size in most of the meta-analyzed studies (6/8, 75%), and the paucity of studies included in the meta-analyses. Thus, until further convincing proof of their effectiveness is offered, serious games should be used to supplement current interventions for verbal and nonverbal learning rather than replace them entirely. Further studies are needed to compare serious games with conventional cognitive training and conventional exercises, as well as different types of serious games, different platforms, different intervention periods, and different follow-up periods. TRIAL REGISTRATION: PROSPERO CRD42022348849; https://tinyurl.com/y6yewwfa JMIR Publications 2023-04-12 /pmc/articles/PMC10134019/ /pubmed/37043277 http://dx.doi.org/10.2196/43607 Text en ©Alaa Abd-alrazaq, Israa Abuelezz, Rawan AlSaad, Eiman Al-Jafar, Arfan Ahmed, Sarah Aziz, Abdulqadir Nashwan, Javaid Sheikh. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 12.04.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Review
Abd-alrazaq, Alaa
Abuelezz, Israa
AlSaad, Rawan
Al-Jafar, Eiman
Ahmed, Arfan
Aziz, Sarah
Nashwan, Abdulqadir
Sheikh, Javaid
Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title_full Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title_fullStr Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title_full_unstemmed Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title_short Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-analysis
title_sort serious games for learning among older adults with cognitive impairment: systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134019/
https://www.ncbi.nlm.nih.gov/pubmed/37043277
http://dx.doi.org/10.2196/43607
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