scholarly journals A framework and immersive serious game for mild cognitive impairment

2021 ◽  
Author(s):  
Sum-Yuet Joyce Lau ◽  
Harry Agius
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Serious Games ◽  
Cognitive Rehabilitation ◽  
The Elderly ◽  
Daily Basis ◽  
Research Literature ◽  
Physical Rehabilitation ◽  
Serious Game

AbstractCognitive decline is common in the elderly. As a result, a range of cognitive rehabilitation games have been proposed to supplement or replace traditional rehabilitative training by offering benefits such as improved engagement. In this paper, we focus on mild cognitive impairment (MCI), an initial stage of cognitive decline that does not affect functioning in daily life, but which may progress towards more serious cognitive deteriorations, notably dementia. Unfortunately, while a variety of serious game frameworks and rehabilitative serious games have been proposed, there is a distinct lack of those which support the distinctive characteristics of MCI patients. Consequently, to optimise the advantages of serious games for MCI, we propose the MCI-GaTE (MCI-Game Therapy Experience) framework that may be used to develop serious games as effective cognitive and physical rehabilitation tools. The framework is derived from a combination of a survey of related research literature in the area, analysis of resident profiles from a nursing home, and in-depth interviews with occupational therapists (OTs) who work with MCI patients on a daily basis. The conceptual framework comprises four sectors that may be used to guide game design and development: an MCI player profile that represents the capabilities of a player with MCI, core gaming elements that support gameful and playful activities, therapeutic elements that support cognitive and physical rehabilitation through tasks and scenarios according to the player’s abilities, and motivational elements to enhance the player’s attitude towards the serious tasks. Together, they provide support for rehabilitation needs and may also serve as a set of comprehensive and established criteria by which an MCI serious game may be evaluated. To demonstrate the use of MCI-GaTE, we also present A-go!, an immersive gesture-based serious game that exploits the framework to enable MCI-diagnosed players to undertake therapeutic tasks supported by an assigned OT. Evaluation with OTs revealed that the immersive game potentially offers more effective support to MCI patients than traditional methods, contributing new possibilities for enhancing MCI rehabilitative training, while a comparative assessment of MCI-GaTE demonstrated that it provides a comprehensive approach not currently offered by state-of-the-art rehabilitative frameworks.

scholarly journals Mild Cognitive Impairment in Clinical Practice: A Review Article

2018 ◽  
Vol 33 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Sukanya Jongsiriyanyong ◽  
Panita Limpawattana
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Preventive Intervention ◽  
Lifestyle Modification ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Review Article ◽  
Subjective Cognitive Impairment ◽  
Rate Of Progression

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.

Mild cognitive impairment: a history and the state of current diagnostic criteria

2014 ◽  
Vol 27 (2) ◽  
pp. 199-211 ◽  
Author(s):  
Adam Gerstenecker ◽  
Benjamin Mast
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Diagnostic Criteria ◽  
Research Literature ◽  
The State ◽  
Clinical Vignette ◽  
Daily Functioning ◽  
Diagnostic Classification ◽  
Future Research

ABSTRACTBackground:Mild cognitive impairment (MCI) is a diagnostic classification used to describe patients experiencing cognitive decline but without a corresponding impairment in daily functioning. Over the years, MCI diagnostic criteria have undergone major changes that correspond to advancements in research. Despite these advancements, current diagnostic criteria for MCI contain issues that are reflected in the research literature.Methods:A review of the available MCI literature was conducted with emphasis given to tracing MCI from its conceptual underpinnings to the most current diagnostic criteria. A clinical vignette is utilized to highlight some of the limitations of current MCI diagnostic criteria.Results:Issues are encountered when applying MCI diagnostic criteria due to poor standardization. Estimates of prevalence, incidence, and rates of conversion from MCI to dementia reflect these issues.Conclusions:MCI diagnostic criteria are in need of greater standardization. Recommendations for future research are provided that could potentially bring more uniformity to the diagnostic criteria for MCI and, therefore, more consistency to the research literature.

Depression and mild cognitive impairment – Comorbidity and/or continuum?

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Late Life ◽  
The Elderly ◽  
Late Life Depression ◽  
Pubmed Database ◽  
Competing Interest ◽  
The Relationship

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Use of Magnetic Resonance Imaging to Identify Mild Cognitive Impairment: Who Should Be Imaged?

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S16) ◽  
pp. 18-20 ◽  
Author(s):  
Liana G. Apostolova
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Clinical Care ◽  
Neuropsychological Testing ◽  
The Elderly ◽  
Cognitive Change ◽  
Normal Aging ◽  
Cognitive Changes ◽  
New Information

Problems with memory are a very common complaint in the elderly and are not synonymous with dementia. Some degree of cognitive decline, manifested as greater difficulty in learning and retrieving new information for instance, develops with normal aging. Thus many older patients do not perform at the same level they did when they were younger but they do perform well when compared to their peers. For many, cognitive change ends at this stage and they proceed to lead normal, healthy, dementia-free lives.The cohort that has cognitive changes beyond what is expected in normal aging but does not yet meet criteria for dementia concerns clinicians greatly as many of these patients eventually become demented. These patients usually go through a latent stage in which neurodegenerative pathology silently spreads in the brain. Once there is enough pathological burden, cognitive decline beyond what is expected for normal aging can be detected by formal neuropsychological testing. Frequently such patients go through a state called mild cognitive impairment (MCI). In this state patients are still functionally intact and live independently, but show cognitive impairment relative to the age- and education-adjusted norms.The MCI state in itself is a prominent risk factor for developing dementia. Most patients with amnestic MCI develop Alzheimer’s disease (AD) dementia over time. At six years, as many as 80% progress to AD. Thus, MCI is a very important topic of research and an increasingly important topic of clinical care.

scholarly journals Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil

2008 ◽  
Vol 30 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Izabella Dutra de Abreu ◽  
Paula Villela Nunes ◽  
Breno Satler Diniz ◽  
Orestes Vicente Forlenza
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Cognitive Decline ◽  
Mental State ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Elderly Subjects ◽  
Cognitive State ◽  
State Examination

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.

scholarly journals Mild Cognitive Impairment and Mild Dementia: The Role of Ginkgo biloba (EGb 761®)

2021 ◽  
Vol 14 (4) ◽  
pp. 305
Author(s):  
Carlo Tomino ◽  
Sara Ilari ◽  
Vincenzo Solfrizzi ◽  
Valentina Malafoglia ◽  
Guglielmo Zilio ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Combination Therapy ◽  
Cognitive Decline ◽  
Ginkgo Biloba ◽  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Egb 761 ◽  
Age Related

Mild cognitive impairment (MCI) and dementia are clinically prevalent in the elderly. There is a high risk of cognitive decline in patients diagnosed with MCI or dementia. This review describes the effectiveness of Ginkgo biloba leaf special extract EGb 761® for the treatment of dementia syndromes and EGb 761® combination therapy with other medications for symptomatic dementia. This drug has shown convincing results, improving cognitive function, neuropsychiatric symptoms and consequent reduction of caregiver stress and maintenance of autonomy in patients with age-related cognitive decline, MCI and mild to moderate dementia. Currently, there is little evidence to support the combination therapy with anti-dementia drugs and, therefore, more evidence is needed to evaluate the role of EGb 761® in mixed therapy.

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