Serious Games for Learning Among Older Adults With Cognitive Impairment: Systematic Review and Meta-Analysis
JMIR
Abd-Alrazaq, A., Abuelezz, I., et al. (2023).
JMIR, 25, e43607.
This systematic review and meta-analysis investigates the effects of serious games on verbal and nonverbal learning for adults with cognitive impairment.
Not stated
From 2010 to July 22, 2022
Randomized-controlled trials
11 in the systematic review; 8 in the meta-analysis
A meta-analysis of 6 studies comparing serious games to no intervention or sham intervention showed no statistically significant difference in verbal learning (SMD 0.27, 95% CI [–0.02 to 0.56]). The quality of evidence was very low. Following sensitivity analysis in which one study was removed due to higher verbal leaning at baseline for its control group, a statistically significant difference was found in verbal learning for the serious gaming group compared to control (SMD 0.33, 95% CI [0.02-0.64]). When a sub-group analysis was carried out, there was no statistically significant difference in effect of serious gaming on verbal learning between individuals with mild cognitive impairment vs. Alzheimer's Disease.
Two studies compared serious gaming to conventional therapy for individuals with mild cognitive impairment. No statistically significant difference was found in verbal learning between groups (SMD 0.01, 95% CI [–0.75 to 0.77]). Limitations included heterogeneity and very low quality of evidence.
Four studies investigated the effects of serious gaming on verbal learning when compared to other serious games for mixed populations such as Alzheimer's Disease, mild cognitive impairment, and dementia. No statistically significant differences were found in three studies while one study showed mixed results.<br /><br />Similarly, the effectiveness of serious games on nonverbal learning was compared with the effects of other serious games for mixed populations with cognitive impairment. No statistically significant differences were found in three studies. One study found a statistically significant difference in nonverbal learning for a recollection training game as compared to a recognition practice game.
One study compared serious gaming to conventional cognitive training and found no statistically significant differences in verbal learning between groups for adults with mild cognitive impairment. <br /><br />Two studies investigated the effectiveness of serious gaming on nonverbal learning for adults with mild cognitive impairment. Meta-analysis demonstrated a statistically significant difference for serious gaming as compared to conventional cognitive training (SMD 1.05, 95% CI [–0.65 to 1.46]). The quality of the evidence was low due to high risk of bias.
Four studies investigated the effects of serious gaming on nonverbal learning as compared to sham or no intervention for mixed populations (e.g., Alzheimer's Disease, mild cognitive impairment). Meta-analysis showed a statistically significant difference in favor of serious gaming (SMD 0.58, 95% CI [0.06-1.09]). Heterogeneity was moderate and the quality of evidence was very low.
