Game Therapies and Improving Dementia Symptoms

Written by: Courtney Lysiak  '23
Edited by: Ziwen Zhou '23

As dementia patients progressively lose brain and motor function, the medical community works tirelessly to create new and improved treatments which will boost the dwindling quality of life for those suffering with the condition. A recent study conducted by nurse Jiaying Zheng, and professors Xueping Chen and Ping Yu examines patient outcomes with game-based therapies for adults with dementia, a progressive neurodegenerative disorder that causes deterioration in memory, thinking and motor skills in around 50 million people worldwide [2]. There are around 10 million new cases every year. Dementia may begin as forgetfulness, losing track of time, or feeling lost in formerly familiar places; however, over time symptoms may become much more severe. As sufferers progress toward the late stage of the illness, they may become unaware of both time and place, unable to recognize friends and family, need assisted care for basic tasks, and experience behavioral changes including aggression. Current treatments for dementia patients are inadequate, with mainstream pharmacological options being expensive and causing serious adverse effects including nausea, vomiting, sleep issues, muscle pain, fatigue, and dizziness. Instead, non-pharmacological interventions have been hailed as the best option for dementia sufferers, specifically game interventions that exercise concentration, memory and motor reaction (key targets for rehabilitation in dementia patients).

This paper reviewed other experimental studies, including five conducted in nursing homes, one in an adult day care center, and one in an assisted living facility. The studies analyzed the effect of  cognitive and/or physical games. In the realm of cognitive games, one dubbed ‘making memories together’ developed by Genco Games in association with The Alzheimer’s Association and the NIH was the first therapeutic game designed with dementia patients in mind. It is a noncompetitive board game in which families create individualized memory cards that help dementia patients tap into their preserved memories and improve family visits. The objective of this game is to help dementia patients have more meaningful and enjoyable interactions with their families, and patients who received this game-based intervention saw a statistically significant reduction in sadness when compared to two other groups which did not receive the treatment. Making Memories Together won first place in the Society for the Arts in Healthcare’s International Healing Arts Competition. 

​Regarding physical games, this review examined the effect of physical games on patients’ cognition, behavioral and psychological symptoms of dementia (BPSD), gait, and balance. One of these studies involved examining the impact of video exercise games on cognitive function in patients with mild to moderate dementia in which games were divided into two categories: upper limbs and lower limbs. The upper limbs game required participants to “grab” coins that appeared to be coming out the television screen, while in the lower limbs game patients were asked to move their legs to a musical rhythm. In both games, players’ cognition, visuospatial and constructive functions all showed improvements. Another study examined the effects of ball games in which patients threw and caught a ball with both hands or kicked and stopped a ball with one foot on agitation and cognition in patients with severe dementia. Subjects showed a significant reduction in agitated behaviors and improved cognition when compared to the placebo group. 
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Finally, when researchers looked at the effects of combined physical and cognitive games across individuals with different stages of dementia, they found that participants’ cognition and BPSD improved greatly. Patients in this group were guided through activities ranging from jigsaw puzzles to origami and board games, as well as the aforementioned ball games. 

Overall, these studies, though preliminary, suggest that game-based treatments for dementia patients tend to benefit cognition, gait, balance, and BPSD. Game therapies may be one of the most promising emerging non-pharmacological treatments for dementia sufferers, an already significant group which is only projected to grow in size in the coming years. The burden of dementia cannot be overstated, and it is crucial that further research into effective therapies to mitigate symptoms is done. 

​Works Cited: 

1. Zheng J, Chen X, Yu P. Game-based interventions and their impact on dementia: a narrative review. Australas Psychiatry. 2017 Dec;25(6):562-565. doi: 10.1177/1039856217726686. Epub 2017 Aug 31. PMID: 28856903.

2. Dementia [Internet]. World Health Organization. World Health Organization; Available from: https://www.who.int/news-room/fact-sheets/detail/dementia#:~:text=Worldwide%2C%20around%2050%20million%20people,dependency%20among%20older%20people%20worldwide.
3. Prince, M, Wimo, A. Word Alzhemer Report 2015. In: Guerchet, M, Ali, G-C, Prince, M. (eds) The incidence of dementia. London: Alzheimer’s Disease International, 2015, p.33.

4. Douglas, S, James, I, Ballard, C. Non-pharmacological interventions in dementia. Adv Psychiatr Treat 2004 ;10 :171–177.
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5. Fenney, A, Lee, TD. Exploring spared capacity in persons with dementia: what Wii™ can learn. Act Adapt Aging 2010 ;34 :303–313.

6. [Image Citation] Wikimedia Commons, Accesible at 
https://upload.wikimedia.org/wikipedia/commons/a/a5/6sided_dice.jpg