The effectiveness of serious games in improving processing speed among elderly people with cognitive impairment: A systematic review and meta-analysis (Preprint)

Abstract

Cognitive processing speed is known to decline by age. Processing speed refers to the time that an individual takes from receiving a stimulus to reacting to it. Serious games, which are video games employed for training and educational purposes, have the potential in improving processing speed. Numerous systematic reviews have summarized the evidence about the effectiveness of serious games in improving processing speed, but they are undermined by some limitations.

This study aims to pool the evidence about the effectiveness of serious games in improving processing speed among elderly people with cognitive impairment.

A systematic review of randomized controlled trials (RCTs) was undertaken. Two search sources were used in this review: 8 electronic databases as well as backward and forward reference list checking. Two reviewers independently checked the eligibility of the studies, extracted data from the included studies, and appraised the risk of bias and quality of the evidence. Evidence from the included studies was synthesized using a narrative and statistical approach (i.e., meta-analysis), as appropriate.

Out of 548 publications identified, 16 RCTs eventually met all eligibility criteria. Very low-quality evidence from 8 RCTs and 6 RCTs showed no statistically significant effect of serious games on the processing speed as compared with no or passive interventions groups (P=0.77) and conventional exercises (P=0.58), respectively. A subgroup analysis showed that both types of serious games (cognitive training games (P=0.26) and exergames (P=0.88)) are as effective as conventional exercises in improving processing speed.

There is no superiority of serious games over no or passive interventions and conventional exercises in improving processing speed among older adults with cognitive impairment. Yet, our findings remain inconclusive due to the low quality of the evidence, the small sample size in most included studies, and the paucity of studies included in the meta-analyses. Therefore, until more robust evidence is published, serious games should be offered or used as an adjunct to existing interventions. Further trials should be undertaken to investigate the effect of serious games that target specifically processing speed rather than cognitive abilities in general.