Effects of Exergaming in People with Dementia: Results of a Systematic Literature Review

Joeke van Santen, Rose-Marie Dröes, Marije Holstege, Olivier Blanson Henkemans, Annelies van Rijn, Ralph de Vries, Annemieke van Straten, Franka Meiland, Joeke van Santen, Rose-Marie Dröes, Marije Holstege, Olivier Blanson Henkemans, Annelies van Rijn, Ralph de Vries, Annemieke van Straten, Franka Meiland

Abstract

Background: Physical exercise benefits functioning, health, and well-being. However, people living with dementia in particular hardly engage in exercise. Exergaming (exercise and gaming) is an innovative, fun, and relatively safe way of exercising in a virtual reality or gaming environment. It may help people living with dementia overcome barriers they can experience regarding regular exercise activities.

Objective: This systematic literature review aims to provide an overview of the cost-effectiveness of exergaming and its effects on physical, cognitive, emotional, and social functioning, as well as the quality of life in people living with dementia.

Methods: PubMed, Embase, Cinahl, PsycINFO, the Cochrane Library, and the Web of Science Core Collection were searched. Selection of studies was carried out by at least two independent researchers.

Results: Three studies were found to be eligible and were included in this review. Two of these showed some statistically significant effects of exergaming on physical, cognitive, and emotional functioning in people living with dementia, although based on a very small sample. No articles were found about the cost-effectiveness of exergaming.

Conclusions: Only a few controlled studies have been conducted into the effectiveness of exergaming, and these show very little significant benefits. More well-designed studies are necessary to examine the effects of exergaming.

Keywords: Cognition; dementia; exercise; neuropsychiatry; play; quality of life; review.

Figures

Fig.1
Fig.1
Selection process of the systematic review (from: Moher et al., 2009) [43].

References

    1. Nocon M, Hiemann T, Müller-Riemenschneider F, Thalau F, Roll S, Willich SN (2008) Association of physical activity with all-cause and cardiovascular mortality: A systematic review and meta-analysis. Eur J Preventive Cardiol 15, 239–246.
    1. Shephard RJ (2016) The economic benefits of increased physical activity as seen through an objective lens In The Objective Monitoring of Physical Activity: Contributions of Accelerometry to Epidemiology, Exercise Science and Rehabilitation, Shephard RJ, Tudor-Locke C, eds. Springer International Publishing, Cham, pp. 313–333.
    1. Penedo FJ, Dahn JR (2005) Exercise and well-being: A review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry 18, 189–193.
    1. Bauman AE (2004) Updating the evidence that physical activity is good for health: An epidemiological review 2000–2003. J Sci Med Sport 7, 6–19.
    1. Warburton DER, Whitney Nicol C, Bredin SSD (2006) Health Benefits of physical activity: The evidence. Can Med Assoc J 174, 801–809.
    1. Baez M, Khaghani Far I, Ibarra F, Ferron M, Didino D, Casati F (2017) Effects of online group exercises for older adults on physical, psychological and social wellbeing: A randomized pilot trial. PeerJ 5, e3150.
    1. Baptista LC, Dias G, Souza NR, Veríssimo MT, Martins RA (2017) Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: Evidence from a cohort study. Qual Life Res 8, 1–11.
    1. Bouaziz W, Vogel T, Schmitt E, Kaltenbach G, Geny B, Lang PO (2017) Health benefits of aerobic training programs in adults aged 70 and over: A systematic review. Arch Gerontol Geriatr 69, 110–127.
    1. Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Casas-Herrero Á, Izquierdo M (2017) Role of physical exercise on cognitive function in healthy older adults: A systematic review of randomized clinical trials. Ageing Res Rev 37, 117–134.
    1. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S (2015) Exercise programs for people with dementia. Cochrane Database Syst Rev, CD006489.
    1. World Health Organization, Factsheet no 385: Physical activity, , Last updated February 2018, Accessed on February 17, 2018.
    1. Dröes RM (1997) Psychosocial treatments for demented patients In Care-giving in Dementia: Research and Applications, Volume 2, Miesen BML, Jones GMM, eds. Routledge, London, United Kingdom, pp. 127–148.
    1. Heyn P, Abreu BC, Ottenbacher KJ (2004) The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis. Arch Phys Med Rehabil 85, 1694–1704.
    1. Yágüez L, Shaw KN, Morris R, Matthews D (2011) The effects on cognitive functions of a movement-based intervention in patients with Alzheimer’s type dementia: A pilot study. Int J Geriatr Psychiatry 26, 173–181.
    1. Gebhard D (2016) Promoting physical activity for people with dementia: A systematic review. Eur J Public Health 26, 48.
    1. El-Kader SMA, Al-Jiffri OH (2016) Aerobic exercise improves quality of life, psychological well-being and systemic inflammation in subjects with Alzheimer’s disease. Afr Health Sci 16, 1045–1055.
    1. Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ, McCormick W, Larson EB (2003) Exercise plus behavioral management in patients with alzheimer disease: A randomized controlled trial. JAMA 290, 2015–2022.
    1. Rolland Y, Pillard F, Klapouszczak A, Reynish E, Thomas D, Andrieu S, Rivière D, Vellas B (2007) Exercise program for nursing home residents with Alzheimer’s disease: A 1-year randomized, controlled trial. J Am Geriatr Soc 55, 158–165.
    1. Hamer M, Lavoie KL, Bacon SL (2014) Taking up physical activity in later life and healthy ageing: The English longitudinal study of ageing. Br J Sports Med 48, 239.
    1. Oxley H (2009) Policies for healthy ageing. OECD Health Working Papers, 42.
    1. Pitkala KH, Weening-Djiksterhuis E, Rodriguez-Mañas L, Mario Barbagallo M, Erik Rosendahl P, Alan Sinclair M, Landi F, Bruno Vellas M (2016) Recommendations on physical activity and exercise for older adults living in long-term care facilities: A taskforce report. J Am Med Dir Assoc 17, 381–392.
    1. Savva GM, Zaccai J, Matthews FE, Davidson JE, McKeith I, Brayne C (2009) Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry 194, 212.
    1. Nyman SR (2011) Psychosocial issues in engaging older people with physical activity interventions for the prevention of falls. Can J Aging 30, 45–55.
    1. Clarke DE, van Reekum R, Simard M, Streiner DL, Conn D, Cohen T, Freedman M (2008) Apathy in dementia: Clinical and sociodemographic correlates. J Neuropsychiatry Clin Neurosci 20, 337–347.
    1. Crombie IK, Irvine L, Williams B, McGinnis AR, Slane PW, Alder EM, McMurdo MET (2004) Why older people do not participate in leisure time physical activity: A survey of activity levels, beliefs and deterrents. Age Ageing 33, 287–292.
    1. Binnekade TT, Eggermont LHP, Scherder EJA (2012) . Onbewogen om bewegen: Lichamelijke (in)activiteit in zorginstellingen, Vrije Universiteit; afd. Klinische Neuropsychologie, Amsterdam.
    1. Hawkins RJ, Prashar A, Lusambili A, Ellard DR, Godfrey M (2017) ‘If they don’t use it, they lose it’: How organisational structures and practices shape residents’ physical movement in care home settings. Ageing Soc, doi:
    1. Heuvelink A, Groot JD, Hofstede-Kleyweg C (2014) Let’s play - Ouderen stimuleren tot bewegen met applied games, TNO and VitaValley, The Netherlands.
    1. Konstantinidis EI, Billis AS, Mouzakidis CA, Zilidou VI, Antoniou PE, Bamidis PD (2016) Design, implementation, and wide pilot deployment of FitForAll: An easy to use exergaming platform improving physical fitness and life quality of senior citizens. IEEE J Biomed Health Inform 20, 189–200.
    1. Fenney A, Lee TD (2010) Exploring spared capacity in persons with dementia: What WiiTM can learn. Act Adapt Aging 34, 303–313.
    1. Aarhus R, Grönvall E, Larsen SB, Wollsen S (2011) Turning training into play: Embodied gaming, seniors, physical training and motivation. Gerontechnology 10, 110–120.
    1. Colombo M, Marelli E, Vaccaro R, Valle E, Colombani S, Polesel E, Garolfi S, Fossi S, Guaita A (2012) Virtual reality for persons with dementia: An exergaming experience. Gerontechnology 11, 402.
    1. Meekes W, Stanmore EK (2017) Motivational determinants of exergame participation for older people in assisted living facilities: Mixed-methods study. J Med Internet Res 19, e238.
    1. Ajzen I (1985) From intentions to actions: A theory of planned behavior In Action Control: From Cognition to Behavior, Kuhl J, Beckmann J, eds. Springer Heidelberg, Berlin, Heidelberg, pp. 11–39.
    1. Hertzog C, Kramer AF, Wilson RS, Lindenberger U (2008) Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychol Sci Public Interest 9, 1–65.
    1. Ajzen I, Fishbein M (2005) The Influence of Attitudes on Behavior In The handbook of attitudes, Albarracín D, Johnson BT, Zanna MP, eds. Lawrence Erlbaum Associates Publishers, Mahwah, NJ, US, pp. 173–221.
    1. Armitage CJ, Conner M (2001) Efficacy of the theory of planned behaviour: A meta-analytic review. Br J Soc Psychol 40, 471–499.
    1. Bamidis PD, Vivas AB, Styliadis C, Frantzidis C, Klados M, Schlee W, Siountas A, Papageorgiou SG (2014) A review of physical and cognitive interventions in aging. Neurosci Biobehav Rev 44, 206–220.
    1. Dröes RM (1997a) Psychomotor group therapy for demented patients in the nursing home In Care-giving in Dementia: Research and Applications, Volume 2, Miesen BML, Jones GMM, eds. Routledge, London, United Kingdom, pp. 95–118.
    1. Dröes RM, van der Roest HG, van Mierlo L, Meiland FJM (2011) Memory problems in dementia: Adaptation and coping strategies and psychosocial treatments. Expert Rev Neurother 11, 1769–1782.
    1. Hopman-Rock M, Staats PGM, Tak ECPM, Dröes R-M (1999) The effects of psychomotor activation programme for use in groups of cognitively impaired people in homes for the elderly. Int J Geriatr Psychiatry 14, 633–642.
    1. Bleakley CM, Charles D, Porter-Armstrong A, McNeill MD, McDonough SM, McCormack B (2015) Gaming for health: A systematic review of the physical and cognitive effects of interactive computer games in older adults. J Appl Gerontol 34, NP166–NP189.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Ann Intern Med 151, 264–269.
    1. Van Santen J, Dröes R-M, Holstege M, Blanson Henkemans O, van Straten A, de Vries R, van Rijn A, Meiland F, Effects of exergaming on people with dementia: A systematic literature review (protocol). PROSPERO 2016:CRD42016053633, , Last updated June 15, 2017, Accessed June 15, 2017.
    1. Ket H, Tips & trucs voor het uitvoeren van systematische reviews met EndNote,VU University Library Amsterdam, , Last updated April 28, 2016, Accessed November 25, 2016.
    1. Higgins JPT, Green S (2008) Cochrane Handbook for Systematic Reviews of Interventions, Wiley, Chicester, England.
    1. Effective Practice and Organisation of Care (EPOC), Data collection form. EPOC Resources for review authors,Norwegian Knowledge Centre for the Health Services, , Last updated 2017, Accessed November 21, 2016.
    1. Cohen J (1988) Statistical power analysis for the behavioral sciences, Lawrence Earlbaum Associates, NJ, Hilsdale. .
    1. Bamidis PD, Fissler P, Papageorgiou SG, Zilidou V, Konstantinidis EI, Billis AS, Romanopoulou E, Karagianni M, Beratis I, Tsapanou A, Tsilikopoulou G, Grigoriadou E, Ladas A, Kyrillidou A, Tsolaki A, Frantzidis C, Sidiropoulos E, Siountas A, Matsi S, Papatriantafyllou J, Margioti E, Nika A, Schlee W, Elbert T, Tsolaki M, Vivas AB, Kolassa IT (2015) Gains in cognition through combined cognitive and physical training: The role of training dosage and severity of neurocognitive disorder. Front Aging Neurosci 7, 152.
    1. Padala KP, Padala PR, Malloy TR, Geske JA, Dubbert PM, Dennis RA, Garner KK, Bopp MM, Burke WJ, Sullivan DH (2012) Wii-fit for improving gait and balance in an assisted living facility: A pilot study. J Aging Res 2012, 597573.
    1. Padala KP, Padala PR, Lensing SY, Dennis RA, Bopp MM, Roberson PK, Sullivan DH (2017) Home-based exercise program improves balance and fear of falling in community-dwelling older adults with mild Alzheimer’s disease: A pilot study. J Alzheimers Dis 59, 565–574.
    1. Scherder E, Scherder R, Verburgh L, Königs M, Blom M, Kramer AF, Eggermont L (2014) Executive functions of sedentary elderly may benefit from walking: A systematic review and meta-analysis. Am J Geriatr Psychiatry 22, 782–791.
    1. Sawilowsky SS (2009) New effect size rules of thumb. J Mod Appl Stat Methods 8, 597–599.
    1. Cohen J (1977), Statistical power analysis for the behavioral sciences (revised ed.), Academic Press, New York.
    1. Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA (2012) Exergaming and older adult cognition: A cluster randomized clinical trial. Am J Prev Med 42, 109–119.
    1. Wollersheim D, Merkes M, Shields N, Liamputtong P, Wallis L, Reynolds F, Koh L (2010) Physical and psychosocial effects of Wii video game use among older women. Int J Emerg Technol Soc 8, 85–98.
    1. Pisica-Donose G, Razzolini O, Bardgett M, Lim F, Samarcq L (2017) Acceptabilité et engagement des personnes âgées fragiles pour l’activité physique avec vélo ergonomique relié à un système de < <réhabilitation virtuelle> >Silverfit Mile. In 5ème Congrès Francophone, Fragilité du sujet âgé & Prévention de la perte d’autonomie, Paris, France.
    1. Ben-Sadoun G, Sacco G, Manera V, Bourgeois J, Konig A, Foulon P, Fosty B, Bremond F, d’Arripe-Longueville F, Robert P (2016) Physical and cognitive stimulation using an exergame in subjects with normal aging, mild and moderate cognitive impairment. J Alzheimers Dis 53, 1299–1314.
    1. González-Palau F, Franco M, Bamidis P, Losada R, Parra E, Papageorgiou SG, Vivas AB (2014) The effects of a computer-based cognitive and physical training program in a healthy and mildly cognitive impaired aging sample. Aging Ment Health 18, 838–846.
    1. Westphal A, Dingjan P, Attoe R (2010) What can low and high technologies do for late-life mental disorders? Curr Opin Psychiatry 23, 510–515.
    1. Rikli RE, Jones CJ (2013) Senior fitness test manual, Human Kinetics, Fullerton.
    1. Delis D, Kramer J, Kaplan E, Ober B (2000) California Verbal Learning Test – second edition. Adult version. Manual, Psychological Corporation, San Antonio, TX.
    1. Lawton MP, Brody EM (1970) Assessment of older people: Self-maintaining and instrumental activities of daily living. Nurs Res 19, 278.
    1. Cromwell DA, Eagar K, Poulos RG (2003) The performance of instrumental activities of daily living scale in screening for cognitive impairment in elderly community residents. J Clin Epidemiol 56, 131–137.
    1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA 185, 914–919.
    1. Powell LE, Myers AM (1995) The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci 50, M28–M34.
    1. Tinetti ME, Richman D, Powell L (1990) Falls efficacy as a measure of fear of falling. J Gerontol 45, P239–P243.
    1. Skevington SM, Lotfy M, O’Connell KA (2004) The World Health Organization’s WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 13, 299–310.

Source: PubMed

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