Impact of an Intervention with Wii Video Games on the Autonomy of Activities of Daily Living and Psychological-Cognitive Components in the Institutionalized Elderly

Maha Jahouh, Jerónimo J González-Bernal, Josefa González-Santos, Diego Fernández-Lázaro, Raúl Soto-Cámara, Juan Mielgo-Ayuso, Maha Jahouh, Jerónimo J González-Bernal, Josefa González-Santos, Diego Fernández-Lázaro, Raúl Soto-Cámara, Juan Mielgo-Ayuso

Abstract

As people age, the risk of disease increases and deterioration becomes more noticeable. These changes can increase the risk of cognitive impairment, with negative consequences for the quality of life and the ability to perform activities of daily living (ADLs) in older people, which translate into greater dependence and loss of wellness. This study aimed to determine the impact and effectiveness of the use of the Wii® game console (Nintendo Company Limited, Kyoto, Japan) on improving performance of basic and instrumental ADLs, as well as its relationship with cognitive impairment levels and mood in institutionalized older people. A longitudinal study was designed, whose study population consisted of people over 75 years of age who lived in a nursing-home or attended a day care center (n = 80; 45 women). Cognitive status was assessed using Lobo's Mini-Cognitive Examination (MCE) and Global Deterioration Scale (FAST-GDS), while the psychological assessment used the Dementia Apathy Interview and Rating (DAIR), Yesavage scale for Geriatric Depression (EGD-15), and Goldberg Anxiety and Depression Scale (EADG). Differences from T1 to T2 in the control group (control; n = 40; 23 women; 83.25 ± 8.78 years; 76.35 ± 13.54 kg) and in the experimental group (Wii; n = 40; 22 women; 85.05 ± 8.63 years; 74.60 ± 13.01 kg) were evaluated using a paired Student's t-test or Wilcoxon's signed rank test, and a two-way repeated measures analysis of variance (ANOVA) test. Differences in Δ (%) and other tests at T1 and T2 were compared using the independent t-test or Mann-Whitney U test, with the treatment category as a fixed factor. The results showed that the Wii® video console had a positive influence for older people, increasing cognitive status and levels of ADLs, and psychological status. In addition, a positive correlation between performance of ADLs and cognitive status was observed, as well as a negative correlation with the psychological status. Through a rehabilitation program with a Wii® game console in the elderly, depression, anxiety and apathy levels were reduced, accompanied by an increase in memory and attention, as well as in performance of basic and instrumental ADLs.

Keywords: Spain; Wii; anxiety; apathy; attention; depression; elderly; memory.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Change percentage during the study in both groups on the ADL test variables. Data are expressed as the mean ± standard deviation (SD). * Significant differences between groups (p < 0.001).
Figure 2
Figure 2
Change percentage during the study in both groups on cognitive variables; data are expressed as the mean ± standard deviation (SD); * Significant differences between groups (p < 0.001).
Figure 3
Figure 3
Change percentage during the study in both groups on psychological test variables; data are expressed as the mean ± standard deviation (SD); * Significant differences between groups (p < 0.001).
Figure 4
Figure 4
Correlations between the cognitive status and psychological status and performance on basic and instrumental activities of daily living.

References

    1. Bolandzadeh N., Kording K., Salowitz N., Davis J.C., Hsu L., Chan A., Sharma D., Blohm G., Liu-Ambrose T. Predicting Cognitive function from clinical measures of physical function and health status in older adults. PLoS ONE. 2015;10:e0119075. doi: 10.1371/journal.pone.0119075.
    1. Razani J., Casas R., Wong J.T., Lu P., Alessi C., Josephson K. Relationship between executive functioning and activities of daily living in patients with relatively mild dementia. Appl. Neuropsychol. 2007;14:208–214. doi: 10.1080/09084280701509125.
    1. Agüero-Torres H., Thomas V.S., Winblad B., Fratiglioni L. The impact of somatic and cognitive disorders on the functional status of the elderly. J. Clin. Epidemiol. 2002;55:1007–1012. doi: 10.1016/S0895-4356(02)00461-4.
    1. Paixão C., Reichenheim M.E. A review of functional status evaluation instruments in the elderly. Cadernos Saude Publica. 2005;21:7–19. doi: 10.1590/s0102-311x2005000100002.
    1. Sanchez M.A.S., Correa P.C.R., Lourenço R.A. Cross-cultural adaptation of the “functional activities questionnaire—FAQ” for use in Brazil. Dement. Neuropsychol. 2011;5:322–327. doi: 10.1590/S1980-57642011DN05040010.
    1. Gühne U., Angermeyer M.C., Riedel-Heller S. Is mortality increased in mildly cognitively impaired individuals? Dement. Geriatr. Cogn. Disord. 2006;21:403–410. doi: 10.1159/000092846.
    1. Black S.A., Rush R.D. Cognitive and functional decline in adults aged 75 and older. J. Am. Geriatr. Soc. 2002;50:1978–1986. doi: 10.1046/j.1532-5415.2002.50609.x.
    1. Mitchell A., Savill-Smith C. The Use of Computer and Video Games for Learning: A Review of the Literature. 3rd ed. Learning and Skills Development Agency; London, UK: 2004. pp. 1–84.
    1. Gee J.P. Good Video Games Plus Good Learning. 1st ed. Peter Lang Publishing; New York, NY, USA: 2007. pp. 1–194.
    1. Ben-Sadoun G., Sacco G., Manera V., Bourgeois J., König A., Foulon P., Fosty B., Bremond F., D’Arripe-Longueville F., Robert P. Physical and Cognitive stimulation using an exergame in subjects with normal aging, mild and moderate cognitive impairment. J. Alzheimer’s Dis. 2016;53:1299–1314. doi: 10.3233/JAD-160268.
    1. Eggenberger P., Wolf M., Schumann M., De Bruin E.D. Exergame and balance training modulate prefrontal brain activity during walking and enhance executive function in older adults. Front. Aging Neurosci. 2016;8:66. doi: 10.3389/fnagi.2016.00066.
    1. Hill N.T., Mowszowski L., Naismith S.L., Chadwick V.L., Valenzuela M., Lampit A. Computerized cognitive training in older adults with mild cognitive impairment or dementia: A systematic review and meta-analysis. Am. J. Psychiatry. 2017;174:329–340. doi: 10.1176/appi.ajp.2016.16030360.
    1. Arvanitakis Z., Capuano A.W., Leurgans S.E., Bennett D.A., Schneider J.A. Relation of cerebral vessel disease to Alzheimer’s disease dementia and cognitive function in elderly people: A cross-sectional study. Lancet Neurol. 2016;15:934–943. doi: 10.1016/S1474-4422(16)30029-1.
    1. Kim K., Choi B., Lim W. The efficacy of virtual reality assisted versus traditional rehabilitation intervention on individuals with functional ankle instability: A pilot randomized controlled trial. Disabil. Rehabil. Assist. Technol. 2018;14:276–280. doi: 10.1080/17483107.2018.1429501.
    1. Donath L., Rössler R., Faude O. Effects of virtual reality training (exergaming) compared to alternative exercise training and passive control on standing balance and functional mobility in healthy community-dwelling seniors: A meta-analytical review. Sports Med. 2016;46:1293–1309. doi: 10.1007/s40279-016-0485-1.
    1. Şimşek T.T., Çekok K. The effects of Nintendo WiiTM-based balance and upper extremity training on activities of daily living and quality of life in patients with sub-acute stroke: A randomized controlled study. Int. J. Neurosci. 2015;126:1061–1070. doi: 10.3109/00207454.2015.1115993.
    1. Uysal S.A., Baltaci G. Effects of Nintendo Wii™ training on occupational performance, balance, and daily living activities in children with spastic hemiplegic cerebral palsy: A single-blind and randomized trial. Games Health J. 2016;5:311–317. doi: 10.1089/g4h.2015.0102.
    1. Moon J., Jung J., Cho H. Effects of balance training using a Wii Fit balance board on balance, gait and activities of daily living in patients with parkinson disease: A pilot randomized controlled trial. Med. Leg Update. 2020;20:1799–1803. doi: 10.37506/mlu.v20i1.638.
    1. Monteiro R., Da Silva L., De Tarso P., Pinheiro M., Rodrigues E., Mendes A., Lage M., Engedal K. Acute effects of exergames on cognitive function of institutionalized older persons: A single-blinded, randomized and controlled pilot study. Aging Clin. Exp. Res. 2017:387–394. doi: 10.1007/s40520-016-0595-5.
    1. Santamaría K.G., Fonseca A.S., Moncada Jiménez J., Solano Mora L.C. Balance, attention and concentration improvements following an exergame training program in elderly. Retos. 2017;33:102–105. doi: 10.47197/retos.v0i33.43574.
    1. Chesler J., McLaren S., Klein B., Watson S. The effects of playing Nintendo Wii on depression, sense of belonging and social support in Australian aged care residents: A protocol study of a mixed methods intervention trial. BMC Geriatr. 2015;15:106. doi: 10.1186/s12877-015-0107-z.
    1. Ritchie K., Artero S., Touchon J. Classification criteria for mild cognitive impairment. Neurology. 2001;56:37–42. doi: 10.1212/WNL.56.1.37.
    1. Millán-Calenti J.C., Tubío J., Pita-Fernández S., González-Abraldes I., Lorenzo T., Maseda A. Prevalence of cognitive impairment: Effects of level of education, age, sex and associated factors. Dement. Geriatr. Cogn. Disord. 2009;28:455–460. doi: 10.1159/000257086.
    1. Millán-Calenti J.C., Tubío J., Pita-Fernández S., González-Abraldes I., Lorenzo T., Fernández-Arruty T., Maseda A. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch. Gerontol. Geriatr. 2010;50:306–310. doi: 10.1016/j.archger.2009.04.017.
    1. Franco M. Desempeño ocupacional, bienestar psicológico y sentido de la vida en personas institucionalizadas. Estudio preliminar. Rev. Psicol. Salud. 2018;6:87–123. doi: 10.21134/pssa.v6i1.1362.
    1. Custodia N., Herrera E., Lira D., Montesinos R., Linares J., Bendezú L. Mild cognitive impairment: Where does normal ageing end and where dementia begins? Rev. Fac. Med. 2012;73:322–330.
    1. Folstein M.F., Folstein S.E., McHugh P.R. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J. Psychiatry Res. 1975;12:189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. López J., Martí A. Instituto de Medicina Legal de Cataluña, Mini-examen cognoscitivo (MCE) Rev. Esp. Med. Leg. 2011;37:122–127.
    1. Reisberg B., Ferris S., Franssen E. An ordinal functional assessment tool for Alzheimer’s-type dementia. Psychiatry Serv. 1985;36:593–595. doi: 10.1176/ps.36.6.593.
    1. Beobide I., Ferro A., Miró B., Martínez S., Genua M.I. The impact of automation on the safety of drug dispensing in nursing homes. Farm. Hosp. 2018;42:141–146. doi: 10.7399/fh.10949.
    1. Katz S., Ford A.B., Moskowitz R.W., Jackson B.A., Jaffe M.W. Studies of illness in the age: The index of adl, a standarized measure of biological and psychosocial function. JAMA. 1963;185:914–919. doi: 10.1001/jama.1963.03060120024016.
    1. Silva G.D.S.F.D., Bergamaschine R., Rosa M., Melo C., Miranda R., Filho M.B. Avaliação do nível de atividade física de estudantes de graduação das áreas saúde/biológica. Rev. Bras. Med. Esporte. 2007;13:39–42. doi: 10.1590/S1517-86922007000100009.
    1. Mahoney F.I., Barthel D.W. Functional evaluation: The Barthel Index. Md. State Med. J. 1965;14:61–65.
    1. Hartigan I. A comparative review of the Katz ADL and the Barthel Index in assessing the activities of daily living of older people. Int. J. Older People Nurs. 2007;2:204–212. doi: 10.1111/j.1748-3743.2007.00074.x.
    1. Mahoney F.I., Wood O.H., Barthel D.W. Rehabilitation of chronically Ill patients: The Influence of complications on the final Goal. South. Med. J. 1958;51:605–609. doi: 10.1097/00007611-195805000-00011.
    1. Lawton M.P., Brody E.M. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Strauss E., Sperry S. An informant-based assessment of apathy in Alzheimer disease. Cogn. Behav. Neurol. 2002;15:176–183.
    1. Incalzi R.A., Cesari M., Pedone C., Carbonin P.U. Construct validity of the 15-Item geriatric depression scale in older medical inpatients. J. Geriatr. Psychiatry Neurol. 2003;16:23–28. doi: 10.1177/0891988702250532.
    1. Gómez C., Campo A. Escala de yesavage para depresión geriátrica (GDS-15 y GDS-5): Estudio de la consistencia Interna y estructura factorial. Univ. Psychol. 2011;10:735–743. doi: 10.11144/Javeriana.upsy10-3.eydg. (In Spanish)
    1. Goldberg D., Bridges K., Duncan-Jones P., Grayson D. Detecting anxiety and depression in general medical settings. BMJ. 1988;297:897–899. doi: 10.1136/bmj.297.6653.897.
    1. Ferguson C.J. An effect size primer: A guide for clinicians and researchers. Prof. Psychol. Res. Pract. 2009;40:532–538. doi: 10.1037/a0015808.
    1. Harada C.N., Love M.C., Triebel K.L. Normal cognitive aging. Clin. Geriatr. Med. 2013;29:737–752. doi: 10.1016/j.cger.2013.07.002.
    1. Lipnicki D.M., Makkar S.R., Crawford J.D., Thalamuthu A., Kochan N.A., Lima-Costa M.F., Castro-Costa E., Ferri C.P., Brayne C., Stephan B., et al. Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study. PLoS Med. 2019;16:e1002853. doi: 10.1371/journal.pmed.1002853.
    1. Adcock M., Fankhauser M., Post J., Lutz K., Zizlsperger L., Luft A.R., Guimarães V., Schättin A., De Bruin E.D. Effects of an in-home multicomponent exergame training on physical functions, cognition, and brain volume of older adults: A randomized controlled trial. Front. Med. 2020;6:321. doi: 10.3389/fmed.2019.00321.
    1. Wiloth S., Lemke N., Werner C., Hauer K. Validation of a computerized, game-based assessment strategy to measure training effects on motor-cognitive functions in people with dementia. JMIR Serious Games. 2016;4:e12. doi: 10.2196/games.5696.
    1. Van Santen J., Dröes R.-M., Holstege M., Henkemans O.B., Van Rijn A., De Vries R., Van Straten A., Meiland F. Effects of exergaming in people with dementia: Results of a systematic literature review. J. Alzheimer’s Dis. 2018;63:741–760. doi: 10.3233/JAD-170667.
    1. Chan C., Ngai E., Leung P., Wong S. Effect of the adapted virtual reality cognitive training program among chinese older adults with chronic schizophrenia: A pilot study. Int. J. Geriatr. Psychiatry. 2009;25:643–649. doi: 10.1002/gps.2403.
    1. Cicek A., Ozdincler A.R., Tarakci E. Interactive video game-based approaches improve mobility and mood in older adults: A nonrandomized, controlled trial. J. Bodyw. Mov. Ther. 2020;24:252–259. doi: 10.1016/j.jbmt.2020.01.005.
    1. Li J., Theng Y.-L., Foo S., Xu X. Exergames vs. traditional exercise: Investigating the influencing mechanism of platform effect on subthreshold depression among older adults. Aging Ment. Health. 2017;22:1634–1641. doi: 10.1080/13607863.2017.1385722.
    1. Contreras K., Cubillos R., Hernández O., Reveco C., Santis N. Virtual rehabilitation in occupational therapy intervention. Rev. Child Radiol. 2014;14:205.
    1. Castellano J., Hurtado M.D., Contreras M.I. Mantenimiento de Roles Ocupacionales en el Envejecimiento. In: Pérez-Fuentes M.C., Molero Jurado M., Gázquez Linares J.J., Barragán Martín A.B., Martos Martínez A., Pérez Esteban M.D., editors. Cuidados, Aspectos Psicológicos y Actividad Física en Relación con la Salud. 1st ed. Volume 2. Asociación Universitaria de Educación y Psicología; Madrid, Spain: 2016. pp. 9–14.
    1. Clement-Carbonell V., Ferrer-Cascales R., Ruiz-Robledillo N., Rubio-Aparicio M., Portilla-Tamarit I., Cabañero-Martínez M.J. Differences in autonomy and health-related quality of life between resilient and non-resilient individuals with mild cognitive impairment. Int. J. Environ. Res. Public Health. 2019;16:2317. doi: 10.3390/ijerph16132317.

Source: PubMed

3
購読する