Engaging cognitive domains of people with dementia during tablet game play

Background: Keeping cognitively active is important for people living with dementia or MCI but finding engaging activities can be challenging. Playing digital games has been shown to engage cognitive processes such as visual attention, working memory, and visuomotor skills, in children and adults. This study explored whether these cognitive domains are engaged when people living with dementia or MCI play digital games. 

Method: Participants (n = 32) with dementia or MCI, mean MoCA 13.9, were recruited from adult day programs to play four mainstream games on touchscreen tablets. Each session was recorded and a video coding scheme was developed using behavioral analysis software to map observable behaviors, including eye gaze, hand movements, and game strategy, to five DSM cognitive domains : complex attention, executive function, learning and memory, language, and perceptual motor (DSM-V, 2013). Five minutes from each initial gameplay session were analyzed to explore the engagement of cognitive domains. 

Results: All five cognitive domains were engaged but varied across the games. For example, a word search games engaged language much more than a jigsaw puzzle game which was higher on perceptual-motor skills. The most engaged cognitive domain was ‘complex attention’ and the least engaged cognitive domain was ‘language’. All participants demonstrated cognitive engagement whilst playing the games. 

Conclusion: Playing digital games can provide cognitive engagement for people living with dementia or MCI. Using mainstream games increases accessibility of opportunities for cognitive engagement, in a way which is also immersing and rewarding. Future research incorporating eye tracking will increase understanding of how people living with dementia learn to play digital games and respond to prompts. This study presents huge potential for low cost cognitive activity for people with dementia or MCI.