Department of Telematics Engineering, University of Vigo, Vigo, Spain.
Department of Telematics Engineering, University of Vigo, Vigo, Spain.
Int J Med Inform. 2019 Jul;127:52-62. doi: 10.1016/j.ijmedinf.2019.04.012. Epub 2019 Apr 17.
Alzheimer's disease is a degenerative brain disease and the most common cause of dementia. Today, 47 million people live with dementia worldwide. This number is projected to increase to more than 131 million by 2050, as populations age. Therefore, the World Health Organization considers serious cognitive deterioration a public health priority.
Advanced cognitive evaluation mechanisms are needed to help make an early diagnosis. These new mechanisms should overcome the limitations of current neuropsychological tests, including delayed detection; being perceived as intrusive; being non-ecological; being dependent on confounding factors; or their administration being expensive, among others. A promising novel approach consists of the introduction of serious games based on virtual reality and machine learning able to assess cognitive traits relevant to the diagnosis of mild cognitive impairment and Alzheimer's disease.
As a result of a preliminary pilot experiment, promising evidence was obtained about the predictive power of this solution. However, for these new serious games to be effective, evidence has to be gathered on the player experience by senior adults, avoiding the limitations of traditional tests at the same time. This study addresses these aspects with the participation of 74 senior users and 15 test administrators.
Main findings confirm the usability and playability of Panoramix, a game battery designed according to the principles discussed above, its technological acceptability and its accessibility. For example, in relation to acceptability, the game battery was scored 4.39 in a 5-point scale, while its average usability score was 4.45 regardless of socio-cultural level or previous experience with digital technologies. In addition, health professionals confirm both, usability and playability, levels with an average score of 6.5 in a 7-point scale. Participants' willingness of using this kind of systems for cognitive evaluation was also confirmed.
Promising results obtained pave the way for additional work to confirm the diagnostic validity according to clinical standards of these new cognitive assessment tools.
阿尔茨海默病是一种退行性脑疾病,也是痴呆症最常见的病因。目前,全球有 4700 万人患有痴呆症。预计到 2050 年,随着人口老龄化,这一数字将增加到 1.31 亿以上。因此,世界卫生组织将严重认知能力下降视为公共卫生重点。
需要先进的认知评估机制来帮助早期诊断。这些新机制应克服当前神经心理学测试的局限性,包括延迟检测;被认为具有侵入性;不具有生态性;依赖于混杂因素;或其管理费用高昂等。一种有前途的新方法是引入基于虚拟现实和机器学习的严肃游戏,以评估与轻度认知障碍和阿尔茨海默病诊断相关的认知特征。
由于初步的试点实验,该解决方案的预测能力得到了有希望的证据。然而,为了使这些新的严肃游戏有效,必须同时避免传统测试的局限性,收集老年人对游戏体验的证据。这项研究通过 74 名老年人和 15 名测试管理员参与来解决这些方面的问题。
主要发现证实了 Panoramix 的可用性和可操作性,Panoramix 是根据上述原则设计的游戏电池,它的技术可接受性和可访问性。例如,在可接受性方面,游戏电池在 5 分制中得分为 4.39,而无论社会文化水平或之前使用数字技术的经验如何,其平均可用性得分为 4.45。此外,健康专业人员在 7 分制中平均得分为 6.5,确认了可用性和可操作性两个水平。还证实了参与者愿意使用这种系统进行认知评估。
获得的有希望的结果为根据临床标准进一步确认这些新认知评估工具的诊断有效性铺平了道路。