March 8, 2010 (Savannah, Georgia) — Elderly adults who play brain fitness games that exercise global aspects of memory show improvements in the domain of delayed memory at 6 months compared with a slight decline in active controls, according to preliminary findings presented here at the American Association for Geriatric Psychiatry 2010 Annual Meeting.
Karen Miller, PhD, University of California at Los Angeles, reported that significant differences were observed at 6 months after randomization between the intervention group who were assigned to the Dakim BrainFitness computerized memory program vs active controls, even though after 2 months of training, "controls” were also given the same training as the intervention group.
Assessed by 4 different memory tests, the group who played the BrainFitness game for the full 6 months gained almost 2 points on memory scores, increasing from 10.4 at baseline to 12.1 at follow-up.
This is in contrast to controls, who, having played the same BrainFitness game from month 2 to month 6, had the same memory scores decrease slightly from 10.2 at baseline to 10.1 at follow-up (P = .001). A total of 38 elderly subjects completed the 6-month trial, 22 at an average age of 82 years in the intervention group and 16 at an average age of 83 years in the control group.
"By month 6, the intervention group had played more than double the number of sessions at 93 compared with only about 40 sessions played by active controls, so it’s the long-term use that improves overall memory. The maximum benefit comes when you keep on playing," Dr. Miller told Medscape Psychiatry.
Pilot Study
Before launching the clinical trial, Dr. Miller and colleagues carried out a pilot study involving 22 elderly subjects, with an average age of 74 years, who were assigned to the Dakim BrainFitness computerized game or to an active control group.
Participants played the game 5 times a week, each session lasting 30 minutes, for 2 months. At the end of the 2-month pilot study, a modest effect size was seen on 1 memory test.
Realizing that this particular version of the BrainFitness game did not exercise traditional aspects of memory training, including encoding and long-term memory, UCLA investigators helped Dakim redesign the game. The version used in their latest clinical trial now exercises short-term memory, critical thinking, visual spatial skills, long-term memory, calculations, and language.
"There is also a variety of 300 to 400 games or events that cycles through each time a senior plays so they are not going through the same format each time," Dr. Miller said.
"There are also 5 levels which can be preselected so this machine allows seniors to move up and down between levels, depending on how well they perform on different aspects of memory," she added.
Dr. Miller also stressed that to see a training effect on memory, it is likely subjects will need to commit to regular memory training exercises, much in the same way people need to commit to other lifestyle behaviors, such as exercise and stress reduction.
She also believes computerized training will only be helpful in preventing memory decline in people whose memory is still relatively healthy.
Memory training devices, such as the program modified and used by the UCLA group, are also likely to benefit subjects with amnestic memory impairment and not those with impairment in multiple domains.
Dr. Miller noted that, in her experience, subjects with impairment in multiple domains continue to deteriorate relatively quickly even when they used the BrainFitness device on a regular basis.
"The longer a person is exposed to the BrainFitness program, the more likely they are to improve in verbal and visual memory. Even if you have no computer skills, you are able to use it," said Dr. Miller.
Preliminary Results
Gary Small, MD, University of California at Los Angeles, told Medscape Psychiatry that these preliminary results are "encouraging" and that the Dakim BrainFitness program is a popular device in centers where it is been tested. "It is very much tailored to the older generation, with an easy-to-use touch screen, so seniors are enjoying it," he added.
On the other hand, companies manufacturing these brain fitness games need to make sure the games are more than just fun and engaging and that they exercise all domains of memory, such as the Dakim BrainFitness program appears to do.
"The issue really is will these devices improve cognitive skills?" Dr. Small added that it is certainly feasible to incorporate the kinds of games and techniques into brain games that improve cognitive skills, as he himself has done it with training programs — companies just need the will to do so.
Dr. Miller and Dr. Small disclose a financial conflict of interest with Dakim. Dr. Small has received consulting and speaker's fees from a number of pharmaceutical companies not relevant to his research with Dakim.
American Association for Geriatric Psychiatry's (AAGP) 2010 Annual Meeting: Session 212. Presented March 6, 2010.
source : http://www.medscape.com/viewarticle/718101?src=mp&spon=25&uac=97984HKregards, taniafdi ^_^
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