Vincenzo De Luca R&D Unit – Federico II University Hospital

Il QMCI come cerniera tra il MCI ed il memory training con smart games

MCI is a condition in which someone has minor problems with cognition – their mental abilities such as memory or thinking. However, the symptoms are not severe enough to interfere significantly with daily life, and so are not defined as dementia.

It is estimated that between 5 and 20 per cent of people aged over 65 have MCI. It is not a type of dementia, but a person with MCI is more likely to go on to develop dementia.

Mild cognitive impairment

Possible Risks or Threats to Brain Health

Some medicines, or improper use of them

Smoking

Excessive use of alcohol

Heart disease, diabetes, and other health problems

Poor diet

Insufficient sleep

Lack of physical activity

Little social activity and being alone most of the time

Studies trialling multi-domain interventions targeting at risk populations show that cognitive stimulation when deployed with other lifestyle measures and cardiovascular risk-factor assessment and treatment may reduce progression to dementia

Fighting cognitive decline

Technology-based cognitive training and rehabilitation have demonstrated promising beneficial effects on various domains of cognition with moderate to large effect sizes.

Cognitive training typically involves guided practice on a set of standardised tasks designed to reflect particular cognitive functions.

Brain training

PERsonalised ICT Supported Service for Independent Living and Active Ageing

Multimodal service model, focusing on nutrition, physical and cognitive function,

supported by an interoperable ICT service infrastructure, utilising intelligent

decision support systems and gamification.

PERSSILAA, offered to older adults (> 65 years) through local community

service, will be seamlessly integrated with health care services.

November 12, 2019 7

PERSSILAA Intervention

ICT SUPPORTED SERVICES

Adapted Physical Activity

Medical Visits

Primoary Nutritional

Intervention

Health and ICT literacy

Cognitive Training

Web-based platform for cognitive telerehabilitation through personalized treatments for patients with neurological afflictions (brain damage, MCI, dementia, Alzheimer's, mental health, intellectual disability, etc.). It has more than 150 specific tasks and 15,000 therapeutic options designed by Guttmann Institute’s neuropsychologists. It acts on the main cognitive areas: orientation, attenuation, elaboration, language, perceiving, calculus, memory, performing functions and social cognition. It is connected to EHR and allows to monitor results and adherence remotely.

Guttmann NeuroPersonalTrainer®

At the baseline, the QMCI, MNA, SF12 and EQ5D was administered in 110, 117, 120, 115 patients and in 88, 81, 46, 49 patients after six month follow up, respectively. The QMCI score improved in 53,4% were stable in 37.9% and impaired only in 8.6% of subjects. The MNA score improved in 49.2% were stable in 29.5% and impaired in 21.1%. The SF12 score improved in 45.6%, were stable in 6.5% and impaired in 47.8%. The EQ5Dscore improved in 53 %, were stable in 20.4% and impaired in 26.5%. Mean T score was measured only at baseline and according with T score 17.1 % subjects were osteoporotic, 54.5% osteopenic and 42.8% had a with normal bone density.

Results

Game mechanics are mainly adapted to engage and motivate patients by transforming them into players by highlighting the skills acquired through scores and thus making the therapeutic process clear and funnier than usual. Further social dynamics borrowed by games can facilitate the development of networks between patients creating social connections and virtual communities that could be powerful clinical resources for elderly patients.

Ascolese A, Kiat J, Pannese L, Morganti L. Gamifying elderly care: Feasibility of a digital gaming solution for active aging. Digit Med 2016;2:157-62

Gaming for brain health

• Early signs of mild cognitive impairment allow multidimensional interventions to delay dementia

• The QMCI is a sensitive tool for MCI

• The twinning between Ireland and Campania RS allowed the customization of the QMCI questionnaire to Italy

Linking assessment with interventions: the QMCI