DOI: 10.1002/alz.075284 ISSN: 1552-5260

Adaptive video games for the assessment and rehabilitation of dementia

Florian Sander, Valeria Manera, Christine R. Krebs, Maylis Touya, Elia Luca Fischer, Traian Popa, Andrea Brioschi Brioschi Guevara, Joaquin A Anguera, Adam Gazzaley, Stefan Klöppel, Gilles Allali, Jean‐François Demonet, Philippe Robert, Arseny A Sokolov
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Neurorehabilitation in dementia becomes an increasingly relevant topic and requires early detection of signs of domain‐specific cognitive decline. To this end, neuropsychological testing is usually performed in specialized centers, which can be difficult to reach for people living in rural regions for example. These centers also usually have long waiting‐lists, which can defer proper diagnosis for long periods of time. Today, increasing attention is devoted to developing rapid cognitive screening batteries that are easy to administer remotely, and have a game‐like interface to reduce test anxiety, capture attention and increase motivation. In terms of treatment, “serious videogames” share the same stimulating, motivating and adaptive qualities, and are surfacing and showing real promise as a viable treatment option (Sokolov et al., 2020).


Regarding assessment: We conducted an observational multi‐centric study, evaluating the reliability of the mobile and adaptive serious videogame ACE‐X in detecting cognitive deficits in patients with subjective cognitive decline and mild neurocognitive disorders consulting specialized memory clinics in Bern and Lausanne in Switzerland, and Nice in France.

Regarding neurorehabilitation and serious games: We have tested a closed‐loop adaptive cognitive exergame in healthy older adults (Anguera et al., 2022), patients with stroke (NCT05169632) and multiple sclerosis (NCT03737825).


Regarding assessment: The results indicate that ACE‐X can reveal deficits in working memory and multi‐tasking relevant for everyday life.

Regarding neurorehabilitation and serious games: The outcomes show sustained benefits in attention, working memory and everyday life. These findings pave the way for integrated, cognitive‐physical, closed‐loop adaptive training for the cognitive neurorehabilitation of people with dementia.


Detecting subclinical signs of cognitive decline in the aging population is crucial, as it allows to put in place early ‐ and thus more effective ‐ interventions. Closed‐loop adaptive assessment serious video games may be used to perform large‐scale screenings of elderly people at home, to identify those that may benefit from a referral to a medical practitioner. Subsequently, interventional serious video games may represent a promising tool for cognitive neurorehabilitation of cognitive decline due to neurodegeneration.

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