Playful multimodal activation with assessment of neuropsychological profiles in Alzheimer’s disease

Publication from Digital
Bildanalyse und Messsysteme, Connected Computing

Lucas Paletta, Silvia Russegger, Martin Pszeida, Sandra Murg , Thomas Orgel, Amir Dini, Anna Jos, Eva Schuster, Ernst HW Koster, Josef Steiner, Maria Fellner

Alzheimer’s Dement. 2020;16(Suppl. 7):e047357, 12/2020



Background: A key problem in developing interventions in dementia care is the lack

of knowledge about the mental processes and individual dependencies between functional impairments evolving over time. Neuropsychological profiles reflect the impact

of the disease on distinctive neuroanatomic networks associated with complex cognitive domains. Recently serious games have been successfully validated with high

potential as dementia biomarkers but increased estimation accuracy and personalised

neuropsychological profiling is still required.

Method: Tablet-PC-based intervention was applied within 10 weeks in Austria, engaging persons with dementia (PwD) with Alzheimer’s disease (AD) living at home in terms

of playful multimodal training and activation (n=15, age M=81.7 years, MoCA score

M=17.9). PwDs interacted with an integrated version of two serious games: (a) 15 PwD

played ‘MIRA’, a playful version of the anti-saccade task, and (b) 8 PwD played ‘MMA’,

a suite of cognitive exercises (puzzle, memory, text gap filling). The games were introduced and assisted by trainers, some PwD learned to play alone.

Result: The score of gaze-based MIRA showed significant correlation with MoCA score

(Rho= .713**) and enabled individual MoCA score estimates with errors of less than

M=2.6 MoCA points. MMA showed correlation with MoCA (Rho=p=.755*) and further MoCA subscores so that the neuropsychological profile could be established

including impairments in visuospatial operations, attention, abstraction, language and


Conclusion: The work outlined within the EU project PLAYTIME indicates successful

steps towards daily use of gaze-based games. MIRA together with the MMA training

enables continuous estimates of Alzheimer’s mental state in general but also to estimate individual neuropsychological profiles to identify personal impairments and their

course over time. The playful training app was very well accepted by PwD users and

offers with its pervasive mental assessment tool a large potential for future long-term

monitoring in numerous AD care services.