Problem addressed
There are 55 million people living with dementia worldwide (WHO, 2022) and more than 205 thousand people with dementia in Portugal (OECD, 2019).
A study from the Lancet Public Health in 2022 estimated that the number of people with dementia worldwide would increase from 57.4 million in 2019 to 152.8 million in 2050.
Additionally, significant research has shown that 40% of dementia cases are attributed to 12 modifiable risk factors, notably highlighting social isolation, physical inactivity, and depression. (Livingstone et al., 2020).
Innovative solution
The Exercogs®are a therapeutic tool created for dementia prevention programs that arises to respond to the social problem of dementia.
This is an innovative tool that combine physical exercise, cognitive skills, and social interaction in a single activity. The Exercogs® are gamified and use augmented reality to provide an interactive and motivating experience.
Exercogs® consists of 4 games that focus on the most perishable areas of healthy and pathological ageing. This solution works 3 domains simultaneously: 1) Cognitive domain stimulates attention, memory and executive functions (reasoning, planning, inhibitory control, cognitive flexibility, decision-making); 2) Physical domain allows for work on mobility, motor coordination and balance; 3) Social domain allows for development of general social skills.
Each of the 4 games has different levels of difficulty that allow the gaming experience to be adapted to the motor and cognitive abilities of the users.
It is worth emphasizing that these games are played in group within a game scenario specially designed to promote social interaction, allowing the creation of healthy connections between older people that are fundamental for their mental and emotional health. In addition, the Exercogs® are gamified and use augmented reality to increase engagement.
This tool was developed by a multidisciplinary team specializing in aging and dementia from the Sisters Hospitallers Idanha | Sintra in collaboration with an academic institution, the Institute of Systems and Robotics at Instituto Superior Técnico.
The development of this therapeutic tool followed these phases:
- Research and Planning: Assessment of senior's needs; survey of market solutions;
- Ideation and Concept Development: Definition of therapeutic objectives; selection of stimulus types; Idealization of game scenarios, cognitive and motor areas;
- Design and Prototyping: Programming video games; implementation of gamification techniques;
- Testing and Evaluation: Testing the prototypes and interaction mechanics with a group of users; usability testing;
- Scientific validation: Experimental study with pre and post-test assessment, with a sample of 204 subjects aged ≥ 65 years old (x̅=78,79; σ=8,049);
- Maintenance and improvement: The solution is being used in pilot studies in different institutions in Portugal for evaluation and continuous improvement.
Key results and benefits
In the scientific validation study, statistically significant improvements were obtained in all evaluated domains when comparing the participants' results before and after the intervention with a program using Exercogs®: Cognitive Domain [t(203) =-19.298; p<.001; d=1,92]; Affective Domain [t(203) =7,673; p<.001; d=0,76]; Social Domain [t(203) =-6,242; p<.001; d=0,62]; Functional Domain [t(203) =-3,244; p<.001; d=0,32]; Quality of Life[t(203) =-10.788; p<.001; d=1,08].
Notable health benefits were observed among users, particularly in cognitive function and quality of life. These findings indicate the potential effectiveness of Exercogs® in dementia prevention programs.
By integrating technology into this therapeutic solution, Exercogs® achieve more effectively promote patient engagement and motivation.
Furthermore, Exercogs® enhance technological literacy in older adults, promoting confidence and autonomy in digital device usage, potentially leading to broader positive effects on daily life and independence.
Overall, these results highlight the importance of technology-driven interventions for promoting cognitive resilience and improving quality of life.
The alliance between the clinic and academia is crucial for solving the challenges of longevity and creating technological solutions that respond to new health needs.
The use of new technologies in health intervention generates high levels of adherence and motivation among older adults, as well as among health professionals.
Exercogs® is a technological solution that has demonstrated health benefits in clinical validation and could be beneficial to include in dementia prevention programs.
Potential for mainstreaming
Exercogs® represent an innovative solution for addressing the global challenge of dementia. Developed through a structured process, they integrate physical exercise, cognitive stimulation, and social interaction. Research involving 204 individuals aged 65 and above demonstrated significant improvements across cognitive, physical, and social domains after using Exercogs®. These findings suggest that Exercogs® have the potential to be integrated into dementia prevention programs, promoting engagement and technological literacy among older adults.
