Post on 18-Apr-2015
A Computer Gamefor Enhancing Cognitive Control in Older Adults
Jeffrey P. Toth, Ph.D. University of North Carolina Wilmington & Minds Refined LLC
Aging & Cognitive Decline
Cognitive Training & Computer-Game Training
Art Dealer by Minds Refined LLC
Copyright 2006 Minds Refined LLC. All Rights Reserved
Cognitive Aging in the U.S.A.
Copyright 2006 Minds Refined LLC. All Rights Reserved
Source: Salthouse (2004)
'Age-related declines are large, begin early in life, are evident in many cognitive abilities, and show little increase in between-person variability.'
Automatic Processes
Cognitive Control
Processes
Age-related Cognitive Decline
Copyright 2006 Minds Refined LLC. All Rights Reserved
Research Targeting Cognitive Control:
Working memory(Klingberg et al.)
Conscious Recollection
(Jennings & Jacoby)
Relaxation, Edu., Mnemonics, Cognitive Drills, etc.
Small effects, limited transfer.
Large effects, extensive transfer.
Attentional Control(Gopher et al.; Kramer et al.)
Can Cognitive Exercise Slow Age-Related Decline?
Early Research:
Copyright 2006 Minds Refined LLC. All Rights Reserved
Can We Make Cognitive-Control Training Fun?
Potential benefits of Computer Game Training
Increased motivation playing, not training.
Decreased anxiety stealth training.
Increase adherence to the "training" program.
Play-at-home training - more inclusive.
Inexpensive.
Copyright 2006 Minds Refined LLC. All Rights Reserved
Small Effects, Limited Transfer
Drew & Waters (1986).
Clark et al. (1987).
Results: Faster RTs, but little or no effects
on Stroop, Trails-B,
WM or LTM.
Dustman et al. (1992).
Goldstein et al. (1997).
Video Game Training: 1st-Generation Games
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Video Game Training: Modern Games
Large Effects, Extensive Transfer
Extension to Older Adults?
Age-appropriate content?
Complex 3D environments. 1st-person perspective. Attention demanding. Rapid detection, response
selection, & execution. Multiple SR mappings. Goal management.
Copyright 2006 Minds Refined LLC. All Rights Reserved
Examine use of COTS games for training cognitive control in older adults.
Embed principles of cognitive-control training into games with age-appropriate themes.
Characteristics of Cognitive Control Training
Train under conditions of interference.
Require inhibition of automatic responses.
Change stimuli to avoid build-up of SR associations.
Increase difficulty gradually, based on performance.
Give immediate, hierarchical feedback.
Can Video Games Slow Cognitive Aging?
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Art Dealer is based on the Avoiding-Repetitions,
Incremented-Difficulty Training Procedure developed by
Jennings & Jacoby (2003)
Copyright 2006 Minds Refined LLC. All Rights Reserved
Art Dealer Training Study - ResultsFigure 1. Lag Levels Achieved Across Game Rounds
0
1
2
3
4
5
6
7
8
9
10
11
12
13
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16
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Game Round
Lag
Lev
el
T1*T2*T3T4T5T6*T7T8*T9T10T11Mean
* no repeated lag levels
Lags
16 & 32
10 & 24
8 & 16
6 & 12
4 & 8
3 & 6
2 & 4
1 & 2
False Alarms to 1st and 2nd Presentations ofLures ('Forgeries') Across Game Rounds
0.00
0.01
0.02
0.03
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0.12
1-5 6-10 11-15 16-20 21-25 26-30
Game Rounds
Pro
po
rtio
n 'B
uy'
(F
alse
Ala
rms)
1st Presentation of Lures2nd Presentation of Lures
Performance Change from Pre- to Post-Test:Near Transfer - Recognition Hits & Accuracy
-0.08
-0.06
-0.04
-0.02
0.00
0.02
0.04
0.06
0.08
0.10
0.12
0.14
Ch
an
ge S
core
(P
ost
min
us P
re)
TrainingControl
Hits* Hits-FAs* Hits* Hits-FAs^
Paintings Words* p < .05; ^ p < .075
Performance Change from Pre- to Post-Test:Far Transfer Measures
-5.00
-4.00
-3.00
-2.00
-1.00
0.00
1.00
2.00
3.00
4.00
5.00
Criterion Measure
Ch
an
ge S
core
(P
ost
min
us P
re)
Training
Control
Raven'sOspan-Rel.**
Ospan-Abs.**Lett.Comp.^
Patt.Comp.**PA-Delay *
PA-Imm.
** p < .01; * p < .05; ^ p < .075
Copyright 2006 Minds Refined LLC. All Rights Reserved
Perhaps. Art Dealer produced notable gains (~10%) on a number of measures associated with cognitive control (speed, working memory, LTM) and generalized beyond the specific stimuli and procedures used in the game.
Can Cognitive Exercise Slow Age-Related Decline?
Fun to play? "Yes" (10 of 11 participants)
Did it feel like a game or a memory test?
"A Game" (10 of 11 participants)
"Fun, challenging, & educational. A great invention!"
Can We Make Cognitive-Control Training Fun?
Copyright 2006 Minds Refined LLC. All Rights Reserved
Theoretical
Maximizing Training & Generalization.
Understand the Role of Motivation.
Unity or Diversity of Cognitive Control?
Training by Gaming - Future Directions
Crazy Shopper (Attentional Control).
Application
Art Dealer 2.0 (LTM).
Trivia Poker (WM).
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Mind Refined LLC - Business Model
Value Proposition Target Cognitive Control. Produce games that are compelling, affordable, & efficacious.
Marketing & Sales Market directly to older adults & senior centers; word of mouth.
Business Strategy Tightly link product to research (evidence-based games).
Market Segment Initial focus on Older Adults (55+) (under rep'ed in VG industry).
Internet sales (CD-ROM); plans for web-based play.
Anyone concerned with mental fitness or specific game content.
Copyright 2006 Minds Refined LLC. All Rights Reserved
Acknowledgements
The Art Dealer study was partially supported by a grant from the NIA to
Larry Jacoby (Wash U) and benefited from theoretical input from Karen Daniels
(UNCW) and graphic magic from Cindi Toth (WebFresco).
"We don't stop playing because we grow old, we grow old because we stop playing"
Copyright 2006 Minds Refined LLC. All Rights Reserved
Effortful.
Mundane tasks & materials Low Motivation.
Training & testing cognition High Anxiety.
Expensive for both trainers and trainees.
Training specific skills or abstract processes?
Training one or more forms of cognitive control?
What are the best ways to implement training?
Individual differences in responsiveness to training.
Limitations of Lab-based Cognitive Training
Applied LimitationsTheoretical Limitations
Copyright 2006 Minds Refined LLC. All Rights Reserved
2 Groups: Game Play vs. No-Contact Control.
Pre-Training/Post-Training Design.
Criterion Measures Recognition Memory for Paintings.
Recognition Memory for Words.
Recall of Paired-Associates (Immediate and Delayed).
Cognitive Speed: Letter- & Pattern-Comparison.
Working Memory: Operation-Span.
Reasoning: Raven's Progressive Matrices.
11 Participants per group (18f/4m), well matched in terms of age (~73), education (~14), self-rated health (~3.7 out of 5) and verbal knowledge (~35 on Shipley vocabulary).
Both groups assessed twice, ~ 1 week apart.
Game-Play Group given Art Dealer 1.0 & User's Guide.
Art Dealer Training Study - Design