严肃游戏用于辅助社区老年人轻度认知障碍筛查的效果验证

Verification of the effectiveness of serious games in assisting the screening of mild cognitive impairment among the elderly in the community

目的自行设计一款严肃游戏(打地鼠游戏),并探究其对辅助社区老年人轻度认知障碍筛查的效果。方法采用便利抽样法在社区招募178名老年人,将其分为非认知障碍组(109例)和轻度认知障碍组(69例)。比较两组老年人在两种游戏模式(限时模式、非限时模式)下的慢、中、快3种速度等级的游戏得分和反应时间,分析其与两组老年人简易智力状态检查量表得分的差异性和相关性。结果差异性检验结果显示:两组老年人在限时模式下(速度等级快、中)的游戏总分差异有统计学意义(t=17.749,P<0.001;t=17.515,P<0.001),速度等级快、中的游戏反应时间差异有统计学意义(Z=10.070,P<0.001;Z=7.991,P<0.001)。Pearson检验显示:两组老年人在限时模式下(速度等级快、中)的游戏总分与其简易智力状态检查量表得分呈正相关(r=0.765,r=0.652),速度等级快、中的游戏反应时间与其简易智力状态检查量表得分呈负相关(r=-0.607,r=-0.644)。logistic回归分析显示:限时模式下的快速、中速游戏得分差异具有统计学意义(P<0.001)。限时模式下快速、中速等级游戏得分曲线下面积分别为0.966、0.961,最佳截断点分别为13.5、14.5。结论本研究严肃游戏的限时模式下快速、中速游戏得分在辅助社区老年人轻度认知障碍筛查方面具有可行性,建议以常规普查游戏的形式应用于社区老年人的筛查。

Objective The aim of this study was to design a serious game(Whack-a-Mole game)and investigate its effectiveness in assisting the screening of mild cognitive impairment among the elderly in the community.Methods A total of 178 elderlies were recruited from the community using convenience sampling and were categorized into a non-cognitive impairment group(109 cases)and a mild cognitive impairment group(69 cases).Game scores and reaction times were compared across three speed levels(slow,medium and fast)in two game modes(time-limited and non-time-limited),and their differences and correlations with the scores on the Mini-Mental State Examination(MMSE)were analyzed.Results The variance test results indicated statistically significant differences between the total game scores of the two groups of elderly in the time-limited mode(fast and medium speed levels)(t=17.749,P<0.001;t=17.515,P<0.001),and in the reaction times of the game at the fast and medium speed levels(Z=10.070,P<0.001;Z=7.991,P<0.001).Pearson test revealed positive correlations between the total scores of the game in the time-limited mode(fast and medium speed levels)of the two groups of elderlies and their scores on the MMSE(r=0.765,r=0.652).Furthermore,the correlation between the reaction time of the game at the fast and medium speed levels and their scores on the MMSE was showing a negative correlation(r=-0.607,r=-0.644).Logistic regression analyses demonstrated a statistically significant difference between fast and medium speed game scores in the time-limited mode(P<0.001).The area under the curve of fast and medium speed game scores in the time-limited mode were 0.966、0.961 and the optimal cut-off point were 13.5、14.5,respectively.Conclusion The fast and medium-speed game scores of the serious game in the time-limited mode are feasible for assisting the screening of mild cognitive impairment among the elderly.It is recommended to be applied as a routine census game for screening the elderly in the community.