The Effects of Exergaming on the Depressive Symptoms of People With Dementia: A Systematic Review and Meta-Analysis

IF 3.5 3区医学 Q1 NURSING Journal of Clinical Nursing Pub Date : 2025-01-24 DOI:10.1111/jocn.17625

Daphne Sze Ki Cheung, Hau Yi Jodie Tse, Duo Wai-Chi Wong, Cheuk Yin Chan, Wing Lam Wan, Ka Ki Chu, Sze Wing Lau, Lok Lam Lo, Tsz Ying Wong, Yee Ki So, James Chung-Wai Cheung, Ken Hok Man Ho

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Abstract

Background

Depressive symptoms are common among people with dementia (PWD). Exergaming consisting of combined cognitive and physical training in gaming is increasingly used to alleviate their depressive symptoms in research. With its potential synergistic neurobiological and psychosocial effects on reducing depressive symptoms among PWD, this review aimed to understand its effectiveness and contents.

Methods

This is a systematic review of the effectiveness of exergames on depressive symptoms among older adults with dementia. A search was conducted on 7 May 2024 of the online databases CINAHL, Embase, PsycINFO, PubMed and the China Academic Journal Network Publishing Database (CNKI). The methodological quality of randomised controlled trials (RCT) and quasi-experimental studies was assessed with RoB2 and ROBINS-I, respectively. A meta-analysis of the included RCTs was conducted.

Results

Six studies consisting of four RCTs and two quasi-experimental studies involving 235 participants with various stages of dementia were included. The meta-analysis showed a significant overall improvement in depression with a large effect size (SMD = 1.46, 95% CI = −2.50, −0.43; p = 0.006). Despite high heterogeneity (I² = 91%), all studies demonstrated a trend of improvement in depression after the intervention. The exergames adopted in the included trials had the following elements: simultaneous motor-cognitive training, a scoring mechanism and a social play. The dose of exergames ranged from 15 to 60 min per session for at least 8 weeks, with a minimum of two sessions weekly. However, the included studies had a moderate-to-serious risk of bias. The certainty of the evidence was very low.

Conclusion

Exergames could be effective at improving the depressive symptoms of older adults with dementia. Yet, a moderate-to-severe risk of bias shows a rigorous study should be conducted in the future.

Implications for Patient Care

This study provides evidence for healthcare professionals and informal caregivers to use exergames to address depressive symptoms in PWD.

Review Registration

The review was registered on PROSPERO with the reference CRD42022372762.

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运动对痴呆患者抑郁症状的影响：系统回顾和荟萃分析

背景：抑郁症状在痴呆症（PWD）患者中很常见。在研究中，越来越多的研究将游戏中的认知和体能训练结合起来，用于缓解抑郁症状。鉴于其在减轻PWD抑郁症状方面可能具有神经生物学和社会心理协同作用，本综述旨在了解其有效性和内容。方法：这是一项系统的综述，对exergames对老年痴呆患者抑郁症状的有效性进行了评价。于2024年5月7日对中国学术期刊网络出版数据库CINAHL、Embase、PsycINFO、PubMed和CNKI进行了检索。随机对照试验（RCT）和准实验研究的方法学质量分别用RoB2和ROBINS-I进行评估。对纳入的随机对照试验进行荟萃分析。结果：纳入了6项研究，包括4项随机对照试验和2项准实验研究，涉及235名不同阶段痴呆的参与者。meta分析显示抑郁症的整体改善显著且效应量大(SMD = 1.46, 95% CI = -2.50, -0.43；p = 0.006)。尽管异质性很高（I2 = 91%），但所有研究都显示干预后抑郁症有改善的趋势。实验采用的运动游戏包括：同步运动认知训练、计分机制和社交游戏。exergames的剂量范围为每次15 - 60分钟，持续至少8周，每周至少进行两次。然而，纳入的研究有中等到严重的偏倚风险。证据的确定性很低。结论：Exergames可有效改善老年痴呆患者的抑郁症状。然而，中等到严重的偏倚风险表明，未来应该进行严格的研究。对患者护理的启示：本研究为医疗保健专业人员和非正式护理人员使用游戏来解决PWD患者的抑郁症状提供了证据。综述注册：该综述在PROSPERO上注册，参考号为CRD42022372762。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.