A diagnosis of dementia turns the world upside down, not only for the person affected but also for their loved ones, as brain function gradually declines. Those affected lose the ability to plan, remember things, or behave appropriately. At the same time, their motor skills also deteriorate. Ultimately, patients with dementia lose their autonomy , are no longer able to manage daily life on their own and require comprehensive care. In Italy, the total number of patients with dementia is estimated at over 1 million (of which about 600,000 with Alzheimer's dementia ) and about 3 million people are directly or indirectly involved in their care.
To date, all attempts to find a drug to treat this disease have failed. Dementia, including Alzheimer's , the most common of several forms of dementia, remains incurable. However, a clinical study conducted in Belgium with the involvement of ETH Zurich researcher Eling de Bruin demonstrated for the first time that motor cognitive training improves both the cognitive and physical abilities of patients with significantly disabling dementia . An exergame was used in the study , a genre of video game that also performs a function of physical exercise, developed by the spin-off of ETH Zurich Dividat .
Improve cognitive ability and prevent dementia through training
In 2015, a team of scientists led by ETH Zurich researcher Patrick Eggenberger showed that older people who train both body and mind simultaneously demonstrate better cognitive performance and can therefore also prevent cognitive impairment. However, this study was only conducted on healthy subjects. “ It has long been suspected that physical and cognitive training also has a positive effect on dementia, ” explains de Bruin, who worked with Eggenberger at the Institute for Human Movement Sciences and Sports at ETH Zurich. "However, in the past it has been difficult to motivate patients with dementia to engage in physical activity for prolonged periods ."
The importance of combining exercise and fun
With the aim of changing this situation, Eva van het Reve, a former doctoral student at ETH Zurich, founded the spin-off Dividat in 2013 together with her doctoral supervisor Eling de Bruin and another doctoral student. “We wanted to design a personalized training program that would improve the lives of older people,” says van het Reve. Fun exercises were developed to encourage people who already had physical and cognitive problems to participate in training, and the Senso training platform was born.
The platform consists of a screen with the game software and a floor panel with four fields that measure steps, weight shift and balance. The goal of the users is to attempt to complete a sequence of movements with the feet as indicated on the screen , simultaneously training both physical movement and cognitive function. The fact that the game is also fun makes it easier to motivate subjects to practice regularly .
Eight weeks of training for patients with dementia
An international team led by Nathalie Swinnen, PhD student at KU Leuven, and co-supervised by ETH Zurich researcher de Bruin, recruited 45 subjects for the study. The subjects were resident in two Belgian nursing homes, with an average age of 85 years at the time of the study, and all with symptoms of severe dementia. “The participants were divided into two groups on a random basis,” explains de Bruin. "The first group trained for 15 minutes with the Dividat Senso three times a week for eight weeks, while the second group listened and watched music videos of their choice." After the eight-week training program, the physical, cognitive and mental capacity of all subjects was measured from the start of the study.
The results offer hope to patients with dementia and their relatives: training with this tool has in fact improved cognitive skills , such as attention, concentration, memory and orientation. “For the first time, there is hope that through targeted play we will be able not only to delay but also to weaken the symptoms of dementia,” de Bruin points out. It is particularly surprising that the control group further deteriorated during the eight-week period, while significant improvements were recorded in the training group . “These highly encouraging results are in line with the expectation that patients with dementia are more likely to get worse without training,” adds de Bruin.
Investigate the neural processes responsible for cognitive and physical improvement
But playful training doesn't just have a positive impact on cognitive abilities – the researchers were also able to measure positive effects on physical capacity, such as reaction time. After just eight weeks, the subjects in the training group reacted significantly faster, while the control group got worse . This is encouraging as the speed at which older people respond to impulses is critical in determining whether they can avoid a fall.
The research team led by de Bruin is currently working to replicate the results of this pilot study with people with mild cognitive impairment , a precursor to dementia. The goal is to use MRI scans to more closely investigate the neural processes in the brain responsible for cognitive and physical enhancement.