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Summary
Conventional cognitive assessment is based on a pencil-and-paper neuropsychological evaluation, which is time consuming, expensive and requires the involvement of several professionals. Information and communication technology could be exploited to allow the development of tools that are easy to use, reduce the amount of data processing, and provide controllable test conditions. Serious games (SGs) have the potential to be new and effective tools in the management and treatment of cognitive impairments in the elderly. Moreover, by adopting SGs in 3D virtual reality settings, cognitive functions might be evaluated using tasks that simulate daily activities, increasing the "ecological validity" of the assessment. In this commentary we report our experience in the creation of the Smart Aging platform, a 3D SG- and virtual environment-based platform for the early identification and characterization of mild cognitive impairment.
KEY WORDS: dementia, mild cognitive impairment, neuropsycho- logical assessment, serious games, virtual reality
Introduction
Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia (Petersen et al., 2001a,b; Petersen et al., 2009; Gauthier et al., 2006; Scott and Barrett, 2007). Current conceptualiza- tions of MCI recognize different subtypes, based on the presence or absence of memory impairment, namely amnestic (aMCI) and non-amnestic (naMCI). These, in turn, may represent the prodromes of different demen- tia types: patients who present with single-domain naMCI can progress to non-AD dementing conditions such as frontotemporal dementia, whereas multiple- domain naMCI can progress to Lewy body dementia or vascular dementia (Jak et al., 2009; Petersen et al., 2009). Patients with aMCI often progress to AD with an annual rate of conversion of approximately 10-15%, compared with a rate of about 1-2% in healthy controls (Schmidtke and Hermeneit, 2008).
Since there is not, as yet, a cure for dementia, strate- gies designed to modify its onset or progression could have a significant impact. Research is, indeed, now focusing on the identification of at-risk populations, as the early recognition of MCI opens up potential new targets for therapeutic interventions: early diagnosis offers the best opportunity to understand the disease progression, to begin long-term planning, and ulti- mately to implement a treatment regimen (Lopez et al., 2005; Weimer and Sager, 2009; Emery, 2011). Despite this, as the symptoms are often subtle and patients maintain their...