ArticleJMIR serious games2021
Dissecting Digital Card Games to Yield Digital Biomarkers for the Assessment of Mild Cognitive Impairment: Methodological Approach and Exploratory Study.
Article in JMIR serious games, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02971124 (Observational Study to Assess Cognitive Performance in Elderly Life Via Meaning Play), which is not on this map. Cited by 10 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Observational Study to Assess Cognitive Performance in Elderly Life Via Meaning Play
Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- Early identification of cognitive impairment in older adults from Advanced Activities of Daily Living (AADL): A scoping review.Public health · 2025Article
- Video Games and Gamification for Assessing Mild Cognitive Impairment: Scoping Review.JMIR mental health · 2025Article
- Smartphone- and Tablet-Based Tools to Assess Cognition in Individuals With Preclinical Alzheimer Disease and Mild Cognitive Impairment: Scoping Review.Journal of medical Internet research · 2025Article
- Definitions of digital biomarkers: a systematic mapping of the biomedical literature.BMJ health & care informatics · 2024Review
- Multidimensional digital biomarker phenotypes for mild cognitive impairment: considerations for early identification, diagnosis and monitoring.Frontiers in digital health · 2024Article
- The Development of Game-Based Digital Mental Health Interventions: Bridging the Paradigms of Health Care and Entertainment.JMIR serious games · 2023Article
- A scoping review of neurodegenerative manifestations in explainable digital phenotyping.NPJ Parkinson's disease · 2023Article
- Feasibility of common, enjoyable game play for assessing daily cognitive functioning in older adults.Frontiers in neurology · 2023Article
- Digital Cognitive Biomarker for Mild Cognitive Impairments and Dementia: A Systematic Review.Journal of clinical medicine · 2022Review
- Digital Biomarkers in Psychiatric Research: Data Protection Qualifications in a Complex Ecosystem.Frontiers in psychiatry · 2022Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMild cognitive impairment (MCI), the intermediate cognitive status between normal cognitive decline and pathological decline, is an important clinical construct for signaling possible prodromes of dementia. However, this condition is underdiagnosed. To assist monitoring and screening, digital biomarkers derived from commercial off-the-shelf video games may be of interest. These games maintain player engagement over a longer period of time and support longitudinal measurements of cognitive performance.
objectiveThis paper aims to explore how the player actions of Klondike Solitaire relate to cognitive functions and to what extent the digital biomarkers derived from these player actions are indicative of MCI.
methodsFirst, 11 experts in the domain of cognitive impairments were asked to correlate 21 player actions to 11 cognitive functions. Expert agreement was verified through intraclass correlation, based on a 2-way, fully crossed design with type consistency. On the basis of these player actions, 23 potential digital biomarkers of performance for Klondike Solitaire were defined. Next, 23 healthy participants and 23 participants living with MCI were asked to play 3 rounds of Klondike Solitaire, which took 17 minutes on average to complete. A generalized linear mixed model analysis was conducted to explore the differences in digital biomarkers between the healthy participants and those living with MCI, while controlling for age, tablet experience, and Klondike Solitaire experience.
resultsAll intraclass correlations for player actions and cognitive functions scored higher than 0.75, indicating good to excellent reliability. Furthermore, all player actions had, according to the experts, at least one cognitive function that was on average moderately to strongly correlated to a cognitive function. Of the 23 potential digital biomarkers, 12 (52%) were revealed by the generalized linear mixed model analysis to have sizeable effects and significance levels. The analysis indicates sensitivity of the derived digital biomarkers to MCI.
conclusionsCommercial off-the-shelf games such as digital card games show potential as a complementary tool for screening and monitoring cognition.
trial registrationClinicalTrials.gov NCT02971124; https://clinicaltrials.gov/ct2/show/NCT02971124.
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