Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 7, 2022
Date Accepted: Jul 29, 2022
Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials
ABSTRACT
Background:
Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental healthcare. However, there is a lack of evidence regarding the effects of serious games on depression in older adults.
Objective:
This study aimed to investigate the characteristics and effectiveness of serious games on depression in older adults.
Methods:
A systematic review and meta-analysis of randomized controlled trials were conducted. Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify eligible studies published until July 6, 2021. Two reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appreciative Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) using the random effect model.
Results:
Seventeen studies with 1280 older adults were included in the systematic review, and fifteen studies were included in the meta-analysis. Serious game interventions are classified into three types: games for physical activity, games for cognitive function, and virtual reality games. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD -0.54, 95% CI: -0.79, -0.29, P<.001). Serious games were found to have a more significant effect size in community or home settings (SMD -0.61, 95% CI: -0.95, -0.26, P<.001), than in hospital settings (SMD -0.46, 95% CI: -0.85, -0.07, P=.02); however, the difference between groups was not significant. Additionally, games for physical activity had a significant effect on reducing depression in older adults (SMD -0.60, 95% CI: -0.91, -0.28, P<.001). However, there was no significant correlation between the duration or number of serious games and depression.
Conclusions:
We found that serious games are beneficial in reducing depression in older adults. Regardless of the study setting, serious games appear to reduce depression. Particularly, games for physical activity have a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence of the effectiveness of serious games on older adults’ depression.
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Copyright
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