JMIR Publications

ABSTRACT

Background:

Exergames have been shown to enhance physical and cognitive performance in older adults, including those with mild neurocognitive disorder (mNCD). In-game metrics generated from user interactions with exergames can facilitate personalized training by capturing real-time performance and enabling individualized adjustments.

Objective:

To identify valid game metrics for measuring in-game domain-specific cognitive performance during exergaming, and to explore game metric performance changes over time during a twelve-week exergame-based training intervention in individuals with mNCD.

Methods:

Data was collected from individuals with mNCD who participated in a home-based exergame intervention that was particularly supervised by study investigators. A cross-sectional analysis was conducted by correlating collected game metrics with standardized neurocognitive reference assessments within the neurocognitive domains trained in the exergames. Additionally, a longitudinal analysis was conducted with visual and curve-fitting analyses to explore game performance changes over time.

Results:

Data was collected from 31 participants. Six out of eighteen game metrics, covering the domains of learning and memory, executive function, and visuospatial skills, were identified as valid indicators for in-game cognitive performance during exergaming. The longitudinal analysis revealed a general trend of initial improvement followed by a plateau and high inter-individual variability of the performance curves.

Conclusions:

The study demonstrated that a selection of game metrics may serve as valid indicators of in-game domain-specific cognitive performance during exergaming. Metrics that reflect the precision of responses may be better indicators for cognitive performance during exergaming than metrics reflecting the speed of responses, highlighting the importance of selecting valid game metrics for implementation in exergame designs. Further research is needed to explore the potential of game metrics and to identify factors contributing to individual variability of in-game performance and performance progression as well as identifying and adopting strategies that facilitate individual learning success and, thus, facilitate effectiveness in improving cognitive (and physical) performance.