The diagnosis of dementia turns the world upside down not only for the victim, but also for his relatives, as brain functions gradually deteriorate. Affected persons lose the ability to plan, remember things, or behave properly. At the same time, their motor skills deteriorate. Ultimately, dementia patients can no longer cope with daily life alone and need comprehensive care. In Switzerland alone, more than 150,000 people share this fate, and an additional 30,000 new cases are diagnosed each year.
To date, all attempts to find a cure for this disease have failed. Dementia, including Alzheimer’s disease, the most common of several forms of dementia, remains incurable. However, a clinical study in Belgium with ETH researcher Eling de Bruen showed for the first time that cognitive motor training improves both the cognitive and physical skills of patients with severely impaired dementia. The study used a fitness game known as Exergame, developed by ETH subsidiary Dividat.
Improving cognitive ability through exercise
In 2015, a team led by ETH researcher Patrick Eggenberger showed that older people who exercise their body and mind simultaneously exhibit better cognitive abilities and thus can prevent cognitive impairment (as reported by ETH News). However, this study was conducted only in healthy people.
“For some time, it was assumed that physical and cognitive training also had a positive effect on dementia,” explains de Bruyne, who worked with Eggenberger at the Institute for Human Movement and Sports Sciences at ETH Zurich. “However, in the past, it has been difficult to motivate people with dementia to engage in physical activity for extended periods of time.”
ETH Extra Income Combines Exercise And Fun
To change this, Eva van Het Reeve, a former ETH graduate student, founded the ETH subsidiary Dividat in 2013 with her research supervisor Eling de Bruin and another doctoral student. “We wanted to develop a personalized learning program that would improve the lives of older people,” says van Het Reeve. Fun exercises were developed to encourage people already suffering from physical and cognitive impairments to participate in training, and thus the Senso training platform was born.
The platform consists of a game software screen and a floor panel with four fields that measure steps, weight offset and balance. Users attempt to perform a sequence of leg movements as shown on the screen, allowing them to train both physical movement and cognitive function at the same time. The fact that fitness play is also enjoyable helps motivate subjects to exercise regularly.
Eight-week training for patients with dementia
An international team led by Natalie Swinnen, a doctoral student at KU Leuven and co-led by ETH researcher de Bruyen, recruited 45 subjects for the study. The subjects were residents of two Belgian nursing homes, averaging 85 years of age at the time of study, all with severe dementia symptoms.
“The participants were randomly divided into two groups,” explains de Bruyne. “The first group trained for 15 minutes with Dividat Senso three times a week for eight weeks, and the second group listened and watched music videos of their choice.” After an eight-week training program, the physical, cognitive and mental abilities of all subjects were measured compared to the start of the study.
Regular play has an effect
The results give hope to dementia patients and their families: training on this simulator really improved cognitive skills such as attention, concentration, memory and orientation. “For the first time, there is hope that through purposeful play we will be able to not only delay but also reduce the symptoms of dementia,” emphasizes de Bruijn.
It is particularly striking that over the eight-week period, the performance of the control group deteriorated further, while the training group recorded significant improvements. “These very encouraging results are in line with expectations that dementia patients are more likely to deteriorate without training,” adds de Bruyne.
But play training not only has a positive effect on cognitive ability – researchers have also been able to measure positive effects on physical performance, such as reaction time. After just eight weeks, subjects in the training group responded significantly faster, while those in the control group worsened. This is reassuring, as the speed at which older adults respond to impulses is critical in determining whether they can avoid falling.
Better understanding of brain processes
A research group led by de Bruen is currently working to replicate the results of this pilot study in people with mild cognitive impairment, the precursor to dementia. The goal is to use MRI to more closely examine the neural processes in the brain responsible for cognitive and physical improvement.
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