Sions, multiple factors to be considered in making decisions, and ill-defined and apparently contradictory contingencies resulting from decisions (Schooler, 1984). The cognitive demand associated with engaging in complex activities may be neuroprotective by decreasing neuronal loss, increasing synaptic connectivity, up-regulating neurotropic factors, or modifying disease pathology (Valenzuela et al., 2007). These processes contribute to a higher level of brain or cognitive reserve that may compensate for aging- or pathologyrelated (e.g., vascular, neurodegeneration) brain changes so that cognitive abilities are preserved (Stern, 2012). Interactive video games are a novel tool to impart cognitive stimulation because they require players to integrate multiple cognitive processes while navigating complex and variable environments (Green and Bavelier, 2008). For example, attentional resources (visual, switch, and divided), processing speed, visuospatial and visuo-motor abilities (Green and Bavelier, 2004) are required to play video games in general, and additional cognitive processes (e.g., executive functions) can be tapped for specific games. In addition, interactive video games can be a source of social stimulation when played with others and can also increase physical activity (Peng et al., 2011). The Nintendo WiiTM has the advantages of being commercially available, older adult friendly, and accommodating to those with mobility impairments. The Wii Sports game package, including bowling, golf, tennis, baseball, and boxing, is particularly popular among older adults. The familiarity of these sports games combined with novelty of the interactive video gaming experience may be an ideal cognitive intervention for those with mild impairments in cognition. While thereInt J Geriatr Psychiatry. Author manuscript; available in PMC 2015 September 01.Hughes et al.Pageare preliminary reports of gains in cognitive functioning among cognitively normal older purchase BUdR adults who have engaged in interactive video games (Jovancevic et al., 2012; Maillot et al., 2012; Rosenberg et al., 2010), it is unclear whether those with MCI will be interested in, capable of, or show cognitive benefit from interactive video gaming. The purpose of this study was to examine the feasibility of a group-based interactive video gaming randomized controlled trial (RCT) in older adults with MCI drawn from the community. We also explored its potential efficacy to improve cognitive performance compared to a health education condition that was matched for social interaction and served as a source of passive cognitive stimulation. We hypothesized that (1) Wii gaming would be feasible, and (2) there would be greater gains in the clinical outcomes in the Wii group, compared to health education group, due to the novelty of the experience and the higher cognitive demands required for playing the games.NIH-PA Author ManuscriptParticipantsMETHODSParticipants were Resiquimod web recruited from an ongoing population-based cohort study of MCI, entitled the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study, composed of older adults originally recruited from the voter registration list. MYHAT participants undergo an annual comprehensive in-home assessment that includes a neuropsychological assessment battery sensitive to mild cognitive impairments and change in cognitive functioning over time (Ganguli et al., 2009). In addition to the conventional MCI criteria, MYHAT also applies a “Cognitive Classificati.Sions, multiple factors to be considered in making decisions, and ill-defined and apparently contradictory contingencies resulting from decisions (Schooler, 1984). The cognitive demand associated with engaging in complex activities may be neuroprotective by decreasing neuronal loss, increasing synaptic connectivity, up-regulating neurotropic factors, or modifying disease pathology (Valenzuela et al., 2007). These processes contribute to a higher level of brain or cognitive reserve that may compensate for aging- or pathologyrelated (e.g., vascular, neurodegeneration) brain changes so that cognitive abilities are preserved (Stern, 2012). Interactive video games are a novel tool to impart cognitive stimulation because they require players to integrate multiple cognitive processes while navigating complex and variable environments (Green and Bavelier, 2008). For example, attentional resources (visual, switch, and divided), processing speed, visuospatial and visuo-motor abilities (Green and Bavelier, 2004) are required to play video games in general, and additional cognitive processes (e.g., executive functions) can be tapped for specific games. In addition, interactive video games can be a source of social stimulation when played with others and can also increase physical activity (Peng et al., 2011). The Nintendo WiiTM has the advantages of being commercially available, older adult friendly, and accommodating to those with mobility impairments. The Wii Sports game package, including bowling, golf, tennis, baseball, and boxing, is particularly popular among older adults. The familiarity of these sports games combined with novelty of the interactive video gaming experience may be an ideal cognitive intervention for those with mild impairments in cognition. While thereInt J Geriatr Psychiatry. Author manuscript; available in PMC 2015 September 01.Hughes et al.Pageare preliminary reports of gains in cognitive functioning among cognitively normal older adults who have engaged in interactive video games (Jovancevic et al., 2012; Maillot et al., 2012; Rosenberg et al., 2010), it is unclear whether those with MCI will be interested in, capable of, or show cognitive benefit from interactive video gaming. The purpose of this study was to examine the feasibility of a group-based interactive video gaming randomized controlled trial (RCT) in older adults with MCI drawn from the community. We also explored its potential efficacy to improve cognitive performance compared to a health education condition that was matched for social interaction and served as a source of passive cognitive stimulation. We hypothesized that (1) Wii gaming would be feasible, and (2) there would be greater gains in the clinical outcomes in the Wii group, compared to health education group, due to the novelty of the experience and the higher cognitive demands required for playing the games.NIH-PA Author ManuscriptParticipantsMETHODSParticipants were recruited from an ongoing population-based cohort study of MCI, entitled the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study, composed of older adults originally recruited from the voter registration list. MYHAT participants undergo an annual comprehensive in-home assessment that includes a neuropsychological assessment battery sensitive to mild cognitive impairments and change in cognitive functioning over time (Ganguli et al., 2009). In addition to the conventional MCI criteria, MYHAT also applies a “Cognitive Classificati.
