Can a game help detect Alzheimer’s?

Making your way through a winding waterway? Steering your boat through a maze? Finding treasure after a long voyage? Sounds like something out of a pirate movie, but these scenarios are actually part of a game available on phones that scientists have been using to test players for early signs of Alzheimer’s disease.

A study conducted by the University of East Anglia and University College London and published in the journal PNAS has found that the video game may help detect who is at risk for Alzheimer’s disease by focusing on the cognitive function of spatial navigation.

The video game called Sea Hero Quest sends people on an adventure, asking them to steer their boat through a virtual waterway maze to reach the final ending point. There are obstacles and checkpoints, tasks to complete throughout the levels and challenging paths to maneuver.

The research looked at more than 27,000 records of players between the ages of 50 and 75. The results showed that those who were genetically at greater risk for Alzheimer’s disease, by having a copy of the APOE4 gene, were easily distinguished from those in a lower risk, non-APOE4 group, by their performance in the game.

With Alzheimer’s and dementia affecting nearly five million people, discovering those at risk of the disease even earlier on can help them take preventative steps before the disease ever sets in.

Dr. Darren Gitelman, a neurologist and the senior medical director of the Advocate Memory Center at Advocate Lutheran General Hospital in Park Ridge, Ill., says several studies in recent years have shown that spatial navigation and orientation deficits may be a more specific way to differentiate Alzheimer’s disease from other types of dementia.

“Spatial navigation is a set of behaviors that allow us to navigate through the world. This includes activities such as knowing where the kitchen is from the bedroom in one’s own house, to finding our way to work each morning,” he says. “A more complex scenario might be finding one’s way to work (without the help of GPS) after being detoured due to construction. It also includes such abilities as translating between a map and the real world.”

Dr. Gitelman says studies show that deficits in spatial navigation may be an early sign of Alzheimer’s for those at risk, even when they do not have other clinical symptoms.

“The brilliant idea of these authors was to embed a cognitive testing tool in a (fun-to-play) game and to use a platform (mobile phone) that people are familiar with and have with them all the time, which allows for millions of people to participate and for the researchers to gather data about every aspect of ‘game’ play,” he says. “The data was then used for well-designed scientific studies.”

Dr. Gitelman believes tests of spatial navigation like this game could be used to evaluate patients but would like to see more tests on individuals.

“The data reported was on large groups of subjects and not individuals,” he adds. “Thus, it still is not clear how sensitive the game is at an individual level and how long one has to play the game to get enough data for diagnostic purposes.”

According to the Alzheimer’s Association, the following are some early signs of Alzheimer’s disease to look for:

1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, at work or in leisure
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Dr. Gitelman says exercise, a healthy diet, engaging in mental exercises and avoiding tobacco and alcohol could help reduce your dementia risks.

He recommends that if you or a loved one are experiencing any of these symptoms, talk with your primary care physician and ask for a more in-depth evaluation of memory if symptoms are out of the ordinary and/or interfere with daily life.

Here’s a quick look at how the game works: