Playing video games may enrich hippocampal memory function in seniors

Abstract

Healthy aging is accompanied by a steady cognitive decline with clear losses in memory. Animal studies have consistently demonstrated that simply modifying an animal’s living environment (known as environmental enrichment) can have a positive influence on age-related cognitive decline in the hippocampus. Previously, we showed that playing immersive 3D video games can improve hippocampal-based memory in young healthy adults, suggesting that the exploration of the large open worlds of modern-day video games may act as proxy for environmental enrichment in humans. Here, we replicated our previous video game study in healthy older adults, showing that playing video games for four weeks can improve hippocampal-based memory in a population that is already experiencing age-related decline in memory. Furthermore, we showed that the improvements last for up to four weeks past the intervention, highlighting the potential of video games as intervention for age-related cognitive decline.

Introduction

Healthy aging is closely associated with a reduction in hippocampal structure and function [[1], [2], [3], [4]]. Nevertheless, studies in animals have shown that the aged hippocampus still retains a certain amount of plasticity that is susceptible to influence by the surrounding environment [5]. Environmental enrichment traditionally describes an experimental manipulation where an animal’s environment is enhanced to promote cognitive, physical, social, and other sensory stimulation [6]. Despite the simplicity of this manipulation, environmental enrichment has been repeatedly shown to provide numerous structural and functional benefits to the hippocampus [7]. Importantly, environmental enrichment has been shown to improve both structural and cognitive deficits associated with aging, such as increased neurogenesis [[8], [9], [10], [11]], dendritic branching and spine density [12], expression of presynaptic proteins [9,13,14], neurotransmitter release [10], enhanced long-term potentiation and depression [15,16], and related hippocampus-dependent behaviors [8,10,11]. Whether the benefits of environmental enrichment are due to physical activity [[17], [18], [19]], spatial exploration [20], learning [21,22], or other aspects of the environment [[23], [24], [25]], the surrounding environment can have a significant impact on the aging hippocampus of animals.

While the effects of environmental enrichment on aging are well defined in animals, it is less clear how this manipulation relates to humans, especially considering that humans already live in an enriched environment compared to the standard laboratory rodent [7]. It is generally thought that leading a physically and cognitively active lifestyle is critical for healthy aging [26]. Several studies have demonstrated that engaging in novel activities [27], directed cognitive training [28], physical exercise [[29], [30], [31]], and a combination of cognitive training, physical exercise, social experience, and diet [[32], [33], [34], [35]] can have a positive impact on age-related cognitive decline in humans. There are clear parallels between enrichment in human and animal studies, suggesting that despite the differences, interactions with the environment can have a meaningful impact on brain structure and function.

Previously, we showed that playing immersive 3D video games could improve hippocampal-based memory in young adults [36]. The Mnemonic Similarity Task (MST) serves as our metric for hippocampal function as it was designed to tap into the hippocampal-dependent process of pattern separation and has previously been demonstrated to be sensitive to hippocampal function and age-related changes in the hippocampus [[37], [38], [39], [40]]. In animals it has repeatedly been shown that exposure to an enriched environment has a widespread effect on hippocampal function, consistent with an overall improvement in hippocampal memory (i.e., MST performance) in humans [7] following a video game intervention.

There are long-standing relationships between the hippocampus and spatial memory [41,42] and between spatial exploration and environmental enrichment in animals [20]. In our prior work [36], we capitalized on these to hypothesize that the spatial exploration provided by the vast open worlds of modern day video games can provide a human proxy for environmental enrichment. The goal of the present study was to determine if the improvements in hippocampal-based memory we observed with video game training in young adults would translate to an aged population, whom already experience age-related decline in hippocampal function.

We made several modifications to the current intervention to adapt to an older population. Similar to our previous study [36], participants played Angry Birds or Super Mario 3D World on a Nintendo Wii U. However, in place of a no-contact control, we employed an active control condition of playing computer-based Solitaire. Even though we did not observe an effect of playing Angry Birds in a younger population, we suspected that this condition might produce a benefit simply because the older adults in this study had no prior experience with modern video games or use a Nintendo Wii U. One element of enrichment that has been described in the animal literature is the fact that enriched environments provide a certain amount of novelty and learning experiences to the animal that can influence the hippocampus [21,22]. Thus, there was a possibility that we would observe effects of learning within our Angry Birds group simply by virtue that playing any video game could provide a rich, novel experience for them. For this reason, the Solitaire condition provided us with a control where participants actively played a game that they were familiar with. Thus, we examined the effect of playing Super Mario 3D or Angry Birds compared to the active control condition of playing Solitaire. In addition, to allow for the potentially slower learning of the game dynamics in older adults, we extended the amount of video game play from 2 to 4 weeks based on previous work suggesting that 10?20 hours of gameplay was needed to observe effects on cognition.

Section snippets

Participants

We initially recruited 56 older adults (60–80 years of age) to participate in our intervention. Of these, five participants were excluded prior to the analysis: three participants scored more than three standard deviations below the average on the recognition metric of the MST (prior to condition assignment) and two did not play the video game for the entire duration of the study (one from Angry Birds and one from Super Mario) as determined by the Wii U which kept track of playing time. In

Training on Super Mario 3D World led to improvements in hippocampal-based memory compared to Solitaire

We had previously observed that playing Super Mario led to improvements in hippocampal-based memory in younger adults [36]. Therefore, our primary endpoint in this study was to determine if playing the video game Super Mario 3D World had a similar effect in older adults. We entered the LDI metric of the MST into a repeated-measures 2 × 4 ANOVA (Geisser-Greenhouse correction) to assess hippocampal-based memory across Super Mario and Solitaire at four time points (Pre, Post1, Post2, Post3). We

Discussion

We tested the hypothesis that playing immersive 3D video games might act as a proxy for environmental enrichment and improve hippocampal-based memory in older adults. We found that older adults who participated in a novel video game intervention (Super Mario 3D World) for 4 weeks showed improved performance on an independent hippocampal-based memory task that persisted for up to four weeks after completion of the intervention. These findings, largely consistent with our previous study in young

Conclusion

We showed that a four-week video game intervention in older adults can improve hippocampal-based memory measured with the MST and may extend to the Rey-O. In conjunction with our previous work, we have shown that these video game interventions are practical, short (4 weeks) with a low daily commitment (～30 min/day), can be done remotely at home, and are effective. These studies highlight a real potential of using video games as a therapeutic intervention for age-related cognitive decline.

Funding

This research was supported by a grant from the?Dana Foundation. In addition, we would like to acknowledge support for participant recruitment from the?UCI ADRCP50AG016573?and for additional salary support from NIA R21AG056145 and NIA R01AG034613.

CRediT authorship contribution statement

Gregory D. Clemenson:?Conceptualization, Methodology, Software, Data curation, Formal analysis, Writing - original draft.?Shauna M. Stark:?Supervision, Conceptualization, Methodology, Writing - review & editing.?Samantha M. Rutledge:?Data curation.?Craig E.L. Stark:?Conceptualization, Methodology, Writing - review & editing.

Declaration of Competing Interest

None of the authors have any conflicts of interest to declare.

Article Original Link:?https://www.sciencedirect.com/science/article/abs/pii/S0166432820303661

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