Some simple computer games can improve the control of the evolution of the cognitive capacity of people with a high risk of suffering from Alzheimer's. And not only that. Based on the results they offer, treatments could also be customized. This is established by a study, published in iScience, which has been led by the Institut Hospital del Mar d'Investigacions Mèdiques and the Barcelonaβeta Brain Research Center, a research center of the Pasqual Maragall Foundation.
The tool has been tested with 56 volunteers who have a diagnosis of subjective cognitive decline, that is, who have begun to perceive (for at least six months) memory failures "and who are somewhat worse than their acquaintances of the same age" explains to La Vanguardia Natàlia Soldevila, the first author of the publication -in which the CIBER de Fisiopatologia de l'Obesitat i la Nutrició (CIBEROBN) has also collaborated- and a researcher at the Hospital del Mar Research Institute. These people were playing a panel of 36 games (designed by the NeuronUP company) for 12 months in three weekly sessions of 30 minutes. Based on the data obtained, the researchers claim that they were able to control the evolution of their cognitive performance very precisely.
The current tests, they argue, do not offer this speed in obtaining data. Not that level of precision either. In addition, they have what is called a learning effect. "They cannot be done very often because, otherwise, the subject remembers them," explains Soldevila. "You have to wait a minimum of six months so that the person does not remember the dynamics of the game." On the contrary, the level of these games is adjusted to the individual: if he does very well, increase the difficulty; if it makes it worse, go down. "By adjusting for each individual's level, we can remove this learning effect from the equation."
In addition, the fact that it is played from home, in a family environment, also eliminates the stress factor that does occur in traditional tests, which are completed in the clinic, underlines Dr. Laura Forcano, a researcher at Hospital del Mar. Research Institute and CIBEROBN.
Another advantage of this tool, according to the researchers, is its greater sensitivity compared to traditional tests. The latter are insufficient to detect changes in people who are cognitively well, "and that is a problem because these subjects, yes, are cognitively well, but they are at risk of suffering from dementia such as Alzheimer's," says Soldevila.
The researchers defend that the tool will allow, if implemented, to adapt the intervention in the future. "The neurologist could be monitoring these people and notify them in case they see that their cognition is declining to evaluate them well and decide on treatment."
Study participants had to meet two requirements. One, having a diagnosis of subjective cognitive decline; Two, being carriers of the APOE4 allele, which is a genetic variation. “It is known that this variation, type 4, is a very relevant factor in Alzheimer's disease. It does not mean that all people who have this allele will develop this pathology, but if you have one with this variation (we receive one allele from the father and another from the mother) you have double the risk, and if you have both you have 5 times more" .
For this group, Soldevila maintains, there are currently no treatments "because research has focused on more advanced stages of the pathology." The problem, he adds, is that "when a clear diagnosis of impaired cognition can be made, it is already very difficult to reverse it."
The tool has been validated from 56 participants, and will now be applied to all the volunteers (129, in which those 56 are included) that are part of the PENSA study. This study aims to test the effect of a lifestyle intervention on the cognition of these people. This intervention includes the implementation of the Mediterranean diet, physical activity and cognitive training. "The participants already played these games for their cognitive stimulation, and we have taken advantage of the fact that they already had this tool as part of the treatment to monitor performance by a health professional."
Soldevila stresses that it is already known, thanks to previous studies, that intervention in lifestyle improves cognition. That is why his research not only affects lifestyle, but also the intake of a supplement, in the form of a pill, which comes from green tea and contains a compound called epigallocatechin gallate. "Not everyone responds the same when you intervene in their lifestyle, and we intend to improve that effect with this green tea compound, so that it benefits more people."
This molecule "has been extensively studied in the context of Down syndrome and good results have been seen." There is also a lot of evidence - Soldevila continues - that this molecule works in animal models. It is as a result of these previous results that the researchers have decided to test it, for the first time, in people with a high risk of suffering from dementia. It is expected that, shortly, they will be able to have the definitive results of this investigation.
