Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial: A nguera et al.

Anguera, Joaquin A.; Gunning, Faith M.; Areán, Patricia A.

doi:10.1002/da.22588

Cited by 116Digital Mental Health InterventionsEducational Games and GamificationAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial: A nguera et al.

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Anguera, Joaquin A., Gunning, Faith M., Areán, Patricia A.·2017·Depression and Anxiety

DOI 10.1002/da.22588PMC PMC6093618

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Abstract

BACKGROUND: Existing treatments for depression are known to have only modest effects, are insufficiently targeted, and are inconsistently utilized, particularly in older adults. Indeed, older adults with impaired cognitive control networks tend to demonstrate poor response to a majority of existing depression interventions. Cognitive control interventions delivered using entertainment software have the potential to not only target the underlying cerebral dysfunction associated with depression, but to do so in a manner that is engaging and engenders adherence to treatment protocol. METHODS: In this proof-of-concept trial (Clinicaltrials.gov #: NCT02229188), individuals with late life depression (LLD) (22; 60+ years old) were randomized to either problem solving therapy (PST, n = 10) or a neurobiologically inspired digital platform designed to enhance cognitive control faculties (Project: EVO™, n = 12). Given the overlapping functional neuroanatomy of mood disturbances and executive dysfunction, we explored the impact of an intervention targeting cognitive control abilities, functional disability, and mood in older adults suffering from LLD, and how those outcomes compare to a therapeutic gold standard. RESULTS: EVO participants demonstrated similar improvements in mood and self-reported function after 4 weeks of treatment to PST participants. The EVO participants also showed generalization to untrained measures of working memory and attention, as well as negativity bias, a finding not evident in the PST condition. Individuals assigned to EVO demonstrated 100% adherence. CONCLUSIONS: This study provides preliminary findings that this therapeutic video game targeting cognitive control deficits may be an efficacious LLD intervention. Future research is needed to confirm these findings.

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Two proof of concept studies showed that computerized cognitive remediation improved both depressive symptoms and executive functions in late-life major depression and in the DED syndrome more than the comparison conditions.
“Two proof of concept studies showed that such training improved both depressive symptoms and executive functions in late-life major depression179 and in the DED syndrome180 more than the comparison conditions.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [179]
Behavioral treatments can improve executive dysfunction and traits linked to neuroticism in older people.
“increasing evidence suggests executive dysfunction and constructs associated with neuroticism respond to behavioral interventions in older adults15–17.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [16]
In late-life depression, both executive-function computerized cognitive training and problem-solving therapy reduced depression, but only the training improved objective executive performance.
“Anguera et al.16 found that both CCT targeting executive functioning and problem-solving therapy improved depression in LLD, yet only CCT improved performance on objective measures of executive functioning.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [16]
In late-life depression, computerized cognitive training, but not psychotherapy, improved negative self-referential processing; after treatment, training patients endorsed fewer negative self-descriptive words than problem-solving therapy patients.
“Notably, Anguera and colleagues also found that CCT, but not psychotherapy, improved negative self-referential processing in LLD. Patients who underwent CCT endorsed less negative words as describing themselves post-treatment when compared to patients who underwent problem-solving therapy.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [16]
Benefits of computerized cognitive training may generalize beyond the specific cognitive tasks practiced, such as improving untrained measures of attention, reducing negativity bias, and enhancing daily functioning, suggesting far transfer effects.
“Notably, the benefits of computerized cognitive training may generalize beyond the specific cognitive tasks practiced, such as improving untrained measures of attention, reducing negativity bias, and enhancing daily functioning, suggesting far transfer effects152,153.”
From Paying attention to attention in depression (2019) · cites this paper as [152]

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Paying attention to attention in depression
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Next-Generation Cognitive-Behavioral Therapy for Depression: Integrating Digital Tools, Teletherapy, and Personalization for Enhanced Mental Health Outcomes
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A Future Research Agenda for Digital Geriatric Mental Healthcare
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Quantifying attention span across the lifespan
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A digital intervention targeting cognitive control network dysfunction in middle age and older adults with major depression
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Technological State of the Art of Electronic Mental Health Interventions for Major Depressive Disorder: Systematic Literature Review
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A meta-analytic investigation of cognitive remediation for mood disorders: Efficacy and the role of study quality, sample and treatment factors
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Enhancing Spatial Attention and Working Memory in Younger and Older Adults
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Effects of valence and arousal on working memory performance in virtual reality gaming
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The Structural and Functional Neuroanatomy of Post-Stroke Depression and Executive Dysfunction: A Review of Neuroimaging Findings and Implications for Treatment
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State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome
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A novel in-home digital treatment to improve processing speed in people with multiple sclerosis: A pilot study
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Academic stress and first-/third-person shooter game addiction in a large adolescent sample: A serial mediation model with depression and impulsivity
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Assessing Cognitive Function in Multiple Sclerosis With Digital Tools: Observational Study
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The effects of treatment via telemedicine interventions for patients with depression on depressive symptoms and quality of life: a systematic review and meta-analysis
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Application of an Adaptive, Digital, Game-Based Approach for Cognitive Assessment in Multiple Sclerosis: Observational Study
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Strategies to Promote Cognitive Health in Aging: Recent Evidence and Innovations
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Video games as rich environments to foster brain plasticity
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Executive dysfunction and risk of suicide in older adults: a population-based prospective cohort study
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The Feasibility and Potential Impact of Brain Training Games on Cognitive and Emotional Functioning in Middle-Aged Adults
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Cognitive Control Training in Healthy Older Adults: A Proof of Concept Study on the Effects on Cognitive Functioning, Emotion Regulation and Affect
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Applications of Serious Games as Affective Disorder Therapies in Autistic and Neurotypical Individuals: A Literature Review
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Assessing the Impact of a Virtual Reality Cognitive Intervention on Tennis Performance in Junior Tennis Players: Pilot Study
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Top-funded companies offering digital health interventions for the prevention and treatment of depression: a systematic market analysis
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Can Addressing Personality Change Enhance Cognitive Functioning and Delay Development of Mild Cognitive Impairment?
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Mobile Mental Health for Depression Assistance
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Authors: Anguera, J. A., Gunning, F. M., & Areán, P. A.
Affiliations: University of California, San Francisco (US)
Weill Cornell Medicine (US)
University of Washington (US)
Corresponding author: Anguera, Joaquin A.
Areán, Patricia A.
ORCID: Anguera, Joaquin A.
Gunning, Faith M.
Areán, Patricia A.
Venue: Depression and Anxiety
Publisher: Wiley
Published: 2017-01-03
Volume: 34
Issue: 6
Pages: 508-517
ISSN: 1091-4269 (ISSN-L)
DOI: 10.1002/da.22588
PMC: PMC6093618
OpenAlex: W2564280321
Cited by: 116
References: 69
Citations by year: 2026: 8 · 2025: 12 · 2024: 14 · 2023: 14 · 2022: 12 · 2021: 18 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 5 · 2016: 1 · 2015: 1
FWCI: 11.27
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: doi.wiley.com/10.1002/tdm_license_1 (tdm)
onlinelibrary.wiley.com/termsAndConditions (vor)
Locations: Depression and Anxiety (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Mental Health (K24MH074717)
Topics: Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: geriatric depression, cognitive control, therapeutic video games, older adults, problem-solving therapy, executive dysfunction, working memory, attention, negativity bias, medication adherence, mood improvement, functional disability
MeSH terms: Proof of Concept Study, Aged, Aging, Cognition Disorders, Depressive Disorder, Female, Humans, Male, Problem Solving, Therapy, Computer-Assisted, Video Games, Executive Function

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Improving late life depression and cognitive control through the use of therapeutic video game technology: A proof-of-concept randomized trial: A nguera et al.

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