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Cognitive self-rehabilitation lacks updated means and tools. The purpose of this paper is to evaluate the effect of cognitively simulating mobile games on the cognitive skills and recreation of older people with memory impairment.

Mobile games that require cognitive skills were developed. The games were tested by memory-impaired older adults, average age of 90. Gaming interventions took place for three months on a daily basis. Game outcomes were automatically recorded and user feedback was collected by interviews. The progress of the testees was also evaluated by means of Trial Making Test A.

Improvement in game scores was found. Other significant effects of game play were enhanced recreation and self-managed activity level. Game play did not have any effect on the traditional Trail Making Test results but the results of the Trail Making game showed improvement. The Trail Making game also showed a large variance in daily scores, which implies that performing just a single Trail Making Test might lead to misreading a person's condition.

The results are an encouragement for conducting further testing (on a larger test group, over a longer time) and continuing with game development for cognitively impaired older adults. A similar game trial will also be arranged for a younger population with better overall health condition.

New business opportunities are also possible in game development and gaming services.

Games have the potential for self-rehabilitation and to support extending independent living at home.

The paper provides a synopsis of novel cognitive recreation tools, an analysis of their effect and user feedback from professional staff as well as potential new ideas for game developers.

This paper aims to adapt and computerize the Trail Making Test (TMT) to support long-term self-assessment of cognitive abilities.

The authors propose a divide-and-combine (DAC) approach for generating different instances of TMT that can be used in repeated assessments with nearly no discernible practice effects. In the DAC approach, partial trails are generated separately in different layers and then combined to form a complete TMT trail.

The proposed approach was implemented in a computerized test application called iTMT. A pilot study was conducted to evaluate iTMT. The results show that the instances of TMT generated by the DAC approach had an adequate level of difficulty. iTMT also achieved a stronger construct validity, higher test–retest reliability and significantly reduced practice effects than existing computerized tests.

The preliminary results suggest that iTMT is suitable for long-term monitoring of cognitive abilities. By supporting self-assessment, iTMT also can help to crowdsource the assessment processes, which need to be administered by healthcare professionals conventionally, to the patients themselves.

Current Army doctrine stresses a need for military leaders to have the capability to make flexible and adaptive decisions based on a future unknown environment, location and enemy. To assess a military decision maker’s ability in this context, this paper aims to modify the Wisconsin Card Sorting Test which assesses cognitive flexibility, into a military relevant map task. Thirty-four military officers from all service branches completed the map task.

The purpose of this study was to modify a current psychological task that measures cognitive flexibility into a military relevant task that includes the challenge of overcoming experiential bias, and understand underlying causes of individual variability in the decision-making and cognitive flexibility behavior of active duty military officers on this task.

Results indicated that non-perseverative errors were a strong predictor of cognitive flexibility performance on the map task. Decomposition of non-perseverative error into efficient errors and random errors revealed that participants who did not complete the map task changed their sorting strategy too soon within a series, resulting in a high quantity of random errors.

This study serves as the first step in customizing cognitive psychological tests for a military purpose and understanding why some military participants show poor cognitive flexibility.

There are many cognitive training tests purporting to both measure older people’s cognitive performance, several of which come with associated training that are deemed to improve cognition. This chapter describes cognitive tests that have been claimed to be linked to driver behaviour, and that training on them could improve driver behaviour. Of special interest are tests that could be completed at home on a computer, as it is suggested this could capture many individuals who are worried about attending a driver assessment centre and are not likely to be referred. Findings suggest that UFOV (Useful Field of View) Time Making Trail (A and B) and Dual N have research suggesting that training on them could improve driver performance for older drivers. However, the robustness of the research is debateable. There are also two physiological tests – a neck and shoulder and a general fitness test that also show promising results for improving driver performance. In addition, education and training is purported to improve driver behaviour, but although there is positive feedback from older people who attend and some short-term improvements, research on long-term improvements on driver behaviour are not yet evident. Overall, there are promising results from individual cognitive, physiological tests and from education and training suggesting that reflection on action and feedback from the task is important to improving driver performance but more research is needed.

The purpose of this paper is to report a pilot experiment to test if multi-player online video games could provide a measurable cognitive therapeutic benefit for brain-injured people.

Single-subject research design with n=3 brain-injured participants. Four alternating intervention and non-intervention weeks. Battery of cognitive tests taken at the start of the experiment and at the end of each week.

Widely varying results with large standard deviation overall.

The experimental design was heavily reliant on multiple participants logging in at the same time. Server logs showed that this happened relatively rarely.

Implications for the next iteration of the experiment are to refine the game design to avoid the need to synchronise the participants. The findings presented may be of practical use to other researchers in this area.

Acquired brain injury has been described as an epidemic, and is rising, with stroke being a leading cause. Traumatic brain injury (e.g. due to road traffic accident) has increasing prevalence in low-middle income countries. This research aims to provide a form of therapy to people for whom physical access to rehabilitation services is limited.

The use of multi-player online video games as rehabilitation is a relatively unexplored area. A positive result in an experiment of this nature would indicate the potential for a new, complimentary form of cognitive therapy for brain-injured people.

Describes how a large ammonia release exposed about 150 nearby residents to this irritating gas and sent seven to hospital emergency rooms. Six weeks later the 41 most symptomatic people completed questionnaires and had physical examinations. The 12 most impaired had subsequent neurobehavioral testing to see if exogenous ammonia was toxic to the brain as is endogenous ammonia in hepatic coma. Spirometry was used to test pulmonary function. Frequencies of 35 symptoms were obtained by questionnaire, as were medical, respiratory and neuropsychiatric histories and data on previous chemical exposures. Comparisons were made with unexposed subjects after adjusting for age, sex, educational level and other determining factors. The exposed group’s mean values were significantly abnormal for simple and choice reaction, balance with eyes open, color discrimination, visual field performance in both eyes and hearing. Also abnormal were cognitive performance on Culture Fair, digit symbol, vocabulary and delayed but not immediate verbal recall. Making trails A and B was slow and fingertip number writing had excessive errors. Spirometric measurements were normal. Confounding features and biases were minimal. Exposure to ammonia, for a few minutes to several hours, was associated with neurobehavioral impairment measured after 22 months. Thus inhaled ammonia shares the toxicity of endogenous ammonia. Effects were persistent and are probably permanent.

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive function and sociodemographic, clinical and incarceration characteristics.

All prisoners aged 60 years and older of five prisons in North Rhine-Westphalia, Germany, were asked to participate. The cognitive screening instruments mini-mental state examination (MMSE) and the DemTect were used to assess global cognition. Executive functions were tested with the trail making test and the frontal-assessment-battery. The Patient Health Questionnaire (PHQ-9) was used to assess participants’ affective state.

The sample of this study consisted of 58 prisoners with a mean age of 65.52 years (standard deviation = 6.03); 82.8% are male. Using the MMSE with age- and education-corrected z-scores, 36.9% of the prisoners showed marginal or impaired global cognition scores. Using the DemTect, 41.4% of the prisoners were classified as being cognitively impaired. Up to 40% of the prisoners showed deficits in executive functioning and around 60% of the prisoners showed depressive symptoms. The correlation analysis revealed significant associations between cognitive scores and age (rho = –0.335, p = 0.014), education (rho = 0.309, p = 0.020), sentence duration (rho = 0.409, p = 0.007) and duration of current incarceration (rho = 0.302, p = 0.043). The DemTect total score was significantly associated with the PHQ-9 (rho = –0.335, p = 0.016).

A large group of the prisoners showed a higher prevalence of cognitive dysfunction than that observed in same-age people who are not incarcerated. Taken together, there is an urgent need for an adequate management of older cognitively impaired prisoners including routine cognitive testing and guidelines-oriented treatment of cognitive symptoms.

This study has several strengths. To the best of the authors’ knowledge, this is the first study examining the cognitive and affective state in a German prison population. The authors considered female and male prisoners, as well as different prison settings, representing a realistic prison sample. The authors used several neuropsychological instruments to get a more detailed insight into the older prisoners’ cognitive status while trying to consider the economy of time and possible attention deficits to prevent dropouts during testing.

Electroconvulsive therapy (ECT) is effective in the treatment of treatment-resistant major depression. The fear of cognitive impairment after ECT often deters patients from choosing this treatment option. There is little reliable information regarding the effects of ECT on overall cognitive performance, while short-term memory deficits are well known but not easy to measure within clinical routines. In this pilot study, we examined ECT recipients' pre- and post-treatment performances on a digital ascending number tapping test. We found that cognitive performance measures exhibited good reproducibility in individual patients and that ECT did not significantly alter cognitive performance up to 2 hours after this therapy was applied. Our results can help patients and physicians make decisions regarding the administration of ECT. Digital measurements are recommended, especially when screening for the most common side effects on cognitive performance and short-term memory.