Scientists develop early detection video game for Alzheimer’s and dementia symptoms

Paz Rey Duarte hasn’t been able to get the message out of her head for 24 hours: “possible risk detected.” Although she hasn’t been formally diagnosed by a doctor, the 73-year-old woman with impeccable grey hair is now convinced that she has Alzheimer’s. “For some time now, I’ve noticed that I forget the simplest things,” she says, adjusting a cotton shawl she wears around her neck to combat the Atlantic coastal chill in her home town of Vigo, in the northwestern region of Galicia in Spain. She can’t remember, for example, the title or author of the book that she’s reading, nor the name of the medication she’s taken every day for months. “I’m worried,” she says.

The senior enrolled in preventative programs at the Association of Relatives of Alzheimer’s and Other Dementia Patients of Galicia (AFAGA) after retiring. At first, before her memory problems became apparent, it was like being a member at a social club for seniors. But just one day before speaking with EL PAÍS, Paz found out that she was at risk of becoming one of the 40,000 new Alzheimer’s cases that are diagnosed every year in Spain, of which 65% are women. The warning didn’t come via a specialist, but rather, a video game.

Rey is a user in the pilot program of The Mind Guardian, an application developed by scientists from the atlanTTic Research Center at the University of Vigo and the Translational Neuroscience group at the Galicia Sur Health Research Institute, in collaboration with Samsung. The South Korean corporation, which financed the project and provided technical and business resources, has so far invested a total of $27 million in its Technology with Purpose program, which applies technological innovation to solving social problems.

The application, which is free and recommended for people over the age of 55, became available on March 11 for Android users in Spain. The Mind Guardian is a screening tool, meaning that it does not offer medical diagnosis as such, but rather, employs three different artificial intelligence techniques and a variety of games in order to analyze its users. Based on the results of tests for episodic, procedural and semantic memory, it determines possible cognitive impairment. The project has been endorsed by the Spanish Society of Neurology and the Spanish Society of Psychiatry and Mental Health.

Rey was identified as a “person at risk” by the app, which suggested that she had two options: consult an expert for a more in-depth diagnosis, and/or wait six months and repeat the app’s tests to see if any change took place. She believes that her best plan of action is to be alert to possible symptoms and ask for advice on habits that could slow the progress of what is, for now, likely cognitive decline.

Made in Galicia

The seed for The Mind Guardian was planted on a hillside in the Spanish parish of Zamanes, just outside the city of Vigo. There, surrounded by oaks, pines, and chestnut trees often damp with the region’s famous rainfall, are located the atlanTTic Research Center laboratories. And it is there that university telecommunications professor Luis Anido has spent years building bridges between neuroscience and technology.

In 2014, with the rates of dementia among the elderly in Galicia on the rise, Anido and his team discovered that, contrary to what one might assume, video games were a very effective way of engaging older adults with technology. And so they set about studying the possibilities of combining gamification and artificial intelligence techniques with medical tests, in order to create an instrument that could measure the cognitive deterioration of users with a certain degree of clinical validity.

In this spirit was born Panoramix, a series of video games that was designed to identify possible neurological disorders in their early stages, when symptoms are not yet evident. The different games are based on the conventional tests used in hospitals and clinics to measure memory capacity and attention. The project began to be tested on AFAGA patients, and yielded conclusive results: 97.1% statistical accuracy in the detection of cognitive impairment.

In the middle of these tests and experiments, Anido received the news that his 88-year-old mother had been diagnosed with Alzheimer’s. His professional work had become irrevocably personal.

“She doesn’t remember me anymore,” says the researcher, leaning on a railing that overlooks the university’s campus, a rugged and barren landscape awaiting the return of spring. He adds, “I don’t remember what she was like before the disease, either. Sometimes I watch family videos from other times, so that I can.” His mother’s Alzheimer’s is already past the point of no return. All that remains is to try to improve her quality of life. But the application that Anido and his colleague, Manuel José Fernández — who says, with complete confidence, that Alzheimer’s is “the pandemic of the future” — have developed could indeed make a difference in the lives of others.

“When she got sick,” recalls the scientist, “my mother wasn’t aware of her own decline. We, her children, had to make all decisions concerning her life and treatment. She lost her freedom. The video game could allow other people to stay a few steps ahead of the disease and plan out their lives for the next few years.” Having the ability to do that kind of planning is, without a doubt, the best reason to download The Mind Guardian.

Timely warnings

The office of Carlos Spuch at the Galicia South Health Research Institute is located on the ground floor of the Álvaro Cunqueiro Hospital. It’s a functional, contemporary building with a façade of enormous metallic slats that overlooks the Vigo estuary. Here, Spuch monitors and reports on the state of neurodegenerative diseases among the aging population of Galicia, where more than 26% of inhabitants are over 65 years old. The area is an open-air laboratory for the study of brain disorders of the elderly. “The key with these diseases is early detection. Diagnosis usually occurs when symptoms are already quite evident and it is too late,” says the neurologist.

Spuch has participated in the scientific evaluation process for The Mind Guardian, collaborating on its clinical studies of patients who have been diagnosed with cognitive decline in order to determine the reliability of the application. “It was the first time I had seen how a technological system could be put at the service of researching neurological disease and I found it interesting,” he says. The value of the tool, according to Spuch, is that it places easy-access early detection within reach of the elderly. “If you wanted to apply the same tests to a patient that are applied through The Mind Guardian, it would require a two-hour consultation with a trained professional. But this allows them to be carried out very easily, at home, in 45 minutes and through playing a game,” he says. In addition, playing the app in a quiet and comfortable environment can avoid “white coat syndrome,” which refers to how test results can be skewed from patients making more mistakes due to being uneasy or stressed in hospital environments.

If their results from playing the app warn of signs of possible cognitive deterioration, users can take that report directly to their doctor to undergo a more thorough diagnosis. “It’s a message that you have to change some habits,” explains Spuch. To slow down deterioration, people can increase their amount of exercise, avoid ultra-processed foods and, above all else, socialize. “Social activity is what makes the difference in terms of cognition,” says Spuch. “The worst thing a person with cognitive impairment can do is isolate themselves.”

Seventy-three-year-old Rey’s experience seems to prove the veracity of that theory. “What I most enjoy about belonging to AFAGA groups is the social aspect. I don’t know if it will work [to stave off cognitive decline], but if it’s based on us having a good time, we’re having a good time.” She also says that if something is going on inside her brain, she wants to know about it, “to see if there is some kind of preventative medicine that I could be missing out on because I’m afraid of test results. I prefer to be conscious of what I’m going to face and be prepared for it,” she says, smiling.

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