Driving video game reverses age-related mental decline

Car racing video games usually appeal to youngsters more than their grandparents. That could change if the results of a new study prove to be persuasive. A team led by Adam Gazzaley report that older adults aged 60 to 85 who played a customised driving video game called "NeuroRacer" didn't just get better at the game with sustained practice, they also improved on other mental tasks tapping memory and attention that decline with age. What's more, the researchers found these cognitive benefits correlated with changes to the electrical activity of the brain, as recorded by EEG.

On the surface, these results appear to represent the "holy grail" of brain training whereby practice on one kind of mental task leads to benefits that generalise to other aspects of mental performance (hopefully with real-life beneficial consequences). The study breaks the recent trend for negative headlines prompted by research and meta-analyses that suggested brain training (especially working memory training) benefits consistently fail to transfer. In April the New Yorker put it starkly – "brain games are bogus".

The multi-task version of NeuroRacer involves two elements: using a control pad to keep a car in the centre of a winding road, while simultaneously responding to the intermittent appearance of shapes on the screen. Players have to press a button as quickly as possible if a green circle appears, but withhold responding to any other shapes. An initial experiment with 174 participants aged 20 to 79 showed that performance on the game declines linearly across the life-span, with a particularly notable drop between the twenties and thirties.

To test the effects of training, Gazzaley and his colleagues invited 16 older participants to play on this multi-task version of NeuroRacer for one hour a day, three days a week, for four weeks. As they improved, the game got harder. The participants' performance was tested at baseline, after training and again six months later. The key measure was how much performance on each element (driving or shape identification) diminished when the two tasks featured together compared with when they were tested on their own.

The researchers' witnessed dramatic improvements in their elderly volunteers. After the training, the participants were better able to perform both elements of the game at once (in fact they now outperformed 20-year-old newcomers to the game), and this improvement was sustained after six months without play. Most exciting of all from a brain training perspective, the participants also showed post-training improvements on computer tasks that depend on working memory (mentally juggling information) and sustained attention.

These gains were not shown by two control groups of older adults. One group trained on the two NeuroRacer game elements (driving and shapes) separately. Their performance improved on these individual elements when presented on their own, but their performance on the multi-task version of the game did not improve, and they didn't show any other cognitive gains. Another control group completed no training, and they too failed to show improvements on the multi-task version of the game or other cognitive gains.

The behavioural results are supplemented by brain wave recordings taken while the participants played the game. Only the group who completed training on the multi-task version of the game showed post-training changes in two neural markers – increased midline theta frontal activity (thought to indicate increased cognitive control) and increased functional connectivity between frontal and posterior brain regions. A follow-up study showed that prior to training, these two neural markers were diminished in older adults compared with younger adults, but post-training, the older adults brains' showed similar activity to the younger group.

Gazzaley and his colleagues said their effect sizes for the benefits of the multi-tasking training were "medium to large" for both the behavioural changes and the neural measures. "The sustained multitasking cost reduction over time and evidence of generalisability to untrained cognitive control abilities provide optimism for the use of an adaptive, interference-rich, video game approach as a therapeutic tool for the diverse populations that suffer from cognitive control deficits (e.g. ADHD, depression, dementia)," the researchers concluded.

These results are certainly promising, and the combination of behavioural and neural measures is admirable, but there are several reasons for skepticism. Although the study featured an "active" control group who trained on the separate elements of the game, the researchers made no attempt to measure their participants' expectations about the likely effects of the different forms of training. It's possible training on the multi-task version of the game led to greater expectations of mental benefits, and this could have formed the basis for a larger placebo effect.

Related to this, there's no mention in the study of whether the researchers who interacted with the participants were blind to the study aims or to which condition each participant had been allocated to. This means it is possible researchers may have inadvertently instilled greater motivation and confidence in the participants in the multi-tasking training condition.

Another thing – we're not given any information on whether the participants were drivers in real life. But assuming a large number were, an obvious question is why the multi-task challenge of the video-game led to benefits above and beyond the likely far more intense multi-task challenge of real-life driving? The power of participant expectations and researcher enthusiasm could provide part of the answer (the way game difficulty adapted to player performance is another likely factor). As well as the small sample size, one further limitation of this new research is the lack of any measure of whether and how the video-game training benefits affected the participants in their everyday lives.

Further reading

J. A. Anguera, J. Boccanfuso, J. L. Rintoul, O. Al-Hashimi, F. Faraji, J. Janowich, E. Kong, Y. Larraburo, C. Rolle, E. Johnston, and A. Gazzaley (2013). Video game training enhances cognitive control in older adults. Nature: 10.1038/nature12486