Mobile game unearths dementia breakthrough
The first findings from a pioneering dementia study based round a mobile game have been unveiled at the Neuroscience 2016 conference in San Diego, showing that spatial navigation abilities begin to decline from early adulthood.
Developed by Deutsche Telekom, with help scientists including UEA’s Prof Michael Hornberger, Alzheimer’s Research UK and gaming companies, Sea Hero Quest is a multi-platform mobile game developed to create the biggest dementia study in history.
More than 2.4 million people have now taken part in the study since it launched in May 2016, generating over 63 years of gameplay – which equates to over 9,400 years’ worth of equivalent lab-based research in this area. The second largest study of this kind contained just 599 participants.
This research will set new standards in dementia research, establishing the first ever global benchmark for human spatial navigation – a key indicator in the development and diagnosis of dementia.
Prof Michael Hornberger, a professor of applied dementia research in UEA's Norwich Medical School, helped in development of the game. He said: “One of the first effects of dementia is a loss of spatial navigation and that’s why it’s of paramount importance we find out more about how the brain’s spatial navigation abilities, in order to identify what goes wrong during the onset of dementia. The amount of data that has already been generated by people playing Sea Hero Quest all around the world is phenomenal and is enabling us to reveal a vital global benchmark of how people, of all ages and from all over the use spatial navigation."
Dr Hugo Spiers of University College London has been leading the analysis of the anonymous player data. Initial findings presented indicate that spatial navigation abilities begin to decline from early adulthood (sample analysis began at 19) and that they continue on this trajectory across the lifespan (for example, those aged 19 were 74% likely to accurately hit a target during the game, whereas this figure had reduced to 46% amongst those aged 75). This progression is in stark contrast to previous smaller scale studies (sample size circa 100), which had suggested such a decline to be expected in later life.
Brain regions that support spatial navigation processes may be more vulnerable in dementia than those involved in memory. Memory, which is the current gold standard for dementia diagnosis, declines naturally with ageing, making it difficult to determine whether a patient has dementia or poor memory due to getting older. However, becoming completely disoriented in space is rare in healthy ageing patients and very common in those with dementia. Therefore, the spatial navigation benchmark established by Deutsche Telekom’s Sea Hero Quest paves the way to determining the earliest spatial navigational changes, making dementia potentially diagnosable long before someone presents symptoms of general memory loss. In turn, this could enable the diagnosis and treatment of patients far earlier with current and future pharmacological and non-pharmacological therapies.
When analysing completion of the ‘flare levels’ (path integration ability which assesses the ability to point back to the start of a novel route) in the game, men and women appear to have employed different spatial navigation strategies to complete the level.
Key differences across the nations have also been found with several of the Nordic countries (Finland, Sweden, Norway, Denmark) appearing to have particularly noteworthy spatial navigation capabilities across the set of 193 nations of the world contributing to the sample.
Understanding these points of difference is significant as it ensures such factors are accounted for during diagnosis and treatment, potentially leading to greater accuracy and efficacy.
"This is the only study of its kind, on this scale, to date. Its accuracy greatly exceeds that of all previous research in this area," explains Dr Spiers in discussing the game's importance. "The findings the game is yielding have enormous potential to support vital developments in dementia research. The ability to diagnose dementia at early stages, well before patients exhibit any signs of general memory loss, would be a milestone. This study is thus now giving us the opportunity to make a real difference to the lives of millions of people living with dementia and those at risk of developing the disease in the future."
Deutsche Telekom’s Sea Hero Quest will now be used to help both predict the onset of the dementia, as well as influence and track the impact the treatment of those already diagnosed with the condition. This will involve developing a new version of the game to allow for the identification of patients, on a device provided in a clinical setting. Patients will then be able to be tested and matched against the global population, accounting for variations in key demographics. Introducing Sea Hero Quest to a clinical setting allows for the measurement of potential improvements in spatial navigational abilities. It could therefore potentially be used in drug trials to assess the effectiveness of drug treatments.
Hilary Evans, Chief Executive of Alzheimer's Research UK, which is co-funding the analysis of Sea Hero Quest data, said: "These new insights into how humans navigate have only come as a result of a new kind of collaboration in dementia research. A health challenge as complex as dementia demands we approach studies innovatively, and the involvement of Deutsche Telekom proves that forward-thinking partners outside of the traditional research bubble can bring unique and powerful strengths. The early data that has very quickly been generated by Sea Hero Quest should inspire other corporations to consider what assets they might bring to research into dementia or any of our most seemingly intractable medical conditions."
Further analysis of the data is still to be undertaken and is expected to take two years to complete. Later analyses of the research will also assess six other demographics tracked by the game including education level, handedness, self rated spatial navigation ability, the geographical environments in which players grew up, hours of sleep and amount of time spent travelling per day.
The impact of this research now looks set to be a real breakthrough in the battle against dementia, a worldwide epidemic predicted to affect 131 million people by 2050.
The game continues to be available for free download from the App Store and Google Play. And the data it produces are still being provided to participating scientists – and, thus, to the dementia research community.