Background: In all types of dementia, cognitive abilities are affected, behaviour is altered and functional capacity is progressively lost. This cognitive deterioration manifests in the decrease of abilities required to perform the activities of daily living (ADL). The objective of this pilot study was to assess the effect of an Occupational Therapy programme based on the training of ADL through cognitive stimulation on the independence of ADL of persons with dementia. Methods: Institutionalized older adults with major neurocognitive disorder or dementia (N = 58) were randomly allocated to receive either the Occupational Therapy ADL cognitive stimulation programme or conventional Occupational Therapy. The cognitive level and the independence level performing ADL were measured at baseline (week 0), after 5 weeks of treatment (week 5) and after 6 weeks of follow up (week 12). A value of p < 0.05 and α = 0.0025 (Bonferroni correction) was considered as statistically significant. Results: The results obtained showed improvements in the level of independence performing ADLs in the intervention group compared to the control group (p = 0.006). The improvements were seen in relation to feeding (p = 0.001), dressing (p = 0.005) and bladder and bowel incontinence (p = 0.003), the changes observed in feeding are statistically significant. However, those improvements were not maintained after the follow up period. There were no significant changes in relation to the cognitive level (p = 0.741). Conclusions: Occupational Therapy based on ADL cognitive stimulation can have a positive effect, increasing the independence of subjects with major neurocognitive disorder or dementia who are institutionalised.

La demencia es una enfermedad de carácter crónico y curso degenerativo que afecta de un amplio modo a la función cognitiva (capacidad de procesar el pensamiento). Debido al aumento de la esperanza de vida y a los avances técnicos en el campo de la medicina, nos encontramos ante un escenario en el que se estima que en el año 2030 el número de personas con demencia alcance los 82 millones, llegando a 152 millones en 2050 (1). Para su tratamiento se han utilizado terapias farmacológicas de éxito cuestionable. En los últimos años, los “serious games” se han abierto paso como una alternativa en el tratamiento de la demencia. Existe una abundante y diversa investigación en relación a este tema. Sin embargo, se hace necesaria una mayor homogeneidad en cuanto al diseño de las intervenciones se refiere, así como de las variables utilizadas, que facilite el futuro de la investigación en dicho campo. Por otro lado, queda patente la necesidad de la presencia de profesionales como los Terapeutas Ocupacionales en dichas investigaciones, los cuales pueden aportar una visión más amplia del impacto de la enfermedad en las distintas áreas ocupacionales, haciendo especial hincapié en el área del juego (2), el cual está recogido en su marco de trabajo para la práctica profesional. En esta revisión sistemática, analizamos artículos que comprenden el uso de “serious games” en el tratamiento de la demencia extrayendo los pros y contras, y sugiriendo pequeños cambios que pueden mejorar la investigación en dicho campo.

BACKGROUND Cognitive stimulation of older people helps to prevent, and even treat, age-related diseases, such as Mild Cognitive Impairment. Playing games reduces the probability of suffering from this pathology related to the loss of the ability to carry out some instrumental activities of daily living. OBJECTIVE This work describes the design and development of a serious game for the cognitive stimulation of the elderly with exercises related to the daily life task of shopping, presenting also a pilot study for its preliminary usability validation. METHODS The designed serious game includes four exercises consisting of shopping in a hypermarket, ordering products, payments and organizing the purchase, dealing thus with the most frequent cognitive problems of elderly associated to episodic declarative memory, naming, calculation and organization, respectively. RESULTS 19 older people participated in the pilot study for the usability validation of the serious game, indicating that they like the aesthetic and interesting topic of the game. It has a high level of entertainment and could be useful in daily life for mental stimulation. It is intuitive, but the ease of use and readability of the instructions could be improved. CONCLUSIONS This study suggests that the innovative serious game developed could be accepted by older people for their cognitive stimulation in order to prevent or treat Mild Cognitive Impairment, although a long-term intervention test should be performed. Its ecological validity design with everyday tasks, adaptable level of difficulty and motivational mechanisms include a differentiating factor compared to similar serious games.