A game-based app for phones and tablets called Project: EVO seems to help
older adults with depression feel better by targeting underlying cognitive
conditions, such as attention and focus, according to two recent studies.
“We found that moderately depressed people do better with
apps like this because they address or treat correlates of depression,” says
Patricia Areán, a University of Washington School of Medicine researcher in
psychiatry and behavioral sciences.
The first study enrolled older adults diagnosed with
late-life depression into a treatment trial where they were randomized to
receive either receive treatment using the app or an in-person therapy technique
known as problem-solving therapy (PST).
The results, published in the journal Depression and Anxiety,
show that the group using Project: EVO demonstrated specific cognitive benefits
(such as attention) compared to the behavioral therapy, and saw similar
improvements in mood and self-reported function.
Joaquin A. Anguera, a University of California, San
Francisco (UCSF), researcher in neurology and psychiatry, is the lead author,
and Areán is the senior author. The researchers have no commercial interests in
the intervention manufactured by Akili Interactive Labs in Boston.
“While EVO was not directly designed to treat depressive
symptoms; we hypothesized that there may indeed be beneficial effects on these
symptoms by improving cognitive issues with targeted treatment, and so far, the
results are promising,” says Anguera.
People with late-life depression (60+) are known to have
trouble focusing their attention on personal goals and report trouble concentrating
because they are so distracted by their worries. Akili’s technology was
designed to help people better focus their attention and to prevent people from
being easily distracted.
Arean says most of the participants had never used a
tablet, let alone played a video game, but compliance was more than 100
percent. The participants were required to play the game five times a week for
20 minutes, but many played it more.
Participants in this arm of the study also attended
weekly meetings with a clinician. The meetings served as a control for the fact
that participants in the problem-solving therapy arm were seen in person on a
weekly basis, and social contact of this nature can have a positive effect on
mood.
Results from the
second study
In another study, researchers randomized more than 600
people across the United States who were assessed as moderately or mildly
depressed to one of three interventions: Project EVO; iPST, an app deployment
of problem-solving therapy; or a placebo control (an app called Health Tips,
which offered healthy suggestions).
Areán, the lead researcher on the study published in
the Journal of Medical
Internet Research, found that people who were mildly depressed were
able to see improvements in all three groups, including the placebo. However,
those individuals who were more than mildly depressed showed a greater
improvement of their symptoms following their use of Project EVO or iPST versus
the placebo.
Areán says much of her research is aimed at providing
effective treatment to people who need it, and these results provide great
potential for helping people who don’t have the resources to access effective
problem solving therapy. But, she stresses, the apps should be used under clinical
supervision because without a human interface, people were not as motivated to
use it. In the second study, 58 percent of participants did not download the
app.
Akili’s technologies are based on a proprietary
neuroscience approach developed to target specific neurological systems through
sensory and digital mechanics. The company’s technology platform used in this
trial is based on cognitive science exclusively licensed from the lab of Adam
Gazzaley at UCSF, and adaptive algorithms developed at Akili, which are built
into action video game interfaces. The technology targets an individual’s core
neurological ability to process multiple streams of information.
Project: EVO is undergoing multiple clinical trials for
use in cognitive disorders, including Alzheimer’s disease, traumatic brain
injury, and pediatric attention deficit hyperactivity disorder (ADHD).
