UConn Health Shares Federal Grant for Clinical Trial to Determine if Video Games Can Relieve Depression in Older Adults

University of Utah Health and UConn Health scientists have received a five-year, $7.5-million grant from the National Institute of Mental Health (NIMH) for a two-site study to test whether a web-based intervention that resembles a video game can alleviate depression in older adults in the comfort and safety of their own homes.

The researchers are recruiting 250 volunteers, ages 60-85, who still feel depressed after receiving treatment for their illness to participate in the study. At UConn Health, the plan is to enroll 100 older adults with major depression, some of who may be taking antidepressant medications but still have depression symptoms.

The project is led by Dr. Sarah Shizuko Morimoto of the University of Utah; UConn Health’s participation is led by Dr. David Steffens, professor and chair of psychiatry at UConn Health.  The two researchers began working together several years ago and have collaborated on her innovative line of research, UConn Today recently reported.

“This novel, computer-based intervention trains key areas of the brain to better problem-solve and manage emotions,” says Steffens. “Initial studies indicate that it may help both mood and cognition in older depressed adults.  We hope to confirm these findings in this two-site study at UConn Health and the University of Utah.”

Depression in older adults is common, underdiagnosed, and undertreated, leading to disability, cognitive decline, and poor health outcomes. If patients have cognitive deficits and depression, they are two times less likely to respond to antidepressant medication. University of Utah Health researchers have developed an intervention that aims to reduce depression and cognitive impairment in older adults by improving the functions of brain regions that may have become damaged due to the aging process.

In previous research, the scientists found that 60­–70% of older patients who were unable to benefit from antidepressant medications and who played specially designed video games reported a 50% decline in depressive symptoms in just 30 days. Study participants were also better able to remember word lists than those in a control group, suggesting playing the games improved their brain function.

The new trial seeks to confirm these results on a larger scale and provide additional evidence that late-life depression with cognitive deficits shares a common neural circuitry that can be optimized by Neuroflex, a non-invasive, non-pharmaceutical set of specialized video games. Neuroflex is a digital solution that appears to not only relieve depressive symptoms but also improve cognitive function, Morimoto says.  Some evidence suggests that Neuroflex games may work by repairing damaged circuits in the brain’s frontal lobe, which seem to reduce the effectiveness of antidepressant medication.

Dr. Kevin Manning, associate professor of psychiatry at UConn Health also uses Morimoto’s interventions Neurogrow and Ultimate Word Master for his K23 Career Development Award funded by the NIMH. Ultimate Word Master is a word game where participants must determine how different words are similar and match in certain categories of various complexity.  With Manning’s research, the games are used remotely by providing research participants with a tablet to use at home.

“Up to 60% of late-life patients who take antidepressants, such as fluoxetine (Prozac) or Sertraline (Zoloft), do not respond to these medications,” says Sarah Shizuko Morimoto, PsyD., leader of the new clinical trial and an Associate Professor of population health sciences at University of Utah Health. “Based on cognitive tests, we suspect that’s because parts of the brain are less functional due to aging and, when exposed to stress, do not allow older patients to bounce back as effectively as they may have when they were younger. These are the same brain structures that respond to antidepressants.”

Morimoto formed a collaboration with the University of Utah Therapeutic Games and App Lab (GApp Lab) to create Neurogrow, a video game in which players plant and tend to a virtual flower garden. Tasks include watering, fertilizing, and eliminating pesky bugs. Players get points for each of these activities. As they advance from level to level, the tasks get more complex. As a result, participants improve their attention, working memory, processing speed, and focus.  Another game, Think+, motivates players to focus on positive images and other affirmative stimuli to shift their attention from negative thoughts.

Steffens, who began working with Morimoto several years ago and will be the primary investigator at the UConn Health site, has been funded by the NIH for over twenty-five years. His research focuses on links between late life depression and subsequent cognitive decline and development of dementia. Assessments include structural and functional brain imaging, neuropsychological testing, blood work for peripheral markers and genetics, personality assessment, functional status, and measures of stress and social support.  He has also developed a clinical geriatric mental health service that focuses on assessment and treatment of anxiety, depression and cognitive disorders in the elderly. 

He became chair of UConn Psychiatry in July, 2012, after more than 20 years at Duke University School of Medicine, where he had served as a professor of psychiatry, vice chair for education and division chief of Geriatric Psychiatry in the Department of Psychiatry and Behavioral Sciences. Dr. Steffens is the past president of the American Association for Geriatric Psychiatry, has authored more than 300 peer-reviewed papers and is the co-editor of the leading textbook in geriatric psychiatry.

Additional information about the clinical trial, or to learn more, call 801-587-1288.