Playfulness for Brain Health in in Mid- & Late-Life: Scoping Review to Support Preventive Non-Pharmacological Interventions Across the Lifespan

Abstract

Objective(s) To support the development of novel non-pharmacological interventions to prevent cognitive decline in mid-life, this paper examines playfulness as a psychosocial-ecological construct among community-dwelling adult populations. This study evaluates the evidence base for its impact on brain health components, and develops a preventive framework with inputs from older adults in community. Based on Deweyan person-place integration (Cutchin, 2004), playfulness is defined as an open, attentive, and fun-loving disposition which may be inhibited or facilitated by one's environment. Data Sources We conducted systematic search on an interdisciplinary database. Search strategies included peer-reviewed journal articles with a focus on “brain health” AND “playful” AND “environmental stimuli” or related terms. We did not limit the search by language or time of publication. Study Selection Titles on adolescents, athletes, psychological experiments (e.g., Ultimatum Game), and psychosis were excluded. Articles were not excluded on the basis of methods or quality. Multiple reviewers screened and selected the articles in stages, stating reasons for exclusion. 43 articles (11.6%) were selected out of initial results of 370 documents. Data Extraction Data were extracted independently by multiple observers for each article, following PRISMA-Sc guidelines. Study design, analytic methods, sample population, setting, and findings on playfulness domains and brain health components were tabulated. Study limitations and implications were analyzed. Articles were not assessed for quality per scoping review methods. Data Synthesis Preventive interventions for brain health may be conceptualized as a “runway” with different focus across the lifespan. Playfulness domains included sports and culture (including exergames) (n=14), social environment (n=15), brain games and stimuli (n=14). More intensive interventions (e.g., exergaming) received more attention. Brain health components included various aspects of cognition (including MRI), mood (e.g., depression, agitation), and social health (e.g., lonely SNPs). Conclusions Playfulness is an important interdisciplinary construct for non-pharmacological prevention of cognitive decline. The resultant “Brain Health Runway” framework promotes low-intensity primary prevention through everyday lifestyle in mid-life, and more intensive secondary interventions in later life. Future research on sports and culture could focus on their cognitive impacts.