Playfulness for Brain Health in Community Settings: Preliminary Analysis from a Systematic Scoping Review to Support Non-Pharmacological Interventions

Abstract

Background: Brain health – defined as stroke, dementia, and their protective factors – becomes more important as lifespan increases. Yet, recent reviews of non-pharmacological interventions in the community suggest that new theory-based approaches may be required (Sikkes et al., 2020). We conduct a scoping review on playfulness as a construct that may support the development of novel non-pharmacological interventions to prevent decline in brain health.

Using Deweyan person-place integration (Cutchin, 2004), we define playfulness as an open, attentive, and fun-loving disposition that may be inhibited or facilitated by one’s environment. We aim to (1) develop a theoretical framework on the person-environmental pathways from playfulness to brain health, (2) critically evaluate the evidence base, and (3) recommend directions and methodologies for future research. This forms part of a preliminary study (NIH Stage 0) toward the development of new interventions.

Methods: We conduct a systematic search on an interdisciplinary database that spans the health, social, and environmental sciences. Conceptualizing playfulness as both a psychosocial and an environmental-behavioral construct, our search strategies included articles with a focus on “brain health” AND “playful” AND “environmental stimuli” or related terms. Documents were screened in two stages by two reviewers per document to identify relevant peer-reviewed journal articles for data extraction and analysis. Titles on adolescents, athletes, autism, gaming behavior, physical rehabilitation, psychological experiments (e.g., Ultimatum Game) and psychosis were excluded.

Results: Systematic search yielded 370 documents. This included 57 documents published in the 2000s, 242 published in the 2010s, 61 in the 2020s, and 10 in the 1970s-90s. Besides articles published in English, 8 articles were published in French, 7 in Chinese, 7 in German, and 5 in other languages. 262 documents remained based on database-provided document type. 59 titles/abstracts were short-listed for full-text review. Preliminary analysis reveals potentially relevant articles from as many as 52 journals ranging from Aging and Mental Health to Technology and Disability, and grew exponentially since 1975.

Conclusions: Playfulness is an important interdisciplinary construct for non-pharmacological prevention of cognitive decline. Subsequent research will solicit the inputs of persons living with dementia from the Community Engagement Advisory Network of a local health authority.