Can Card Games Be Used to Assess Mild Cognitive Impairment?: A Study of Klondike Solitaire

This research investigates the potential of Klondike Solitaire as a nonintrusive, longitudinal screening tool for mild cognitive impairment (MCI). The study aims to bridge the gap between traditional, brief clinical screening tests—which are often hampered by practice effects and patient stress—and the natural, frequent gameplay patterns of older adults. By mapping specific in-game actions to established cognitive functions, the authors propose a method for assessing cognitive health through everyday digital engagement.

The methodology involved a structured analysis conducted by three health professionals from a university hospital memory clinic, including a neuropsychologist, a geriatrician, and a clinical psychologist. The researchers identified 22 distinct, unambiguous player actions within Klondike Solitaire and mapped them against 10 cognitive functions, such as attention, executive function, memory, and object recognition. The reliability of this mapping was validated through statistical analysis, yielding an average intraclass correlation of 0.79.

Key findings indicate that attention, executive function, object recognition, abstraction, and memory are the cognitive domains most strongly correlated with Solitaire gameplay. Qualitative feedback from the participating health professionals confirmed that the game offers a unique, low-effort format for cognitive monitoring that avoids the practice effects associated with formal testing. While the experts noted that it remains difficult to isolate specific cognitive deficits due to the intertwined nature of the game’s demands, they concluded that the tool is highly promising for screening purposes. Future research is intended to refine the mapping of these actions and expand the scope of the study to include a broader range of cognitive functions and a larger cohort of health professionals.