Genes4All: A digital serious game supporting genetic counselling and testing in neurodegenerative disorders

Andrea Miguel¹, Camila Gabriel², Mehmet Kocabey³, Ahmet Okay Caglayan³, Melike Canan Günes³, Maria del Pilar Caro Martinez², Foivos Mastroleon⁴, Asimina Brouzou⁴, Christophoros Vasileiou⁴, Magda Tsolaki⁵_, Maria Mouka⁴, Maria Kofoed⁶, Andreas Jespersen⁶, Marina Makri⁵, Victoria Fernandez^1,7

¹ Research Center and Memory Clinic, Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Spain

² Heidelberg University, Germany

³ Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, Türkiye

⁴ Challedu, Athens, Greece

⁵ Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Makedonia, Greece

⁶ The Danish Committee for Health Education, Copenhagen, Denmark

⁷ CIBERNED

Abstract:

Background:

Genetic counselling and testing in neurodegenerative disorders are increasingly relevant in clinical care, but implementation remains challenging and varies across countries due to differences in healthcare systems, resources, and regulatory frameworks. Patients and relatives face complex decisions regarding genetic testing, risk interpretation, and long-term planning, while access to specialized counselling services is often limited. Clinicians in dementia care frequently lack structured tools to support communication of genetic risk and testing options in routine practice.

Methods:
Genes4All is a 36-month European Erasmus+ project (started October 2024) developing a digitally supported service model for genetic counselling in neurodegenerative disorders. The consortium includes partners from Denmark, Greece, Spain, Germany, and Türkiye, integrating expertise in clinical care, genetics, digital health, and education. The model comprises: (1) a guide for integrating genetic counselling into clinical workflows; (2) a digital serious game to improve genetic literacy and engagement; and (3) an open-access platform supporting understanding of genetic testing, risk, and decision-making. At submission, the project has run ~18 months. A first version of the serious game has been tested with 25 end-users across countries (15 public/relatives, 10 professionals). A second round of piloting is planned for 2026, alongside testing of the digital tool and guide via the project website.

Results:
The project has established the foundations of the Genes4All model and advanced its digital components. The serious game supports understanding of inheritance, genetic testing, risk, and decision-making, while the guide and platform aim to facilitate implementation in clinical settings. Initial user testing assessed usability, comprehension, and relevance for relatives and professionals, informing ongoing refinement

Conclusions:
Genes4All introduces a scalable, digitally supported approach to integrating genetic counselling and testing into dementia care. By combining clinician guidance, digital education, and patient-centred tools, the model may strengthen genetic literacy, support shared decision-making, and improve integration of genetic counselling into care pathways.