JMIR Publications

ABSTRACT

Background:

Game based cognitive assessments (GBCAs) have the potential to transform the field of cognitive testing by enabling more effective screening of age-related cognitive decline. However, we lack a strong understanding of the usability and overall user experience of these games. This is a risk because the primary target users for GBCAs, older people, are seldom involved in game design research and development.

Objective:

This review attempts to address this gap by investigating the usability, acceptability and enjoyability of GBCAs for older people.

Methods:

This study followed established practices for undertaking evidence-based systematic reviews.

Results:

The initial database search returned 15,232 records. After a thorough screening process, eight studies remained for extraction and analysis. A synthesis of the included papers identified two overlapping yet distinct areas of focus: system usability and subjective user experience. Usability scores were mostly positive across the studies included. However, in several of the game studies, older and cognitively impaired participants tended to find GBCAs less usable. This trend was found even when games were explicitly designed for older and impaired users, and tasks were simplistic and representative of basic daily activities. In our second focus area, user experience, we identified the importance of perceived challenge in mediating gameplay experience across groups. That is, getting the difficulty level just right seems essential to a good user experience, specifically enjoyment.

Conclusions:

Through this review we have identified key learnings for researchers interested in designing and developing GBCAs. These include: (a) validity is very necessary but not sufficient; (b) clarify the intended user; (c) create games that align with the unique preferences and needs of older people; and (d) wherever possible, always provide each user their optimal challenge. Clinical Trial: Prospero ID: CRD42023433298