JMIR Publications

ABSTRACT

Background:

In face of an increasing treatment need of persons with dementia, effective and efficient interventions with a focus on quality of life need to be established. In this context, Serious Games have received increasing attention. However, there is a lack of applications specifically designed for people with dementia.

Objective:

In the current prospective pilot study, we examined the usability of a newly developed Serious Game app (“Digimenz”).

Methods:

43 persons with cognitive impairment and mild to severe dementia completed the repeated-measures study procedure. Participants were recruited on an inpatient geriatric psychiatric ward and in a long-term-care facility. Each participant played three Serious Games (experimental conditions) and spent time reading a newspaper (control condition). Data on app-usability was collected through self-ratings and observation. We analyzed differences in usability regarding the conditions, the cognitive capacity and the recruitment sites.

Results:

The Serious Games were accepted in both settings (long-term-care: 100% interested, psychiatric ward: 76% interested), although study completion was lower in the psychiatric sample (37%) than in the long-term-care sample (93%). The global usability was rated good (System Usability Scale global mean: 79). More severely impaired patients had more pronounced difficulties in learning how to play the games (ρMMSE, Learnability=-0.61, P<.001) and playing them alone (ρMMSE, Support=-0.49, P<.001). Nevertheless, playing the games was associated with a more positive mood (LR ChiSq=25.08, DF=3, P<.001), independent of the level of cognitive functioning (LR ChiSq=0.65, DF=1, P=.42). All games could be played with a moderate error rate (0.19-0.49).

Conclusions:

Our results indicate that the Serious Games have a positive impact on the well-being of dementia patients, given adequate support. Although challenging, participative development of Serious Games with people being severely impaired by dementia is an important research target. Limitations like low data quality and a simplified design are inherent in this study population. Still, we demonstrate how usability testing in this target group is possible through careful definition and operationalization. To accommodate severely impaired patients, future developments should incorporate a broader range of difficulty and adaptations to group settings. Clinical Trial: German Clinical Trials Register, DRKS00031363.