JMIR Publications

ABSTRACT

Background:

Healthy aging has emerged as a global priority. However, older adults’ participation in health promotion programs remains low, and traditional health promotion models have achieved limited success in fostering sustained engagement among this population. MHealth-based gamification interventions offer a promising way to address these challenges. However, no published reviews support or against the use of mHealth-based gamification interventions as health promotion strategies in older adults.

Objective:

This review aims to summarize what is known about the impact of mhealth-based gamification interventions that target different kinds of health behavior in older adults.

Methods:

A comprehensive literature search was conducted across 8 databases: PubMed, Scopus, Web of Science, Embase, Cochrane Library, CINAHL, PsycARTICLES, and IEEE Xplore Digital Library, from their inception to February 2025. To gain a broad understanding of this field, the search terms “mHealth”, “gamification”, and “older adult” were used. Two reviewers independently screened titles, abstracts, and full texts via Rayyan. All articles selected and data extracted were double-checked. Game elements were encoded based on Aschentrup et al’ s classification framework.

Results:

This scoping review identified 8 studies. Only 1 article was published before 2022. These studies demonstrated the effectiveness of such interventions in improving physical function(n=1)，improving adherence(n=1)，promoting physical activity(n=2), identifying mild-cognitive impairment(n=1), improving cognitive function(n=2), promoting digital literacy(n=2), promoting social engagement(n=1), and improving enjoyment and motivation(n=3). Game elements used were ranked by frequency as progress, challenges, goals, levels, reward, storytelling/narration, leaderboard, sensation, surprise, and avatar. No research was found to use the game element of "social sharing". MHealth types included augmented real-based training system, wrist-worn wearable device, mobile phone, tablet, and windows platform and devices. Notably, only 2 studies applied theoretical frameworks (behavioral economic principles and gamification theory), and 3 omitted the concrete approach to gamification.

Conclusions:

This study highlights that mHealth-based gamification interventions for elderly health promotion are rapidly evolving and hold promising potential. Future research should assess long-term impacts, integrate theoretical frameworks, identify optimal game elements and their quantity, establish reporting guidelines, design personalized social-interactive interventions, expand to broader health domains, and analyze nursing economics for cost-effectiveness.