JMIR Publications

ABSTRACT

Background:

In the context of global aging, cognitive decline among older adults has become a prevalent issue, significantly impacting their daily lives. Serious games have demonstrated potential in enhancing cognitive abilities in this population. However, most existing serious games designed for older adults rely heavily on visual interfaces, which are often potentially detrimental for those with pre-existing visual impairments.

Objective:

This study had two primary objectives: (1) to design a theoretical prototype for a haptic-driven serious game for older adults based on the Design-Play-Experience (DPE) framework, aiming to enhance cognitive abilities including attention, logical reasoning, and decision making while simultaneously mitigating challenges associated with visual impairment; and (2) to conduct a pilot study evaluating the prototype's usability, accessibility, and user experience within the target population.

Methods:

We employed a mixed method research design comprising theoretical design and a pilot user study. First, the Design-Play-Experience (DPE) framework was systematically applied to develop a game prototype by integrating haptic feedback technology (utilizing built in smartphone vibration motors) across its three core dimensions: Design (haptic symbol system, accessible interface), Play (dynamic difficulty adjustment), and Experience (emotional engagement). Subsequently, a pilot study was conducted with 10 older adults (mean age 62.9 ± 3.35 years; 5 male, 5 female; all with self-reported mild visual impairments such as presbyopia). Following interaction with the prototype, data were collected remotely using the System Usability Scale (SUS) and semi- structured interviews administered via video conferencing. Quantitative data from the SUS were analyzed using descriptive statistics, while qualitative data from the interviews were processed using thematic analysis.

Results:

Pilot user studies showed that the game prototype had good usability, with an average System Usability Scale (SUS) score of 89.5 (95% confidence interval: 87.6 to 91.4), which is considered “excellent”. Thematic analysis of the interviews revealed three significant themes: (1) Intuitive haptic feedback: Participants were able to quickly grasp and value the vibrational cues used to identify cards; (2) Reduced eye strain: The combination of large fonts, high contrast interfaces, and haptic feedback was praised for its effectiveness in relieving eye strain; (3) Simplicity: The simplified card game mechanics were considered both fun and challenging.

Conclusions:

This study demonstrates that a haptic-driven serious game based on the Design-Play-Experience (DPE) framework offers a feasible and well received approach for concurrently addressing cognitive stimulation and visual impairment in older adults. These preliminary positive findings establish a solid foundation for future research. The key innovation lies in systematically integrating the theoretical design framework with haptic technology to create a reusable blueprint for accessible cognitive training tools. Future studies should focus on larger scale efficacy trials to statistically verify cognitive benefits and long term engagement.