Development and Evaluation of a Cognitive Training Game for Older People: A Design-based Approach

In the research field of cognitive aging, games have gained attention as training interventions to remediate age-related deficits. Cognitive training games on computer, video and mobile platforms have shown ample and positive support. However, the generalized effects are not agreed upon unanimously, and the game tasks are usually simple and decontextualized due to the limitations of measurements. This study adopted a qualitative approach of design-based research (DBR) to systematically review and pragmatically examine the regime, presentation and feedback design of a cognitive training game for older adults. An overview of the literature of cognitive aging and training games was conducted to form the theoretical conjectures of the design, and an iterative cycle and process were employed to develop a mobile game for older adults who are homebound or receiving care in a nursing home. Stakeholders, i.e., elderly users and institutional administrators, were invited to participate in the design process. Using two cycles of design and evaluation, a working prototype of an iPad-based app that accounted for the needs of elderly adults in terms of form, appearance and working function was developed and tested in the actual contexts of the participants' homes and an assisted living facility. The results showed that the cognitive training game developed in this study was accepted by the participants, and a high degree of satisfaction was noted. Moreover, the elements of the interface, including its size, layout and control flow, were tested and found to be suitable for use. This study contributes to the literature by providing design suggestions for such games, including the designs of the cognitive training structure, interface, interaction, instructions and feedback, based on empirical evidence collected in natural settings. This study further suggests that the effectiveness of cognitive training in mobile games be evaluated through field and physical testing on a larger scale in the future.