Cognitive Benefits of Digital Games for Older Adults

Strategies for Increasing Participation

Robyn Schell and David Kaufman

Simon Fraser University, 8888 University Dr, Burnaby, BC, Canada

Keywords: Digital Games, Cognitive Benefits, Barriers, Older Adults.

Abstract: There is evidence that shows that playing digital games has cognitive benefits for older adults. However, to

reap these cognitive benefits, barriers that prevent full participation in gameplay must be overcome. This

position paper describes the cognitive benefits of digital gaming for older people, outlines some of the

obstacles they may face when playing digital games, and offers strategies that could help reduce these barriers

so more older adults could enjoy the benefits of playing digital games.

1 INTRODUCTION

Between 2000 and 2050, the proportion of the world's

population over 60 years will double from about 11%

to 22% and the number of people aged 60 years and

over is predicted to increase from 605 million to two

billion (World Health Organization (WHO), 2014).

The WHO report also predicts the number of people

aged 80 and older will quadruple in the period 2000

to 2050.

Concern about the long-term impact of ageing

populations is influencing public debate about quality

of life as we age and about the resources needed to

appropriately support older people to be physically

and mentally active. Technology can play a role in

this area as an increasing number of older adults are

using technology as part of their daily lives. In April

2012 the Pew Research Center found for the first time

that more than half of older adults 65 years or more

used the Internet and 47% said that they have a high-

speed connection at home (Pew Internet Research

Project, 2012).

Older adults are also playing more digital games.

Annual reports published by the Entertainment

Software Association (ESA) show that mature

gamers are becoming an expanding segment of the

gaming population in the US. In 1999, 9% of the

digital game audience was over 50 (Entertainment

Software Association, 2005) while by 2011 29% of

those who played games were aged 50+

(Entertainment Software Industry, 2011).

There is evidence showing that playing digital

games can help to sustain and develop cognitive

abilities, but there are barriers that prevent older

adults from fully participating in playing them. This

position paper outlines the cognitive benefits of

playing digital games, the obstacles that can inhibit

participation, and suggests how these obstacles might

be addressed so that more older people could enjoy

the cognitive benefits associated with digital gaming

in greater numbers.

2 COGNITIVE ABILITIES

OF OLDER ADULTS

As people age, they often suffer losses in general

cognitive abilities (Green and Bavelier, 2004).

Although the impact of cognitive decline varies,

impaired executive function has the most significant

impact (Muijden et al., 2012). Executive function

manages our ability to perform certain tasks related to

perception, response, and maintenance of contextual

information that is related to working memory,

reasoning, and problem solving (Botvinick et al.,

2001) (National Center for Learning Disabilities,

2014). In addition to normal ageing issues, diseases

associated with ageing such as Alzheimer’s,

Parkinson’s, and stroke can negatively affect the

cognitive abilities of older adults. However, while

cognitive decline is often considered to be a natural

outcome of ageing, cognitive neuroscience suggests

that this process could be slowed and perhaps even

reversed with training or therapeutic techniques

(Green and Bavelier, 2004).

Schell, R. and Kaufman, D.

Cognitive Beneﬁts of Digital Games for Older Adults - Strategies for Increasing Participation.

In Proceedings of the 8th International Conference on Computer Supported Education (CSEDU 2016) - Volume 2, pages 137-141

ISBN: 978-989-758-179-3

137

3 DIGITAL GAMES AND

COGNITIVE ABILITIES

Digital games draw upon multiple cognitive abilities

and are designed to be fun to play. Games scaffold

learning supporting participants to continue to play

despite challenges they encounter in the game. These

attributes could mean that digital games have the

potential for enhancing the lives of older adults

(IJsselsteijn et al., 2007).

With the advances of virtual-reality interactive

technology, digital games have become an innovative

venue for leisure activities for older adults (Chiang et

al., 2012). For example, Nintendo Wii Fit™ and

XBOX 360 platforms by Microsoft and Play Station

Eye can support play that reflects the player’s

physical movement. Wii Bowling or Wii Fit digital

games have been found to improve concentration,

attention, memory, visual-spatial skills, hand eye

coordination, decision making, and speed reactions

(Calvert, 2004). Researchers have also determined

that executive control processes such as switching

tasks, working memory, and visual short-term

memory can be significantly improved after playing

digital games (Basak et al., 2008).

In their meta-analysis of studies that examined

physical and cognitive impact of digital games on

older adults, Zhang and Kaufman (2015) found that

playing digital games had positive impact on older

adults’ balance, mobility, executive function, and

processing speed. These authors also suggested that it

is a fallacy that older people cannot learn digital

games since older adults are just as capable as

younger people in learning new things and adapting

to new ideas and change. Their results confirm the

findings of previous studies that “older adults do not

need to be technologically savvy to benefit from

training” (Kueider et al., 2012, p.11). However, older

people have shown a preference for games that do not

call for quick and exact movement and non-violent

games (Nap et al., 2009).

4 CHALLENGES FACED BY

OLDER ADULTS IN PLAYING

DIGITAL GAMES

Providing enjoyable and interesting leisure activities

to older adults is a serious challenge within the

domains of care and technology (Bouwhuis, 2006).

Barriers such as lack of guidance, lack of role models,

fear, preferences, and lack of social support limit

participation in physical activity (Allender et al.,

2006). It is possible that these same barriers also

impede the level of older adults’ participation in

interactive computer games especially in those that

require higher levels of dexterity, balance, and

strength.

4.1 Game Equipment and Game

Design

Inappropriate game design can also diminish the

enjoyment of the game, reducing the health benefits

and improvements to the quality of life that playing

games can offer (Whitlock et al., 2011). When a

technology is user friendly and not too difficult to use,

and suited to the needs of an older demographic, older

players are more likely to adopt and enjoy the

experience of using it (Sauve et al., 2015). Usability

is a factor in increasing the participation of older

people in playing digital games.

Marston’s comparison of the Nintendo Wii and

Sony PlayStation2 consoles found that the choice of

consoles can negatively impact game play (Marston,

2013). Her study included 68 participants with a mean

age of 57 years who played Wii golf, tennis, or boxing

on either Nintendo Wii with a remote or PS2 with a

game pad. By measuring the level of flow— the

quality of immersiveness and feelings of satisfaction

associated with gaming—Marston concluded that the

Wii remote was easier to use than the game pad on

the PS2 console, facilitating more natural interaction

with the game.

Some findings have suggested that readily

available commercial digital games are not easily

accessible to the frailest elderly (Gerling and Masuch,

2011). Gerling and Masuch’s study of a digital game,

SilverPromenade, developed for the Nintendo Wii for

this age group, included 18 people in two groups

living in full care homes with average ages of 80 and

81 and varying degrees of cognition and physical

impairment. All but one of the participants depended

on assistive devices and experienced some sensory-

motor impairments. Eight had some experience with

playing digital games and were familiar with Wii

Sports equipment. Gerling’s findings suggested that

the Wii remote could be better designed for older

adults if there were no small buttons and game play

did not include time-based interactions.

Observational data indicated that using the Wii

remote for pointing activities posed barriers to those

with more severe issues with coordination and

dexterity issues. A short questionnaire showed that

training participants beforehand provided a better

experience for these players and that previous game

experience had a positive effect on game

CSEDU 2016 - 8th International Conference on Computer Supported Education

138

performance. Gerling and Masuch concluded that the

participants were able to learn and use new

technologies despite their physical limitations

although there were some issues with game control.

A study by Hwang et al., (2011) also focussed on

the design of digital games for older adults. This

research produced and evaluated an embodied

interactive video game (EIVG) that integrated human

physical movement similar to the human-computer

interaction experienced when playing Wii Bowling.

The purpose of the study was to understand the

usability and dependability of the game system for

those with limited physical abilities. The study

interviewed and observed 30 people aged 60 plus who

were recruited from a rural community, as well as a

group of elementary school volunteers, and a nursing

home. Players interacted with animations via a

webcam using their body movement to interface with

the game system so no remote or keyboard was

needed. The first game involved categorizing food for

health, the second game was about identifying the

symbols of Asian and European countries, and the

third was based on speed of movements made during

the game. The study found evidence that this kind of

interface reduced player’s physical barriers. Players

were able to move any part of the body, eliminating

the need to manage a remote and buttons while

playing the game (Hwang et al, 2011). From the

studies described here it appears that game equipment

and game design both play an important role in game

usability for older adults but the impact may vary by

age and frailty of the player.

4.2 Psychosocial Barriers

Lack of instruction on how to play digital games and

use the equipment, a lack of incentives to invest their

time in using technology, and the low value of

technology in their lives also negatively affect

participation among older people (Marston, 2012).

Acquiring technical proficiency can be a source of

anxiety for older adults who are playing digital games

for the first time (Wollersheim et al., 2010). In some

cases, older people may feel that playing digital games

is not appropriate for someone of their age (De Schutter

and Vanden Abeele, 2010). In addition, the concept of

“stereotype threat” may shape perceptions, whereby

older adults believe they will not be able to understand

digital games or like them (Schultz, 2006), creating the

expectation of failure. These negative feelings may

hinder older adults from playing digital games and

prevent them from enjoying the cognitive benefits

games they might offer.

To allow older adults to achieve some level of

success in playing digital games, IJsselsteijn et al.

(2007) recommended providing positive feedback on

learning goals rather than performance goals to

increase the sense of self-efficacy. IJesselsteijn et al.

also found the social aspects of playing digital games

to be a strong motivator for older players. Allender et

al. (2006) found that enjoyment and strong social

networks were associated with greater participation in

physical activity. It is possible that games that

promote social connection could also increase the

level of activity and participation of older people in

playing digital games. Voida and Greenberg

described Wii as a computational meeting place

where older adults establish social contacts with peers

and can experience intergenerational play. Voida and

Greenberg’s study included 30 participants from

different age groups playing together in the same

location. Their data suggested that intergenerational

play provides developmental benefits for both older

and younger players as well as creates an entry point

for older players to become more digitally literate

(Stephens et al., 2008).

Leisure activities such as playing games has been

found to be a venue for informal learning and one of

the chief reasons individuals initially learn how to use

computers (Voida and Greenberg, 2012). Support for

learning new technology is important to encouraging

adoption and peer-to-peer mentoring is one method

for developing greater computer literacy among older

adults (Selwyn, 2005). Setting up equipment was

found to be a particular challenge for older adults

playing Wii bowling and a task often taken care of by

a key person who was proficient with the technology

or enjoyed using technology (Schell, Hausknecht, &

Kaufman, 2015). Therefore, it seems that further

guidance and support for game set up could help to

build greater technical expertise among older players

while enhancing their sense of self efficacy. It is

possible that more instruction and practice on how to

play would also promote greater engagement and self

confidence in playing digital games.

Nevertheless, despite challenges presented to

older adults playing digital games, perceived benefits

can be more important to ageing individuals than the

costs of poor design (Sharit, Czaja, Perdomo, & Lee,

2004). McLaughlin, Gandy, Allaire, & Whitcomb

(2012) viewed the potential advantages of playing

digital games within the context of a cost/benefit

analysis. Through this model, the motivations of older

adults for playing digital games can be understood as

a balance between the perceived advantages of

playing and disadvantages such as barriers

encountered during game play. By promoting the

cognitive and social advantages of playing digital

Cognitive Beneﬁts of Digital Games for Older Adults - Strategies for Increasing Participation

139

games more older adults may be encouraged to play

(Higgins et al., 2010). Older adults have also cited the

lack of realistic role models in the community as a

deterrent to playing digital games and some older

adults have wondered whether playing digital games

is inappropriate for their age group (De Schutter &

Vanden Abeele, 2010). Publicizing the fact that

greater numbers of older people are playing digital

games may help reduce these misconceptions and

increase participation in playing digital games.

Appropriate incentives may also prompt older

people to play digital games increasing the value of

this technology in the lives of older people.

McLaughlin et al. (2012) suggested integrating a

reward system to encourage participation. Perhaps

small prizes offered to winners in a game tournament,

would be a fairly straightforward strategy to organize

and implement and might provide incentives to older

gamers to play digital games.

5 DIGITAL GAMES

AND COGNITIVE ABILITIES

Older people could enjoy the cognitive benefits of

playing digital games but a number of factors would

need to be considered so that an optimal environment

for play can be created for them. These factors

include ensuring appropriate games and equipment

are available; providing instruction and training;

facilitating the social aspect of playing games; and

providing incentives for participation publicising the

advantages of playing digital games such as their

ability to help maintain and improve cognitive

abilities as one ages.

ACKNOWLEDGEMENTS

We wish to thank the AGE-WELL National Centre of

Excellence for their financial support of this paper.

REFERENCES

Allender, S., Cowburn, G. and Foster, C., 2006.

Understanding participation in sport and physical

activity among children and adults: A Review of

Qualitative Studies. Health Education Research, 21,

pp. 826-835.

Basak, C., Boot, W. R., Voss, M. W. and Kramer, A. F.,

2008. Can training in a real-time strategy video game

attenuate cognitive decline in older adults? Psychology

and Aging, 23(4), pp. 765-777.

Botvinick, M., Braver, T., Barch, D. L., Carter, C. and

Calvin, J. D., 2001. Conflict monitoring and cognitive

Control. Psychological Review, 108, pp. 624-652.

Bouwhuis, D., 2006. Not care but leisure.

Gerontechnology, 5(2), pp. 63-65.

Calvert, S. L., 2004. Cognitive effects of digital games. In:

J. Raessens and J. Goldstain, eds, Handbook of

Computer Game Studies. Cambridge, MA: MIT Press,

pp. 125-131.

Chiang, I. T., Tsai, J. C. and Chen, S. T., 2012, March 27 -

30. Using Xbox 360 Kinect games on enhancing visual

performance skills on institutionalized older adults with

wheelchairs, Proceedings of Fourth IEEE International

Conference on Digital Game and Intelligent Toy

Enhanced Learning 2012, March 27 - 30.

De Schutter, R. and Vanden Abeele, V., 2010. Designing

meaningful play within the psycho-social context of

older adults. Fun & Games, (September), pp. 13-15.

Entertainment Software Association (ESA), 2005.

Essential Facts About the Computer and Video Game

Industry: Sales, Demographics, and Usage.

Entertainment Software Industry, 2011 - last update,

Essential Facts of Computer and Video Game Industry.

Available: http://www.theesa.com/facts/pdfs/ESA_EF

_2011.pdf [February 16, 2013].

Gerling, K. M. and Masuch, M., 2011. When gaming is not

suitable for everyone: Playtesting Wii games with frail

elderly, In 1st Workshop on Game Accessibility:

Xtreme Interaction Design (FDG 2011) 2011.

Green, C. S. and Bavelier, D., 2004. The cognitive

neuroscience of digital games. In: P. Messaris and L.

Humphreys, eds, Digital Media: Transformation in

human communication. New York, NY: Peter Lang, pp.

211-223.

Higgins, H. C., Horton, J. K. and Hodginson, B. C., 2010.

Lessons learned: Staff perceptions of the Nintendo Wii

as a health promotion tool within an aged-care and

disability service. Health Promotion Journal, 21(3), pp.

189-195.

Hwang, M., Hong, J., Hao, Y. and Jong, J., 2011. Elders'

usability, dependability, and flow experiences on

embodied interactive video games. Educational

Gerontology, 37(8), pp. 715-731.

IJsselsteijn, W. A., Nap, H., De Kort, Y. and Poels, K.,

2007. Digital game design for elderly users,

Proceedings of 2007 Conference on Future Play

Can be found in google at http://dl.acm.org.proxy.lib.

sfu.ca/citation.cfm?id=1328206 2007, pp. 17-22.

Kueider, A. M., Parisi, J. M., Gross, A. L. and Rebok, G.

W., 2012. Computerized cognitive training with older

adults: A systematic review. PLoS ONE

, 7(7), pp. 1-13.

Marston, H., 2012. Older adults as 21st game designers. The

Computer Games Journal, 1(1), pp. 80-102.

Marston, H.R., 2013. Design recommendations for digital

game design within an ageing society. Educational

Gerontology, 39(2), pp. 103-118.

McLaughlin , A., Gandy, M., Allaire, J. and Whitcomb, R.,

2012. Putting fun into video games for older adults.

Ergonomics in Design: The Quarterly of Human

Factors Applications, 20(2), pp. 13-22.

CSEDU 2016 - 8th International Conference on Computer Supported Education

140

Muijden, J. V., Band, G. P. and Hommel, B., 2012. Online

games training aging brains: Limited transfer to

cognitive control functions. Frontiers in Human

Neuroscience, 6, pp. 1-13.

Nap, H., de Kort, Y., and IJesselsteijn, W., 2009. Senior

gamers: preferences, motivations and needs.

Gerontology, 8 (4), pp. 247 - 262.

National Center for Learning Disabilities, 2014-last update,

What is executive function?. Available: https://www.

understood.org/en/learning-attention-issues/child-

learning-disabilities/executive-functioning-issues/

understanding-executive-functioning-issues.

PEW Internet Research Project, 2012-last update, Older

Adults and Technology Use. Available: http://www.

pewinternet.org/2014/04/03/older-adults-and-

technology-use/ [09/11, 2014].

Sauve, L., Renaud, L., Kaufman, D. and Duplaa, E., 2015.

Validation of the educational game of seniors: "Live

Well, Live Healthy!" International Educational

Technology Conference, IETC, 2014 2015, pp. 674-682.

Schell, R., Hausknecht, S., and Kaufman, D., 2015. Social

benefits of playing Wii bowling. games and culture,

V11 (1-2), pp. 81 - 103.

Schultz, R., 2006. Age stereotype. Encyclopedia of Aging

A-K. 4th edn. New York, NY: Springer.

Selwyn, N., 2005. The social processes of learning to use

computers. Social Science Computer Review, 23(1), pp.

122-135.

Sharit, J., Czaja, S., Perdomo, D. and Lee, C., 2004. A cost-

benefit analysis methodology for assessing product

adoption by older user populations. Applied

Erognomics, 35, pp. 81-92.

Stephens, R., Satwica, T. and McCarthy, L., 2008. In-game,

in-room, in-world: reconnecting video gameplay to the

rest of kids’ lives. In: R. Stephens, T. Satwica and L.

McCarthey, eds, The Ecology of Games: Connecting

Youth, Games, and Learning. Cambridge, MA: MIT

Press, pp. 41-66.

Voida, A. and Greenberg, S., 2012. Console gaming across

generations: exploring intergenerational interactions n

collocated console gaming. Universal Access in the

Information Society, 11, pp. 45-56.

Whitlock, L., McLaughlin, A. and Allaire, J., 2011. Video

Game Design for Older Adults: Usability Observation

from an Intervention Study. Proceedings of the Human

Factors and Ergonomics Society Annual Meeting 2011,

pp. 187-191.

Wollersheim, D., Merkes, M., Shields, N., Liamputtong, P.,

Wallis, L., Reynolds, F. and Koh, L., 2010. Physical

and psychosocial effects of Wii video game use among

older women. International Journal of Emerging

Technologies & Society, 8(2), pp. 85-98.

World Health Organization (WHO), Ten Facts on Ageing

and Life Course. Available: http://www.who.int/

features/factfiles/ageing/en/ [Sept 10, 2014].

Zhang, F. and Kaufman, D.M., 2015. Physical and

cognitive impacts of digital games on older adults: A

meta-analytic review. Journal of Applied Gerontology,

pp. 1-22.

Cognitive Beneﬁts of Digital Games for Older Adults - Strategies for Increasing Participation

141