A Pervasive Game for Elderly People with Augmented Reality:
Description and First Validation
Álvaro Pérez
1
, Jesús Gallardo
1a
, Raquel Lacuesta
1b
and Silvia Hernández
2c
1
Department of Computing and Systems Engineering, University of Zaragoza, Teruel, Spain
2
Pre-departmental Unit of Fine Arts, University of Zaragoza, Teruel, Spain
Keywords: Pervasive Games, Elderly People, Augmented Reality.
Abstract: The rise of videogames in our culture has caused that they are no longer seen as simple games for kids and
have spread to all the segments of population. The use of videogames by elderly people can help to improve
their quality of life, exercising their mental functions. Inside the field of videogames, the concept of pervasive
game appeared with intensity some years ago. This kind of games exceed any of the classic dimensions of
games: temporal, spatial or social. In order to achieve this evolution, pervasive games use to take advantage
of non-traditional interaction technologies and novel paradigms, such as augmented reality. In this paper we
introduce a novel pervasive game oriented towards elderly people that makes use of augmented reality. The
game has been developed following a user-centered approach with participative design. In the game, players
have to find certain elements in their environment (e.g., in a nursing home) so that they unlock memories that
they store in an album and can value. Here, we describe the game in detail and show a first validation that we
have carried out in order to test its usefulness. In that validation, users find the game useful and easy to play
with.
1 INTRODUCTION
People over 65 years old are the segment of the
population that has grown the most in recent years.
For this reason, the most significant change in the
next generation of elderly people will be their high
level of education. It is now imperative to harness
their learning capacity to engage them in initiatives
that enable their personal development (Morillas and
Martínez, 2013). In Spain, the consumption of video
games represents more than half of the total
audiovisual leisure, ranking at the top of the list. Over
the years, the taste for video games has ceased to be
the exclusive heritage of children and young people
to integrate elderly people. As consequence, more and
more video games are part of the daily life of the
population as a tool of socialization, ceasing to have
only a playful purpose and being able to be used as
educational tools for their audience.
According to AEVI (Spanish Association of
Video Games) 47% of the total turnover of video
a
https://orcid.org/0000-0001-9895-0837
b
https://orcid.org/0000-0002-4773-4904
c
https://orcid.org/0000-0003-3557-3442
games worldwide comes from mobile video games
and it is also observed that they are experiencing a
great growth year after year (12.8% more than in
2017) (AEVI, 2019). So right now, smartphones are
presented as the main platform for the creation and
consumption of video games.
The introduction of elderly people in Information
and Communication Technologies is also important
to eliminate the digital divide. Digital divide can be
a form of exclusion and dependency for people who
are not integrated into the information society. In the
specific case of Spain, the elderly people are
gradually entering, although much remains to be
done. One of the resources used that has shown to be
useful for improving certain aspects in the lives of
elderly people is the video games. Thus, in (Allaire et
al., 2013) a study related to video games, that was
conducted among 140 people of average age 77,5
years with different profiles concluded that those who
played video games regularly or occasionally showed
Pérez, Á., Gallardo, J., Lacuesta, R. and Hernández, S.
A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation.
DOI: 10.5220/0010532001030109
In Proceedings of the 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2021), pages 103-109
ISBN: 978-989-758-506-7
Copyright
c
2021 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
103
better values in the socio-emotional field than those
who had never played.
An emerging paradigm in video games is
pervasive games. According to Montola (2005),
pervasive games are a genre of play that breaks the
traditional boundaries of the game, defined in terms
of spatial, temporal and social dimensions. When
producing games according to this new paradigm, the
particularities of these games must be considered, and
their specific characteristics given by the pervasive
expansions in the axes of time, space and social
interaction, those that are not present in traditional
games.
Pervasive games have had a rapid growth in
different fields, as evidenced by the proliferation of
game experience designs of this type (Arango-López
et al., 2017a). There are works (Kasapakis and
Gavalas, 2014) that compile numerous developments
resulting from design experiences in context such as
education, health, entertainment and tourism, among
others. Thus, from the collection of experiences
emerged the definition that says that "A pervasive
game offers the player a game experience enriched by
an evolution of the game dynamics, expanding the
space of the game according to the context in which
it is played. In this way, the boundaries of the game
world are broken, making reality a part of it and the
elements present in that reality can have an influence
on the game" (Arango-López et al., 2017b). This
definition was presented based on the identification
of the main elements present in this type of games,
which are: devices, context, social interaction, time,
space, multi-reality and crossmedia. All linked by
means of a pervasive narrative.
Taking all this into account, we have designed and
developed a pervasive game oriented towards elderly
people, with the aim of improving their quality of life,
both physically (since they will have to move around
their environment to play, which stimulates physical
activity) as at a cognitive level (since the game
involves unlocking memories, which will stimulate
your memory). The game consists of looking for
certain objects (usually photos) that, when detected,
generate virtual objects through augmented reality.
Touching that item will unlock a memory that will
become part of an album, and advance the player in
his progress. Our game will be pervasive on a spatial
level, having to move to be able to complete it and
potentially have any location, temporary, as it could
be played at any time, and also social, as people who
play can interact in the meantime with other people
who are not players.
In order to test the usefulness of our game, we
have carried out an initial validation in which we have
worked on the technological acceptance of the game.
Therefore, we have used a questionnaire based on
TAM (Davis, 1989), the most popular model for
technological acceptance. By means of this
questionnaire, we have asked about the perceived
usefulness of the game and its perceived ease of use.
The rest of the article is organized as follow.
Section 2 collects related work on pervasive games
for elderly people. Section 3 describes in detail the
game presented. Section 4 explains the initial
validation that we have carried out. And finally, in
Section 5 we gather the conclusions on the work
carried out and some lines of future work.
2 RELATED WORK
In recent years, there is a lot of activity in the
development of games for elderly people. In addition,
the authors of these works have drawn interesting
conclusions as to what should be taken into account
when developing video games for adults. Several
relevant works in this area will be mentioned below.
In (Cota et al., 2015), the authors conducted a study
on aspects that lead elderly people to play games for
the mobile phone. The study consisted of developing
a catalogue of games, so that the preferred genres of
elderly people were identified. From there, the
authors developed a game called Traveling the
World, with several mini-games of the genres
preferred by the elders. Through this work, the
authors identified several elements of motivation
relevant to the elderly people, such as, for example:
the interaction of the player always has an associated
result, the difficulty increases gradually, the
mechanics are simple, information about the benefits
of playing, or aspects of usability, such as color
contrast or large, clear images.
Another interesting example of game, which has
certain similarities with the one we will present later,
is the one described in (Mubin et al., 2008). This
game, also designed for mobile phones, combines a
classic game of looking for identical cards with the
search for specific physical locations. In this way, we
could say that there is also something pervasive about
it. It is a game that can be collaborative, and thus
enhance the social aspect. After the evaluation of the
game, called Walk2Win, the authors drew certain
recommendations, such as: this type of games should
reach as wide an audience as possible (even if certain
elders participate passively), rules should be
minimized, it is interesting to introduce elements of
familiar games, gender distinctions should be
ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health
104
eliminated, and the environment should be
customizable.
Another type of games is that in which, using
devices such as Microsoft Kinect or other similar, the
elderly people are sought to perform some type of
exercise, either within the scope of a rehabilitation
plan or simply to keep them active. An example
would be described in (Gerling et al., 2011). In that
case, the authors used Nintendo Wii to develop a
game called SilverPromenade that simulated virtual
rides while posing certain mini-games to older
people. From the experience, the authors drew three
useful conclusions for developers of this type of
game: the capabilities of the target audience should
be carefully explored, the right choice of metaphors
is fundamental to making it easy to enter the game,
and games should be designed to suit a wide range of
players and situations.
Lastly, we are going to mention another example
of activity for adults which shares with the game that
we will introduce some points such as the use of
virtual or augmented reality and the aim of
stimulating players’ memory. This is the Virtual
Maze Task (Cárdenas-Delgado et al., 2017). This
activity is not presented by their authors as a game,
but it includes some aspects that we may understand
as gamification elements, as users have to learn routes
in a maze. In this work, authors studied the difference
in performing this activity with an immersion
approach or with physical activity, regarding
satisfaction, interaction and other aspects.
Thanks to this study of related work, we have been
able to obtain valuable ideas that have subsequently
resulted in the design of our application. In the section
dedicated to the design of the application we will
detail the points that we have taken into account.
3 THE GAME ENCUÉNTRATE
In this section, we are going to explain in detail the
process of design and development of EncuéntraTe, a
pervasive game oriented towards elderly people that
makes use of augmented reality technology so that
players can move in a given environment searching
for memories to be unlocked.
3.1 Analysis
Our first intention when facing this project was to
develop a pervasive game that might help improving
life quality in elderly people, influencing on aspects
as keeping them active, getting their mind exercised
or boosting their social abilities. For the design and
development of the game we had the support of a
residential complex for elderly people that includes
apartments for non-dependent people, a residential
center for dependent people and a senior day center.
We followed a user-centered design approach from
the very beginning of the development process, so
that the final idea of game got generated among the
development team, the staff in the residential
complex and a group of elderly people. Thus, two
meetings in which the idea of the game was thought
through were organized. The first meeting included
members of the development team and members of
the staff of the complex. In this meeting, participants
generated the idea of the game consisting on locating
certain elements placed in the complex and unlocking
memories when doing that, so that the memories got
stored in an album and they made the game to
advance. By using augmented reality, the elements of
the game that allow the memories to get unlocked
would appear.
Later, a second meeting was organized. This
meeting was a focus group in which some residents
of the complex participated, together with some staff
members and members of the development team. In
this meeting, the approach decided in the first meeting
was validated, and a list of categories in which the
memories got classified was elaborated. The
categories chosen were culture, sports, history, music
and cinema, and personalities. It was decided that in
the election of the memories special interest would be
given to memories from the region of Aragon, where
the residents live.
Together with the first meeting and the focus
group, the user-centered analysis included a process
of observation of the elderly people in the residential
complex. From this observation we could conclude
that a great disparity of profiles exists in the complex,
as residents that are dependent in a higher or lower
degree live together with other residents with a high
level of autonomy.
Specifically, these were the goals defined for the
design of the app:
To develop a pervasive mobile videogame
adapted for its use by elderly people.
That the game uses augmented reality for
integrating it with the environment in which it
will be played (i.e., the residential complex).
To elaborate an album of memories with which
the user gets identified. Those memories will
get unlocked when playing the game.
To develop the game experience in a way in
which players get encouraged to keep
exploring their environment in search of more
memories to unlock.
A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation
105
3.2 Design and Implementation
Next, we are going to explain in detail the features of
the design of the app. We are going to start with its
architecture. The game will work over the Android
operating system, the most popular one nowadays in
the field of mobile devices. The environment chosen
for the development of the game has been Unity, an
engine for multiplatform videogames that is widely
used nowadays by the community of videogame
developers. Inside Unity, the platform Google
Firebase has been chosen to support programming by
means of its APIs, which make easier to handle
authentication and other features. Lastly, regarding
augmented reality, the platform that we have chosen
has been Vuforia, which SDK allows tracking a great
diversity of both 3D and 2D objects using almost any
kind of camera integrated in a mobile device. This
implies a great level of compatibility with most actual
devices. In Figure 1 it can be seen a schema of the
architecture of the app.
Figure 1: Architecture of the system.
Regarding user interface design, as this is an
application oriented towards elderly people, we have
chosen a design with big and clear buttons, simple
fonts and no complex gestural navigation. The
application starts with a welcome screen and another
one for user login. Next, the game screen is shown. In
this screen is where augmented reality is deployed.
Therefore, it is not necessary to navigate through
menus or other screens that may make interaction
more complicated. The game screen is made up of the
images provided by the camera of the device,
enriched by the augmented reality elements, as we
will explain now.
The way in which the game works implies that the
player has to locate certain images in the real world
so that, when the mobile device focuses on them, a
virtual object appears on the screen. These images are
photographs that are stored in the game database. The
object that appears is a button that belongs to a certain
category. When this button is touched in the screen, a
memory from that category gets unlocked. This
implies that a screen with the information about that
memory appears. This screen includes an image a
brief description and the possibility to listen to the
narration of the description. Also, some memories
have a video instead of an image. When the player
exits this screen, a positive support will be shown so
that the player gets encouraged to keep on searching
for memories. In this point, if the player has achieved
a certain number of memories of this category, a
medal will be awarded to him/her. Also, he/she will
be asked about his/her opinion on the memory
unlocked. This is made with a thumbs up/thumbs
down system. In any moment, the player can see all
memories unlocked by touching the album button in
the game screen. Also, in that screen it is possible to
go to a ranking screen where he/she can compare with
other players.
Regarding the visual design of the application, we
chose to provide it with the appearance of an old
album in which paper and leather would be the
textures that would predominate. Icon are quite
simple, so that they can be identified in an easy way.
All this work of visual design was carried out by a
professional graphical designer. A more modern
design was discarded as we understood that our
audience preferred a more traditional appearance, and
it would have not fitted well with the theme of
memories and albums that supposes the common
thread of the app.
Specifically, the following points, which were
identified in the study of related work as beneficial in
a work of this kind, have been taken into account in
this design:
Simple mechanics: the only interaction that is
needed for progressing in the game is to move
all around the environment searching for the
goals and touching the virtual buttons that
appear.
Minimize the rules: in order to achieve goals, it
is only needed to unlock memories, with no
other rule.
Big and clear images: all the elements that
appear in the game have a big size in order to
avoid usability problems in elderly people.
Elimination of gender discrimination: there is
no element in the game that may discriminated
depending on the player’s gender.
Reaching a broad audience: as we will explain
later, we have chosen a set of memories that
cover a wide period of time so that players of
ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health
106
different ages can find some memories to get
identified with.
Elements of other games: the categories of
memories can recall the ones in popular quiz
games.
Next, we are going to show some screens of the
app as examples of its user interface and visual
appearance. To start with, in Figure 2 it can be seen
an example of the game screen. In it, three fixed
buttons appear. The one in the upper part of the screen
is used to go to the screen in which the player can see
the awards that he/she has achieved when unlocking
memories. The two buttons in the lower zone of the
screen are for going to the ranking of the game and to
go the album with all the memories already unlocked,
respectively. Regarding the central button in the
figure, it is the virtual object that has appeared in the
augmented reality when focusing the mobile device
on an image that the game database identifies as an
object to find. In this specific case, this virtual button
will unlock a memory of the sports category.
Figure 2: Game screen.
As a second example of screen in Figure 3 we
depict an example of memory, specifically a memory
of the personalities category. This memory has been
shown directly after it has been unlocked. It can be
seen how the user interface includes an image of the
memory (in this case, the image is a person’s photo),
a description, and audio controls for handling the
narration of the description. This way, the description
can be read, listened, or both, depending on the
player’s preference.
Lastly, in Figure 4 another example of memory is
shown. This time we have chosen a memory of the
music category, and we have accessed it through the
album. It can be seen how the user interface is similar
to the one in the previous memory, but with a video
Figure 3: Memory of the personalities category.
of the song instead of the image of the person that we
had before. The video has its own playing controls,
which are shown over the video itself so that it is clear
that they refer to it, and not to the narration of the
description. Also, as we have reached this memory
through the album (i.e., it was previously unlocked
and now we are reviewing it), we have some controls
for navigating through the album.
Figure 4: Memory of the music category.
3.3 Design and Implementation
As it has been mentioned previously, a critical
component of the application is the collection of
memories that the elderly people will unlock during
their progress in the game. They should be attractive
so that players get encouraged to keep on playing and
find new ones. The categories were defined in the
analysis phase, thanks to the focus group with
potential players, and then the development team
selected the specific memories. The goal was to create
a collection of memories recognizable for the
A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation
107
residents, which help them to remember moments of
their life and to learn curiosities of their environment.
Thus, memories from the 50s until our days were
chosen. The total number of memories for each
category goes between 15 and 20.
4 FIRST VALIDATION
In order to validate the application, it was tested by
six people over 45 years of age (the age threshold had
to be lowered to achieve a larger population). Each of
these people was provided with a device with the
game installed and the necessary targets (printed
images) to unlock the memories. After each person
used the application long enough, they filled a
validation questionnaire in based on the
questionnaires used in the TAM model (Davis, 1989)
to verify technological acceptance. In this way, we
verified the interest of the participants in having an
application of this type in their daily lives We
measured the perceived usefulness and the perceived
ease of use. The questions that were asked were the
following:
Question 1: I think playing “EncuéntraTe”
would improve my qualities such as physical
condition or memory.
Question 2: I find “EncuéntraTe” game useful
to me.
Question 3: Playing “EncuéntraTe” would be
easy for me.
Question 4: I see that the game “EncuéntraTe”
is flexible enough to interact with it.
Question 5: It would be easy for me to master
“EncuéntraTe” game.
Thus, questions 1 and 2 refer to perceived
usefulness, while questions 3, 4 and 5 refer to
perceived ease of use. These questions were answered
by the study participants, giving each one a numerical
value between 1 and 5, being 1 the worst score and 5
the best. Survey results are shown in Table 1; we
reflect score averages in Figure 5.
Table 1: Results of the first validation.
Quest.
User
#1
User
#2
User
#3
User
#4
User
#5
User
#6
#1 5 5 5 4 3 4
#2 4 4 5 4 4 5
#3 4 4 3 3 3 5
#4 5 4 3 4 3 4
#5 5 3 2 5 4 4
Figure 5: Questions average for the first validation.
As we have tested the application with a small
population we can just show the first impressions
based on these results. In the case of the questions
related to perceived usefulness, the answers average
is 4.33 out of 5. This seems to indicate that the
participants in the study perceived the application as
useful for the purposes for which it was designed.
However, the result when calculating the average of
the answers to the questions on perceived ease of use
drops to 3.78. Thus, we could infer that the
participants in the study did not perceive the
application so easy of use, despite they evaluate well
its usefulness. This should lead us, in future more
exhaustive studies, to identify specific usability
problems and correct them in order to improve this
perception of ease of use of our application.
5 CONCLUSIONS AND FUTURE
WORK
In this work we have presented “EncuéntraTe”, a
pervasive mobile game aimed at elderly people. The
game makes use of augmented reality and has been
developed to be played in nursing homes for elderly
people or similar centers. The game consists of
locating in the real world a series of real images. Once
found, the application is used to see different virtual
objects that appear by means of augmented reality.
Tapping on these virtual items users unlock memories
which are displayed and can also be narrated to the
player. Memories are also stored in an album. The
game has an achievement and ranking system to
encourage the player to keep playing. Therefore, with
this game we have contributed to the development of
a novel game for elderly people that uses current
technologies and consider specific requirements
proposed in the literature as positive in the
development of games aimed at the elderly. Our game
includes the ideas behind pervasive games together
ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health
108
with the aim of stimulating the elders’ memory and
having them performing physical activity. In this
sense, this is a novel way in which such aspects are
tackled.
We have carried out a very preliminary validation
of the game. The game seems to be valued positively
in terms of its usefulness, but has aspects to improve
in terms of its ease of use. Therefore, it is necessary
to carry out more complete studies to help us to
identify the points for improvement that would
change that perception. Such new studies will imply
a larger number of users with a higher average age.
As future work, in addition to the aforementioned
studies, we will add new functionalities to the
application. Specifically, we will include some help
or tutorial functionality that allows to improve the
game usability. We also will intend, based on the
evaluations that players make of memories, that the
game can be adapted to their tastes, promoting the
appearance of memories that are in line with their
preferences. For example, if it is observed that the
preferred memories of a user refer to a certain time
period, the application would work on showing more
memories in that same period. Also, the possibility
for family members to include personalized
memories and rewards will be also considered.
ACKNOWLEDGEMENTS
Work partly funded by the Spanish Science and
Innovation Ministry, the National Research Agency
(AEI) and the EU (FEDER) through the contract
RTI2018-096986-B-C31, by Fundación Bancaria
Ibercaja through the contract JIUZ-2020-TEC-04,
and by the Aragonese Government (Group
T60_20R).
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