ADE2: Towards a Method for Implementing Serious Games for

Older People's Memory Training

Priscila Cedillo

, Jefferson Arias

, Emily Arteaga

, Cristina Sánchez-Zhunio

and Daniela Prado-Cabrera

Department of Computer Science, Universidad de Cuenca, Av. 12 de abril s/n, Cuenca, Ecuador

Keywords: Serious Games, Older Adults, Human-Computer Interaction, User Experience, Memory, Attention, Software

Engineering, Health Care.

Abstract: Over the years, cognitive deterioration appears, which is even more evident as age increases; therefore, it

requires attention and treatment. Among the older adults' primary needs are learning and entertainment. These

needs promote older people, caregivers, and health personnel to seek technological solutions that help during

their free time while training the executive functions in the home or gerontological centers. Hence, serious

games can teach without neglecting entertainment and fun. Thus, it is necessary to develop techniques,

methods, tools, or standards for creating serious games by following a process that considers all the needs and

specific characteristics of older adults. Hence, this paper presents a method named ADE2 that aims to facilitate

the development of serious games for older adults aligned to usability standards, human-computer interaction

(HCI) techniques, and healthcare and software engineering experts' considerations. Evaluating the feasibility

of the method has been presented the construction of a serious game and a case study that evaluates the game's

use perception. The evaluation was developed from the point of view of the psychological area and the end-

user (older adult).

1 INTRODUCTION

The older adult population's growth has motivated

researchers to look for ways to preserve these

individuals' cognitive functions (e.g., attention,

memory). Here, technological applications can

provide positive support to reach that objective

(Portugal et al., 2013); those applications can be

applied at different treatment stages. Depending on

the intervention's time and cognitive deterioration

level, they can be classified as primary, secondary,

and tertiary interventions, being the primary

intervention when there are no manifestations of

illness (Alves et al., 2009; Yanguas, 2007). These

cognitive functions' training allows the older adult to

have a greater degree of independence (Lustig et al.,

2009).

https://orcid.org/0000-0002-6787-0655

https://orcid.org/0000-0002-8131-7637

https://orcid.org/0000-0003-3411-878X

https://orcid.org/0000-0002-9952-4853

https://orcid.org/0000-0003-1241-1782

This objective can be achieved through serious

games, which are technological applications that

entertain and are also used as tools that promote

learning, cognitive-affective stimulation, among

others, contributing to cognitive aspects, skills, and

abilities, aspects socializers, and digital literacy

(Ledo Rubio et al., 2016; Selzer et al., 2006).

Moreover, with serious games, the Human-

Computer Interaction (HCI) accessibility criteria

must be considered, consisting of appropriately

detailed and documented activities to obtain a robust

design. HCI allows the consideration of the player's

characteristics, the interactions during the game, and

the game's behavioral implications to include in the

solutions. Therefore, better games can be designed

and developed for society. Besides, the combination

of serious games with HCI allows inquiring more

deeply into the positive or negative impact of end-

users with those solutions.

Cedillo, P., Arias, J., Arteaga, E., Sánchez-Zhunio, C. and Prado-Cabrera, D.

ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training.

DOI: 10.5220/0010456900460056

In Proceedings of the 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2021), pages 46-56

ISBN: 978-989-758-506-7

To design serious games for older people, it is

necessary to address the support of semantic and

communicative components of knowledge to form

effective tools to train the attention and memory of

this population (Marchetti et al., 2015). Said

information can be obtained, stored, retained, and

later retrieved, which are aspects that older adults

must maintain in constant training (McLeod, 2013).

Several primary studies address the creation of

serious games for end-users in different domains and

knowledge fields. In this sense, Bouchard et al.

(2012) present a serious game focused on older adults

with Alzheimer's, but at a tertiary intervention level,

without considering the first stages of intervention.

Although this contribution is interesting and presents

a positive tool for people, it does not report any health

experts' feedback. Lin et al. (2018) developed serious

games to be used in a technological laboratory; these

games focus on older people's attention and memory.

These serious games are adjusted to physical abilities

and cognitive functions, but whether older adults can

use serious games is not considered. Although those

solutions represent important tools for older people,

they do not report the steps involved in their

implementation; thus not considering the roles of

each expert, the accessibility criteria (Pesántez et al.,

2020), or a clear description of aspects that need to be

considered to reach a target effective serious game.

Consequently, it is necessary to have a method that

allows the creation of serious games considering all

needed aspects for their implementation.

This paper presents a method for creating serious

games named ADE2. This method includes all

aspects related to the accessibility and good practices

to reach effective serious games for older people;

those games are oriented to satisfy the training of

specific cognitive functions (i.e., attention, memory).

Therefore, the main contributions of this research are:

i) An initial version of ADE2 method, its activities,

guidelines, and artifacts involved ii) the

implementation of a serious game which has been

built considering each step of ADE2, iii) a case study

that shows the use of the serious game oriented to

train the attention and memory, which has been used

by two older adults and two psychologists, their

perceptions after they have tried and their feedback

about the experience playing the game. This serious

game was also evaluated in a controlled environment;

due to the COVID-19 pandemic, the test with a higher

number of participants is left as future work.

This article has the following structure: Section 2

presents related work. Section 3 presents the ADE2

method. Section 4 shows the viability of the method

by creating a serious game step by step. Section 5

contains a case study where older people and health

experts are involved. Furthermore, in Section VI,

conclusions and future work are presented.

2 RELATED WORK

Studies that present serious games' methodologies

and development to training attention and memory

are analyzed in this section. The aim is to check if

there are methods to build serious games focused on

older adults, which provide training and evaluation of

attention and memory.

Tost et al. (2014) and Tong & Chignell (2014)

present serious games development using traditional

software engineering methodologies such as agile

methodology. Lin et al. (2018) present a serious game

development to stimulate older adults' cognitive and

physical functions without presenting the approach,

methodology, or development technique that shows

that it is necessary to apply accessibility criteria for

older adults.

On the other hand, Bouchard et al. (2012) present

a development approach where guidelines are

addressed to design and implement serious games that

adapt to older adults' needs using artificial

intelligence techniques and difficulty adjustment.

Likewise, Blasko et al. (2014) describe the

development of a game (SPOT), which has the

advantage of improving attention deficit disorder and

cognitive problems in older adults. Savazzi et al.

(2018) also describe a serious game for

neurorehabilitation; physiotherapists validated this

solution.

Rodriguez-Fortiz et al. (2016) present the

development of serious games on a web platform that

can improve accessibility from a computer or mobile

device, where it is possible to develop serious games

by focusing on the design of interfaces for the elderly

population and its multiple needs.

Facing the psychological aspects, so far, it has

been determined that older adults can significantly

improve their cognitive skills through the constant

use of a serious game. This is supported by the study

of Chi et al. (2017), who present the design of a game

package called "Smart Thinker," which is presented

to improve the subject's basic cognitive skills.

Related to the presented solutions, it is possible to

conclude that there is no methodology to create

serious games where guidelines are applied for an

effective design for older adults, which is able to

fulfill the objective of training and evaluating

cognitive functions and have it validated by software

engineering and healthcare experts.

ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training

3 THE ADE2 METHOD

For the creation of a serious game to train and

evaluate the cognitive functions of an older adult, a

development method has been created, which

integrates accessibility features and considered the

participation of several professionals in different

knowledge areas (e.g., psychologists, software

engineers, project specialists, among others).

3.1 ADE2

The first phases to build serious games are based on

two models: ADDIE (Bhushan & Bhushan, 2006),

which is used for software development, and

DODDEL (McMahon, 2007), which is used to create

serious games. The ADDIE model was used to

capture requirements, implementation of the

application, and the evaluation of the solution; the

DODDEL model was used to carry out the situation

analysis document, the design of the solution because

this model is oriented to the design of games, the

evaluation of the application to elaborate documenta-

tion and the delivery. The ADE2 method is that it is a

pipeline process, which provides the advantage of

continuity with the domain expert throughout each

artifact, especially in terms of cognitive functions.

The ADE2 method contains the following phases: i)

analysis of the situation, ii) analysis of requirements,

iii) design, development, iv) evaluation, and v)

delivery; these phases are presented in Figure 1. Also,

in each of the steps, verification and validation are

carried out. Initial specifications are checked at

verification, and validation consists of meeting the

needs of all those involved (Sommerville, 2016).

These phases are explained below:

Figure 1: Main Method for building serious games for older people (ADE2).

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

3.1.1 Analyzing the Situation

This activity is shown in Figure 1(1), where the

participants are the domain expert, the requirements

engineer, and the project manager. The following

guidelines are used based on the domain specification

document: geriatric protocols and geriatric standards,

as shown in Figure 1(a)(b) to obtain the artifact called

domain analysis document. In this document, users

will find detailed context, environment, and

objectives to which the serious game will be destined

(see Figure 1(c)).

3.1.2 Analyzing the Software Requirements

This activity is based on the domain analysis

document (see Figure 1(2)). Here, the requirements

engineer, the domain expert, and the project manager

perform the requirements' formal specifications. The

Ambient Assisted Living (AAL) & Elderly *

Requirements Method guide can be used by actors

such as the video game designer and the Human-

Computer Interaction (HCI) expert who expands the

specification of requirements. If the serious game is

focused on the environment of assisted living, it may

be more robust and useful for this type of

environment.

3.1.3 Designing

This activity is shown in Figure 1(3); the HCI expert,

and the videogame designer, carry out the game's

prototyping through the use of a prototyping tool.

This prototype must consider the following

guidelines: WCAG 2.1 & WAI-AGE by W3C

accessibility criteria and HCI design principles. Using

the guide called theoretical framework helps choose

the most appropriate technologies to perform serious

game development.

3.1.4 Development & Deployment

In the game's development and implementation, the

software engineer and designer use the Ambient

Assisted Living (AAL) & Elderly * UI Creation

Method to implement user interfaces that are easy to

understand and use for an older adult (see Figure

1(4)).Then, the quality engineer and the developer

carry out the game's implementation. To move to the

evaluation phase, the project manager must accept the

final version of the game, which must not contain

errors, and comply with the requirements raised in the

initial step of the ADE2 method.

3.1.5 Evaluation

This activity is shown in Figure 1(5). Once the

previous activity artifacts have been obtained, the

tester and the quality engineer develop the user

manual and perform the game's final tests. The final

artifact will be achieved, a serious game; the project

director will deliver it in the last step.

3.1.6 Delivery and Feedback

This activity is shown in Figure 1(6). As a final phase,

the project director, and the software engineer, deliver

the game for later use by an older adult.

3.2 Artifacts in the ADE2 Method

3.2.1 Domain Specifications Document

This document specifies the environment in which the

user is located, what are the limitations of the

environment, and other characteristics that the

domain expert, in this case, the health area, considers

necessary to describe. This document is made to have

a clear idea of the environment and adapt the

requirements to it. Also, geriatric protocols and

standards should be incorporated because they belong

to the technical-administrative aspect that influences

older people's quality of care.

3.2.2 Domain Analysis Document

Here, it is possible to obtain the most relevant

information to document the situation's analysis in a

more summarized way. This document describes the

application's purpose, the limitations, the users, the

main characteristics, and the experts' requirements.

3.2.3 Requirements Specification

For the requirements specification, aspects must be

obtained related to environmental and contextual

details in which the application will be made. The

final application design restrictions should include

the user-persona document (Institute of Electrical and

Electronics Engineers, 2008). This document details

the characteristics of the user who will use the

application. It is convenient for designers when

sketching the application.

3.2.4 Serious Game Design

The user-persona and requirements specification

documents must be considered to develop the

prototype. At this point, several aspects should be

ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training

addressed: if the solution is responsive, allows

collaborations in real-time, the operating system in

which it runs, and the type of approach. Also,

accessibility criteria must be considered, which

provide information on the typography, fonts, and

multimedia necessary to develop applications for

older adults.

The HCI principles are another necessary task in

the design because, in these principles, there are

activities that must be included in the design to make

it more user-friendly, such as shortcuts and

informative comments.

3.2.5 Framework

It is necessary to start by developing a theoretical

framework document, in which it is specified which

of the possible frameworks meets the requirements to

carry out the application. Once a framework has been

chosen, all the advantages, disadvantages, and

characteristics must be included in the theoretical

document.

3.2.6 Serious Game Pre-tested &

Deployment

Once the game has been developed in the chosen

framework, it could finally be deployed. This activity

provides the first test run of the application and the

documentation with its results, errors, and solutions.

In the ADE2 method, this is considered one of the

most important deliverables, because it is the first

version of the application developed. It is important

to add that you can return to this stage as many times

as necessary until the game works correctly.

3.2.7 Platform and Environment

Configuration

This activity should include the components that will

allow for the application to be tested. Among these

components are the operating system and the

application parameters for later use by end-users. The

application must follow the detailed specifications

within the requirements analysis document and

comply with the accessibility criteria and HCI

principles.

3.2.8 Serious Game Tested

Once the application has successfully passed the tests

according to the inputs and all corrections and

recommendations have been resolved, the application

will finally be ready for deployment.

3.2.9 Report & Documentation

This document should include all the failures of the

tests and the expert's recommendations in the domain.

It must match the requirements specification.

3.2.10 User Manual

This document must specify the functionalities

available in the application, the buttons and their

action, and everything about installing the application

if required.

3.2.11 Serious Game Deployed & Ready to

Use

Once all the documents have been developed and the

application is ready, it is necessary to install it on the

platform or environment specified in the

requirements document for final use.

3.3 Guidelines in the ADE2 Method

3.3.1 Geriatric Protocols & Standards

Including Geriatric Protocols and Standards is one of

the advantages of ADE2. These are the contents that

the domain expert provides to the project manager to

have a clear idea about approaching the end-users.

There are specifications in these protocols and

standards according to the environment and the older

adults' needs.

3.3.2 Requirements Template

To make a correct specification of requirements, it is

essential to follow the IEEE 830 standard (Institute of

Electrical and Electronics Engineers, 2008). In this

standard, the purpose, the scope of the system,

definitions, an overview, perspectives, functions of

the system, product, specific requirements, and others

can be specified.

3.3.3 User Persona Template

ADE2 recommends the use of the personal data

template. This template must be filled with end-user’s

information. The information about the motivations,

frustrations, hobbies, and other activities and attitudes

of the end-user are found. Figure 2 provides an

example of the user persona template.

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

Figure 2: Example of a user-persona template.

3.3.4 Accessibility Criteria

Another advantage of ADE2 is the accessibility

criteria because, in this, the interface development

process is found, but focused on a particular end-user

(Arch, 2008). This document will present the size and

style of the text, the contrast, color, multimedia, and

others that need to be adapted to the design for better

user acceptance (see Table 1).

3.3.5 Prototype Tool

The prototyping tool must be the one that meets the

requirements and best adapts to the accessibility

criteria and the user persona template.

Table 1: Accessibility Criteria.

Type Description

Text size Most of the older adults have visual

problems; therefore, they need the text

size to be of considerable size for later

use.

Text type

and style

The text type or style can be easily or

difficultly viewed by the older adult, it

depends on visual problems.

Contrast

and color

It is used to distinguish the visual

elements within the game.

Multimedia These resources guide users to carry out

the tasks easily.

Text to

speech

This parameter can be used by users who

have a large percentage of vision loss;

thus, they can overcome these types of

obstacles through their voice, such as,

for example, filling in the space of their

name if required.

It is important to note that various prototyping tools

should be considered and, their respective advantages

and disadvantages should be listed. This will guide

the choice of a tool that meets the specifications

required for the prototype.

3.3.6 Theoretical Framework

This document provides information on the type of

candidate technologies used for the back-end and

front-end, their advantages and disadvantages to

facilitate the actors' implementation and design

process.

3.3.7 Design HCI Principles

Table 1 presents the HCI design principles; it is a

guide that helps the designer to create an application

that meets the requirements that are necessary to

create a cleaner and more user-friendly application

(Sosa-Tzec & Siegel, 2014).

HCI design principles have their guidelines for

any operating system. It features activities such as

using shortcuts, reporting task findings, offering

simple error handling, and more.

4 DEVELOPMENT SERIOUS

GAME USING ADE2

In this section, the six activities involved in the ADE2

method have been applied to create a puzzle game.

Each of these activities is described at a high level and

is detailed in Figure 3. The serious game's goal is to

ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training

reinforce an older adult's memory; it is based on self-

recognition through the use of their photographs. This

serious game represents an essential resource for the

patient's training and cognitive rehabilitation at home

and in a health center. Therefore, there is a current

trend for procedures to design and apply intervention

programs to promote patient motivation and

minimize the total treatment time.

In Figure 4, the interface of the puzzle game is

shown. This game is available at the following URL:

https://puzzlegame-8ab23.web.app/home.

To access the game, the user must be registered in

the system through a personal ID number. Then the

user selects the desired image to start the assembly of

the puzzle.

Figure 3: Steps to create the serious game using the ADE2 method.

1. Analysis of

the situation

1.1 Analysis of the situation:

The Project Manager and the Domain Expert

define:

a) The most common diseases associated with

attention and memory in an older adult.

b) The main needs of an older adult based on

geriatric standards and protocols.

2. Analyzing the

software requirements

2.1 Establishment of game

requirements:

The Project Manager, based on the

situation analysis document, performs the

requirements specification (IEEE 830

Template [23]), so all the previously

raised needs are met by the puzzle game.

2.2 Selection of user person

template:

The Domain Expert chooses a

user-person template, which serves

to obtain the greatest amount of

relevant information, to be used in

the game design phase.

3.1 Selection of prototype tool:

The Project Manager and the

HCI Expert select a tool to carry

out the prototyping of the

application, they take the

different considerations for the

design, to improve user

experience in using the serious

game.

3.2 Elaboration of the

prototype:

The Designer and the

Video Game Designer

make the prototype of the

application using the tool

selected in 3.1.

3.3 Selection of the

theoretical framework:

The Project Manager and

the Video Game Designer,

choose the technology to

carry out the development

and implementation process

of the application.

3.4 Interface design:

The Project Manager

approves the final sketch

of the graphical

interfaces, these sketches

meet each of the

requirements that were

raised in the initial

activities.

3. Design

4. Development & Deployment

5. Evaluation

6. Delivery

and feedbak

4.1 Development:

Once the deliverables of phase

3.3 have been defined, in which

the technologies to implement

the game must be chosen, in this

case they were angular and

typed, the Developer proceeds to

carry out the task of

implementing the puzzle game.

4.2 Deployment:

The Developer has

deployed the platform in

a web environment for

easy access. The game is

available at the following

URL: https://

puzzlegame-

8ab23.web.app/home.

5.1 Testing:

The Development Team is in

charge of:

a) Identify game programming

errors and correct them.

b) Make a user manual

c) Document the source code

for new versions.

6.1 Delivery and feedback:

Finally, the Project

Manager delivers the

developed application,

which was oriented towards

a web environment, so it is

easily accesible to older

adults.

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

5 CASE STUDY

A game built following the ADE2 method was

evaluated through a case study. It follows the

methodology proposed by Runeson et al. (2012). The

activities to be followed during the execution of the

case study are i) design, ii) ethical considerations, iii)

preparation for data collection: procedures and

protocols for data collection are defined, iv)

collecting evidence: execution with data collection on

the studied case, v) analysis of collected data and

reporting, and vi) threats of validity analysis.

Figure 4: Puzzle game and units of analysis.

5.1 Design

Here, the main objective is to know the perceptions

of health personnel and end-users regarding serious

games created for cognitive training. In this context,

the research questions are i) How does the

psychologist perceive the technological solution's

clinical utility? And ii) How does the end-user

perceive the usefulness of the technological solution?

The case study method is holistic-multiple, and the

units of analysis are presented in Figure 5. The case

study method is embedded-unique, and the units of

analysis are presented in Figure 5. In this case, it

corresponds to an embedded-unique case study. Due

to within a case, multiple units of analysis are studied.

It is considered unique because two particular

phenomena are explored in a single context (Runeson

& Höst, 2009).

Figure 5: Embedded unique method.

5.2 Ethical Considerations

Although a research study is primarily based on trust

between the investigator and the case (Amschler &

Pradhan, 2001), some explicit prevention measures

have been considered to prevent future problems. The

main ethical factors included in this case study's: i)

informed consent, ii) review of board approval, iii)

confidentiality, and iv) feedback.

5.3 Preparation for Data Collection

Two surveys have been designed based on the

Technology Acceptance Model (TAM) proposed by

Davis (1985). This model consists of evaluating the

Perceived Ease Of Use (PEOU), the Perceived

Usefulness (PU), and the Intention To Use (ITU) in

the future. The designed surveys were focused on the

elderly and the health expert. This questionnaire, as it

is shown in Appendix 1, uses a 5-point Likert scale.

5.4 Collecting Evidence

The game was presented to two older adults with the

support of two different experts in cognitive health

(Psychologist) (see Figure 6). Participants have been

selected by convenience of therapeutic groups. Then,

the professional and the end-user answered the survey

questions.

Figure 6: Case study with older adults and an expert in the

area of healthcare.

5.5 Data Analysis and Results

Reporting

The average of the responses obtained for each

construct of TAM was calculated (see Figure 7).

With this, it was concluded that both health experts

and older adults mention that the puzzle steps are easy

to understand; besides, this technological input can

reduce cognitive training time and effort. They also

rescue that it is a useful input since it allows the

ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training

patient's cognitive training; for this reason, it could be

used in the future.

5.6 Threats of Validity

The four threats that can put the case study at risk

have been analysed, these are presented by Cook &

Campell (1979) and are detailed below:

Figure 7: Results of the case study: user perceptions.

5.6.1 Construct Validity

Construct validity focus on the relation between the

theory behind the case of study and the observation.

To analyse whether the operative measures studied

represented what the researchers had planned to

investigate and what they investigated.

For this step, validated questionnaires were used,

which have an ideal Cronbach's alpha; thus, the

interview questions' constructs will be interpreted in

the same way by the researcher and the people

interviewed.

5.6.2 Internal Validity

Depending on how the subjects in a group are

selected, the selection effects may vary. In this study,

the age, educational level, profession, and any

previous experience that the participants have with

technology could influence the ease of use when

using the proposed solution.

5.6.3 External Validity

The selection of the sample of individuals who

participated was made at convenience. Due to the

COVID-19 pandemic, access to the elderly

population is restricted.

5.6.4 Reliability

From the interviews to the analysis, the evidence

chain was carried out respecting the data's literality.

Moreover, the qualitative responses were quantified

using a Likert scale to avoid introducing

interpretation bias.

6 CONCLUSIONS AND FUTURE

WORK

The ADE2 method considers design aspects for older

adults based on standards and protocols in creating

serious games to train and evaluate cognitive

functions, creating the prototypes following the

domain analysis document and the individual user

allows for a clearer design that goes hand in hand with

the end-user and the recommendations of the health

expert.

This method is designed to be applied in the

engineering of serious game development for older

adults in a scalable or iterative way. To test the

viability of the method, a serious game consisting of

a puzzle has been built. It has been presented to two

psychologists (health care personnel) for evaluation

and two older adults to use the serious game who is

the direct manager to consider the interest and

usability that will be provided in the application. The

results show that the game is perceived as easy to use

and as useful. Finally, in future work, each task of the

ADE2 method will be studied in depth to expand and

specialize each activity, role, and guide that

intervenes in each phase; it is also expected to

evaluate the method with experts in software

engineering through controlled experiments and

evaluate the game with more populations to present a

discussion complete of the results obtained.

ACKNOWLEDGMENT

This work is part of the following research projects:

“Fog Computing applied to monitor devices used in

assisted living environments; case study: platform for

the elderly people”, “Design of architectures and

interaction models for assisted living environments

aimed at older adults. Case study: playful and social

environments” and “Integration of New Technologies

for the Design of Cognitive Solutions in Ambient

Assisted Living for Elderly People: Evaluation of

Attention and Memory Areas”. Therefore, we thank

DIUC of Universidad de Cuenca and CEDIA for its

support.

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ADE2: Towards a Method for Implementing Serious Games for Older People’s Memory Training

APPENDIX 1

These questions have been applied to psychologist and

older adults

1. I found the puzzle complex and difficult to follow

2. I believe that the puzzle could reduce the time and effort

required for cognitive training

3. In general, the puzzle is difficult to understand

4. The steps to solve the puzzle are clear and easy to

understand

5. In general, I consider the puzzle to be useful

6. The puzzle is difficult to learn

7. I consider that the puzzle is useful to improve the cognitive

training process, specifically to improve the ability to

remember events of daily life

8. If I need to use a tool for cognitive training, I would

consider this puzzle in the future

9. I think the puzzle is NOT expressive enough to define how

it is solved

10. The use of this puzzle could improve the patient's

cognitive performance

11. I believe that patients can easily master the puzzle

12. In general, I think that the puzzle CANNOT be used as an

aid to improve performance in remembering certain objects

and events

13. If necessary, I would use this puzzle in the future

14. I would not recommend the use of the puzzle

15. Do you have any suggestions on how to make this game

easier to use?

16. Why you do or do not intend to use this game in the

future?

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health