Innovative Game Concepts for Alzheimer Patients

  • Christian EichhornEmail author
  • David A. Plecher
  • Gudrun Klinker
  • Martin Lurz
  • Nadja Leipold
  • Markus Böhm
  • Helmut Krcmar
  • Angela Ott
  • Dorothee Volkert
  • Atsushi Hiyama
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10927)


The paper starts with an overview of the research field of application and game development for the elderly. We identified important focus points in the area of elderly people activities, technological trends and motivation concepts. The identified experiences and insights will then be used to suggest an innovative game concept, which focuses on cognitive training models and a strategy to reach every elderly person with a multi-dimensional difficulty setup. Furthermore, the ideas and thoughts behind the development of two traditional game concepts will be introduced. As part of project enable we evaluated all three games in a nursing home environment with Alzheimer patients and we will report about our first experiences and the early feedback we collected.


Generational difference in IT use Gerontechnology across cultures and disciplines Handheld devices for the elderly Health care technologies and services for the elderly Involving the elderly in HCI methodology Multimedia design for the elderly Technology which support memory retrieval Technology for the elderly’s leisure and entertainment Use and design of smart phones for the elderly Serious games Gamification Cognitive exercise Alzheimer’s disease Nursing home 



The preparation of this paper was supported by the enable cluster and is catalogued by the enable steering committee as enable 015 ( This work was funded by a grant of the German Ministry for Education and Research (BMBF) FK 01EA1409A.


  1. 1.
    Albaina, I.M., Visser, T., van der Mast, C.A., Vastenburg, M.H.: Flowie: a persuasive virtual coach to motivate elderly individuals to walk. In: 2009 3rd International Conference on Pervasive Computing Technologies for Healthcare, PervasiveHealth 2009, pp. 1–7. IEEE April 2009Google Scholar
  2. 2.
    Almeida, L., Menezes, P., Dias, J.: Augmented reality framework for the socialization between elderly people. In: Handbook of Research on ICTs for Human-Centered Healthcare and Social Care Services, pp. 430–448. IGI Global (2013)Google Scholar
  3. 3.
    Andersen, C.L., Gudmundsson, H.P., Achiche, S., Boelskifte, P.: Challenges and limitations of applying an emotion-driven design approach on elderly users. In: DS 68-7: Proceedings of the 18th International Conference on Engineering Design (ICED 11), Impacting Society through Engineering Design, vol. 7: Human Behaviour in Design, Lyngby/Copenhagen, Denmark, 15–19 August 2011 (2011)Google Scholar
  4. 4.
    Baum, C., Edwards, D.F.: Cognitive performance in senile dementia of the Alzheimer’s type: the kitchen task assessment. Am. J. Occup. Ther. 47(5), 431–436 (1993)CrossRefGoogle Scholar
  5. 5.
    Bouchard, B., Imbeault, F., Bouzouane, A., Menelas, Bob-Antoine J.: Developing serious games specifically adapted to people suffering from Alzheimer. In: Ma, M., Oliveira, M.F., Hauge, J.B., Duin, H., Thoben, K.-D. (eds.) SGDA 2012. LNCS, vol. 7528, pp. 243–254. Springer, Heidelberg (2012). Scholar
  6. 6.
    Brauner, P., Calero Valdez, A., Schroeder, U., Ziefle, M.: Increase physical fitness and create health awareness through Exergames and gamification. In: Holzinger, A., Ziefle, M., Hitz, M., Debevc, M. (eds.) SouthCHI 2013. LNCS, vol. 7946, pp. 349–362. Springer, Heidelberg (2013). Scholar
  7. 7.
    Bravata, D.M., Smith-Spangler, C., Sundaram, V., Gienger, A.L., Lin, N., Lewis, R., et al.: Using pedometers to increase physical activity and improve health: a systematic review. JAMA 298(19), 2296–2304 (2007)CrossRefGoogle Scholar
  8. 8.
    Caprani, N., O’Connor, N.E., Gurrin, C.: Touch screens for the older user, pp. 95–118. InTech (2012)Google Scholar
  9. 9.
    Castilla, D., Garcia-Palacios, A., BretóN-LóPez, J., Miralles, I., BañOs, R.M., Etchemendy, E., et al.: Process of design and usability evaluation of a telepsychology web and virtual reality system for the elderly: Butler. Int. J. Hum. Comput. Stud. 71(3), 350–362 (2013)CrossRefGoogle Scholar
  10. 10.
    Coppola, J.F., Kowtko, M.A., Yamagata, C., Joyce, S.: Applying mobile application development to help dementia and Alzheimer patients. In: Proceedings of the Student-Faculty Research Day, CSIS, Pace University, pp. A6.1–A6.7. Helene & Grant Wilson Center for Social Entrepreneurship (2013)Google Scholar
  11. 11.
    de Siqueira, A.S.S., Yokomizo, J.E., Jacob-Filho, W., Yassuda, M.S., Aprahamian, I.: Review of decision-making in game tasks in elderly participants with Alzheimer disease and mild cognitive impairment. Dement. Geriatr. Cogn. Disord. 43(1–2), 81–88 (2017)CrossRefGoogle Scholar
  12. 12.
    Enable (2018). Accessed 21 Jan 2018
  13. 13.
    Entertainment Software Association: More than 40 million Americans age 50-plus play video games (2016). Accessed 26 Aug 2016
  14. 14.
    Fogg, B.J.: Persuasive technology: using computers to change what we think and do. Ubiquity, December 2002. Article no 5CrossRefGoogle Scholar
  15. 15.
    Fukada, S.: Japan faces its old age with robots and virtual reality (2018). Accessed 10 Feb 2018
  16. 16.
    GestureTek (2018). Accessed 13 Jan 2018
  17. 17.
    Holzinger, A., Searle, G., Nischelwitzer, A.: On some aspects of improving mobile applications for the elderly. In: Stephanidis, C. (ed.) UAHCI 2007. LNCS, vol. 4554, pp. 923–932. Springer, Heidelberg (2007). Scholar
  18. 18.
    Ijsselsteijn, W., Nap, H.H., de Kort, Y., Poels, K.: Digital game design for elderly users. In: Proceedings of the 2007 Conference on Future Play, pp. 17–22. ACM, November 2007Google Scholar
  19. 19.
    Jeng, M.Y., Pai, F.Y., Yeh, T.M.: The virtual reality leisure activities experience on elderly people. Appl. Res. Qual. Life 12(1), 49–65 (2017)CrossRefGoogle Scholar
  20. 20.
    Kobayashi, M., Hiyama, A., Miura, T., Asakawa, C., Hirose, M., Ifukube, T.: Elderly user evaluation of mobile touchscreen interactions. In: Campos, P., Graham, N., Jorge, J., Nunes, N., Palanque, P., Winckler, M. (eds.) INTERACT 2011. LNCS, vol. 6946, pp. 83–99. Springer, Heidelberg (2011). Scholar
  21. 21.
    Kojima, T., Hiyama, A., Kobayashi, K., Kamiyama, S., Ishii, N., Hirose, M., Akiyama, H.: Frailty prevention exercise for middle-aged and aged female using motion instruction systems in virtual environment. Trans. Virtual Reality Soc. Jpn. 21(2), 273–281 (2016)Google Scholar
  22. 22.
    Koutny, J.: Serious game to support a healthy nutrition for the elderly. Bachelor Thesis, TU München (2017)Google Scholar
  23. 23.
    Lee, S., Zhai, S.: The performance of touch screen soft buttons. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pp. 309–318. ACM, April 2009Google Scholar
  24. 24.
    Levy, F., Leboucher, P., Rautureau, G., Komano, O., Millet, B., Jouvent, R.: Fear of falling: efficacy of virtual reality associated with serious games in elderly people. Neuropsychiatric Dis. Treat. 12, 877 (2016)CrossRefGoogle Scholar
  25. 25.
    Mahoney, F., Barthel, D.: Functional evaluation: the Barthel Index. Maryland State Med. J. 1965(14), 56–61 (1965)Google Scholar
  26. 26.
    Malik, S.A., Azuddin, M., Abdullah, L.M., Mahmud, M.: Exploring older people’s experience with augmented reality (AR) applications. J. Eng. Appl. Sci. 10, 18004–18011 (2015)Google Scholar
  27. 27.
    Malik, S.A., Abdullah, L.M., Mahmud, M., Azuddin, M.: Mobile applications using augmented reality to support older people. In: Research and Innovation in Information Systems (ICRIIS), pp. 374–379. IEEE, November 2013Google Scholar
  28. 28.
    One Caring Team (2016). Accessed 25 Aug 2016
  29. 29.
    Ownby, R.L., Czaja, S.J.: Healthcare website design for the elderly: improving usability. In: AMIA Annual Symposium Proceedings, vol. 2003, p. 960. American Medical Informatics Association (2003)Google Scholar
  30. 30.
    Palacio, R.R., Acosta, C.O., Cortez, J., Morán, A.L.: Usability perception of different video game devices in elderly users. Univ. Access Inf. Soc. 16(1), 103–113 (2017)CrossRefGoogle Scholar
  31. 31.
    Park, E.C., Kim, S.G., Lee, C.W.: The effects of virtual reality game exercise on balance and gait of the elderly. J. Phys. Ther. Sci. 27(4), 1157–1159 (2015)CrossRefGoogle Scholar
  32. 32.
    Platoni, K.: Virtual reality aimed at the elderly finds new fans (2016). Accessed 25 Aug 2016
  33. 33.
    Pratchett, R.: GAMERS IN THE UK. Digital play, digital lifestyles. BBC (2005). Accessed 25 Aug 2016
  34. 34.
    Pyae, A., Liukkonen, T.N., Saarenpää, T., Luimula, M., Granholm, P., Smed, J.: When Japanese elderly people play a Finnish physical exercise game: a usability study. J. Usability Stud. 11(4), 131–152 (2016)Google Scholar
  35. 35.
    Reid, D.: Virtual reality: an enabling environment for occupational performance of leisure activities for the older stroke survivor. Univ. Toronto Med. J. 80(3), 192–194 (2003)Google Scholar
  36. 36.
    Rendever (2016). Accessed 25 Aug 2016
  37. 37.
    Rodríguez-Fórtiz, M.J., Rodríguez-Domínguez, C., Cano, P., Revelles, J., Rodríguez-Almendros, M.L., Hurtado-Torres, M.V., Rute-Pérez, S.: Serious games for the cognitive stimulation of elderly people. In: 2016 IEEE International Conference on Serious Games and Applications for Health (SeGAH), pp. 1–7. IEEE, May 2016Google Scholar
  38. 38.
    Sherry, J.L., Lucas, K., Greenberg, B.S., Lachlan, K.: Video game uses and gratifications as predictors of use and game preference. In: Playing Video Games: Motives, Responses, and Consequences, vol. 24, pp. 213–224 (2006)Google Scholar
  39. 39.
    Silva, K.G., De Freitas, T.B., Doná, F., Ganança, F.F., Ferraz, H.B., Torriani-Pasin, C., Pompeu, J.E.: Effects of virtual rehabilitation versus conventional physical therapy on postural control, gait, and cognition of patients with Parkinson’s disease: study protocol for a randomized controlled feasibility trial. Pilot Feasibility Stud. 3(1), 68 (2017)CrossRefGoogle Scholar
  40. 40.
    Strengers, J.: Smartphone interface design requirements for seniors. Information Studies. University of Amsterdam, Amsterdam (2012). Accessed 15 Jan 2018
  41. 41.
    Suchacek, P.: Intervention- and design strategies of a serious game for elderly. Bachelor Thesis, TU München (2016)Google Scholar
  42. 42.
    Tong, T., Chan, J.H., Chignell, M.: Serious games for dementia. In: Proceedings of the 26th International Conference on World Wide Web Companion, pp. 1111–1115. International World Wide Web Conferences Steering Committee, April 2017Google Scholar
  43. 43.
    Torres, A.C.S.: Cognitive effects of video games on old people. Int. J. Disabil. Hum. Dev. 10(1), 55–58 (2011)CrossRefGoogle Scholar
  44. 44.
    Van Schaik, P., Blake, J., Pernet, F., Spears, I., Fencott, C.: Virtual augmented exercise gaming for older adults. CyberPsychol. Behav. 11(1), 103–106 (2008)CrossRefGoogle Scholar
  45. 45.
    Vanni, O.: This VR startup lets people in elder care still get a taste of the outside world (2016). Accessed 25 Aug 2016
  46. 46.
    Vogel, T., Brechat, P.H., Leprêtre, P.M., Kaltenbach, G., Berthel, M., Lonsdorfer, J.: Health benefits of physical activity in older patients: a review. Int. J. Clin. Pract. 63(2), 303–320 (2009)CrossRefGoogle Scholar
  47. 47.
    Weisman, S.: Computer games for the frail elderly. Gerontologist 23(4), 361–363 (1983)CrossRefGoogle Scholar
  48. 48.
    West, J.H., Hall, P.C., Hanson, C.L., Barnes, M.D., Giraud-Carrier, C., Barrett, J.: There’s an app for that: content analysis of paid health and fitness apps. J. Med. Internet Res. 14(3), e72 (2012)CrossRefGoogle Scholar
  49. 49.
    Wiemeyer, J., Kliem, A.: Serious games in prevention and rehabilitation—a new panacea for elderly people? Eur. Rev. Aging Phys. Act. 9(1), 41 (2012)CrossRefGoogle Scholar
  50. 50.
    Williams, D., Yee, N., Caplan, S.E.: Who plays, how much, and why? Debunking the stereotypical gamer profile. J. Comput. Mediated Commun. 13(4), 993–1018 (2008)CrossRefGoogle Scholar
  51. 51.
    Williams, P., Drolet, A.: Age-related differences in responses to emotional advertisements. J. Consum. Res. 32(3), 343–354 (2005)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Christian Eichhorn
    • 1
    Email author
  • David A. Plecher
    • 1
  • Gudrun Klinker
    • 1
  • Martin Lurz
    • 2
  • Nadja Leipold
    • 2
  • Markus Böhm
    • 2
  • Helmut Krcmar
    • 2
  • Angela Ott
    • 3
  • Dorothee Volkert
    • 3
  • Atsushi Hiyama
    • 4
  1. 1.Chair for Computer Aided Medical Procedures and Augmented RealityThe Technical University of MunichMunichGermany
  2. 2.Chair for Information SystemsThe Technical University of MunichMunichGermany
  3. 3.Institute for Biomedicine of AgingFriedrich-Alexander-Universität Erlangen-NürnbergNürnbergGermany
  4. 4.Research Center for Advanced Science and TechnologyThe University of TokyoTokyoJapan

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