Abstract

With increasingly aging societies in the western countries, an ever-growing prevalence of dementia and its most common subset, Alzheimer's disease, can be observed. As this neurodegenerative disease is still incurable, its destructive effects can only be slowed down. One promising approach to this end is the application of serious games. These digital applications help elders train their cognitive abilities in a pleasant environment to mitigate the decline caused by the natural aging process and dementia. In this thesis, a serious card game is designed and implemented, with special attention paid to emotional factors for increasing intrinsic motivation and encouraging prolonged play. In order to assess the influence of different interaction schemes, a comparison between a touch-based digital and a physical tactile game-mode will be drawn. Social aspects will be explored by using a shared-screen multi-player mode. In an evaluation at a senior citizen nursing home using a custom questionnaire, the qualities of the aforementioned modes are assessed. Results suggest higher potential in a purely digital approach with many quality-decreasing factors in the physical alternative, due to the degraded motor control and precision of the target group. The importance of large dedicated user interfaces is validated as input errors are the predominant issue in the shared-screen approach. Emotional factors such as reminiscence and scene familiarity prove to be a helpful tool to engage the elderly.

Project Description

In this thesis a serious game was conceived and implemented to help senior citizens and dementia patients train their cognitive abilities and be motivated to play through emotional factors in the game design. Two evaluations, one early in development and one after completion, guided the project in a user-centered design approach. In order to compare different input schemes and modalities, two major sub-projects were implemented, one game-mode entirely digital on a touch screen device, and another mode mixing digital and physical elements. Here, cardboard smart playing cards with RFID tags were combined with a digital display for emotional elements and assistance. A digital companion and guide was implemented following a state machine pattern for assisting and guiding players at various levels. Furthermore, to explore social aspects and levels of engagement, a shared-screen multi-player mode using a cardboard view-blocker placed on top of the screen was devised.

Conclusion

The evaluations clearly showed the strengths and weaknesses of the present design, particularly the need for dedicated screens per player in a multi-player environment and the difficulty of dealing with degraded motor precision when utilizing physical game elements. Furthermore it was found that it is important to focus on familiarity when developing metaphorical game components, such as the right material composition for tactile playing cards and proper textures for digital interfaces.

The prototypes showed stability and acceptability with the target group as the users generally enjoyed playing and understood the rules, even showing natural understanding of the core rule, the ordinal sequence of the playing cards. The visual presentation proved to be clear and high in usability as little to no accidental invocations of functions were observed in the single-player mode. The usage of animations and vibrotactile feedback worked well for accessibility, particularly for attention-grabbing in the stages of assistance.

From this it can be concluded that the most promising approach explored in this thesis was the purely digital one, showing highest player engagement and action success rate, along with little to no uncertainty about game elements or interaction.

Paper