Background Serious games have been found to have enhancing and preventative effects on cognitive abilities in healthy older adults. Yet, there are few results on the effects in older seniors with age-related low cognitive impairments. Their special needs were considered when designing and using innovate technology in the area of prevention, which is especially relevant owing to the continuously aging population. Objective The objective of this study was to evaluate the impact of a serious game on the cognitive abilities of seniors in order to potentially implement innovative resource-oriented technological interventions that can help to meet future challenges. Methods In this controlled trial, we tested the serious game MemoreBox, which features modules specifically designed for seniors in nursing homes. Over a period of 1 year, we tested the cognitive abilities of 1000 seniors at 4 time points using the Mini-Mental Status Test. Only half of the participating seniors engaged with the serious game. Results The study included an intervention group (n=56) and a control group (did not play; n=55). Based on the in-game data collection, a second intervention group (n=38) was identified within the original intervention group, which exactly followed the planned protocol. There were no noteworthy differences between the demographic and main variables of the overall sample. The large reduction in the sample size was due to the effects of the COVID-19 pandemic (drop-out rate: 88.9%). The CI was set at 5%. Mixed analysis of variance (ANOVA) between the cognitive abilities of the intervention and control groups did not show a statistically significant difference between time and group (F2.710,295.379=1.942; P=.13; partial η²=0.018). We noted approximately the same findings for mixed ANOVA between the cognitive abilities of the second intervention and control groups (F3,273=2.574; P=.054; partial η²=0.028). However, we did observe clear tendencies and a statistically significant difference between the 2 groups after 9 months of the intervention (t88.1=−2.394; P=.02). Conclusions The results of this study show similarities with the current research situation. Moreover, the data indicate that the intervention can have an effect on the cognitive abilities of seniors, provided that they regularly play the serious game of MemoreBox. The small sample size means that the tendency toward improvement cannot be proven as statistically significant. However, the tendency shown warrants further research. Establishing an effective prevention tool as part of standard care in nursing homes by means of an easy-to-use serious game would be a considerable contribution to the weakened health care system in Germany as it would offer a means of activating senior citizens in partially and fully inpatient care facilities. Trial Registration German Clinical Trials Register DRKS00016633; https://tinyurl.com/2e4765nj

Background The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. At the beginning of 2020, the COVID-19 pandemic led to many restrictions, which affected seniors in care facilities in the form of severe isolation. The isolation led, among other things, to a lack of exercise, which has led to a multitude of negative effects for this target group. Serious games can potentially help by being used anywhere at any time to strengthen skills with few resources. Objective The aim of this study is to evaluate the effectiveness of a serious game to strengthen motor skills (study 1) and the influence of pandemic restrictions (study 2) on seniors in care facilities. Methods The data on motor skills (measured by the Tinetti test) originated from an intervention study with repeated measurements that was interrupted by the pandemic conditions. Data were collected 4 times every 3 months with an intervention group (IG, training 3 times for 1 hour per week) and a control group (CG, no intervention). There were 2 substudies. The first considered the first 6 months until the pandemic restrictions, while the second considered the influence of the restrictions on motor skills. Results The sample size was 70. The IG comprised 31 (44%) participants, with 22 (71%) female and 9 (29%) male seniors with an average age of 85 years. The CG comprised 39 (56%) participants, with 31 (79%) female and 8 (21%) male seniors with an average age of 87 years. In study 1, mixed-design ANOVA showed no significant interaction between measurement times and group membership for the first measurements (F2.136=1.414, P<.25, partial η2=.044), but there was a significant difference between the CG (mean 16.23, SD 1.1) and the IG (mean 19.81, SD 1.2) at the third time of measurement (P=.02). In study 2 the mixed-design ANOVA (used to investigate motor skills before and after the pandemic conditions between the 2 groups) couldn’t reveal any significant interaction between measurement times and group membership: F1.67=2.997, P<.09, partial η2=.043. However, there was a significant main effect of the time of measurement: F1.67=5.44, P<.02, partial η²=.075. Conclusions During the first 6 months, the IG showed increased motor skills, whereas the motor skills of the CG slightly deteriorated and showed a statistically significant difference after 6 months. The pandemic restrictions leveled the difference and showed a significant negative effect on motor skills over 3 months. As our results show, digital games have the potential to break down access barriers and promote necessary maintenance for important skills. The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. This potentially great benefit for the challenges of tomorrow shows the relevance of the topic and demonstrates the urgent need for action and research. Trial Registration Deutsches Register klinischer Studien DRKS00016633; https://tinyurl.com/yckmj4px

BACKGROUND Beginning of 2020 the corona pandemic, led to many restrictions which affected seniors in care facilities, in form of severe isolation. The isolation led, among other things, to a lack of exercise, which leads to a multitude of negative effects for this target group. Serious Games can potentially help by being able to use them anywhere at any time to strengthen skills with few resources. OBJECTIVE The aim of this study is to evaluate the effectiveness of a Serious Games to strengthen motor skills (Study 1) and the influence of pandemic restrictions (Study 2) for seniors in care facilities. METHODS The data on motor skills (measured by the Tinetti test (36)), originated from an intervention study with repeated measurements that was interrupted by the pandemic conditions. Data was collected 4 times (every 3 months) with an intervention group (IG, training three times one hour per week) and the control group (CG, no intervention). There are two sub-studies. The first considers the first 6 months until the pandemic restrictions, the second considers the influence of the restrictions on the motor skills. RESULTS The sample size is n=70. The IG consists of n= 31, with 22 female and 9 male seniors with an average age of 85. The CG consists of n= 39 participants (female: 31; male: 8) with an average age of 87. Study 1: The Mixed ANOVA shows no significant interaction between the measurement times and group membership for the first measurements F(2.136) = 1.414, p <.247, partial η² = .044, but there is a significant difference between the CG (M = 16.23; SD = 1.1) and the IG (M = 19.81; SD = 1,2) at the third time of measurement p = .023. Study 2: The Mixed ANOVA used to investigate motor skills before and after the pandemic conditions between the groups did not reveal any significant interaction between the time of measurement and group membership: F(1.67) = 2.997, p <.088, partial η² = .043. However, there was a significant main effect for time of measurement F(1.67) = 5.44, p <.023, partial η² = .075. CONCLUSIONS During the first six months, the IG increased their motor skills, whereas the CG deteriorated slightly, which let them differ statistically significant after 6 months. The pandemic restrictions leveled the difference and showed a significant negative effect on motor skills over the time of 3 month. As our results show, digital games have the potential to break down access barriers and promote necessary maintenance for important skills. The pandemic has highlighted the importance of low-threshold opportunities for exercise and physical activity. This potentially great benefit for the challenges of tomorrow shows the relevance of the topic and demonstrate the urgent need for action and research. CLINICALTRIAL DRKS00016633

BACKGROUND Exergames have not only found to have enhancing and preventative effects on physical but also on cognitive abilities in healthy older adults. Yet, there are just few results on effects for older seniors with age-related low physical and/or cognitive impairments. Their special needs were considered when designing and using innovate technology for the field of prevention, especially being relevant due to the continuously ageing population. OBJECTIVE In this controlled trial, we test a serious game with various modules specifically designed for seniors in care homes, the so-called MemoreBox. METHODS Over a period of one year and four points in time 1.000 seniors were tested in their cognitive abilities via the Mini-Mental-Status-Test. Half used the serious games three times a week for one hour and half did not. The objective data from the games gave us the opportunity to divide the intervention-group through identify those who played regularly. RESULTS The sample consists of an intervention group (n=56) and a control group (n=55) that does not play. Due to the technical data, a second intervention group (n=38) could be identified within the original intervention group, which carried out the study design correctly according to plan. The are no noteworthy differences between the demographic and main variables of the overall sample. The large reduction in the sample size is due to the effects of the corona-situation, in the middle of the survey (Drop-Out 88,9%). The Confidence Interval was set at 5%. The mixed ANOVA between the cognitive abilities of the IG and the CG couldn’t show a significant difference between time an group F(2,710,295,379) = 1.942, p <.129, partial η² = .018. The same for the mixed ANOVA between the cognitive abilities of the IG2 und CG F(3.273) = 2.574, p <.054, partial η² = .028, but with a clear tendencies and a significant difference between the two groups after 9 month of intervention t(88.1) = - 2,394, p = .021. CONCLUSIONS The results of this paper basically report something like the current research situation and the tendency for the intervention to be effective on the cognitive abilities of seniors can be formulated, provided that they regularly play the serious games of the MemoreBox. The small sample, the non-existent RCT and the no significance at an α= 5% suggest additional, further research. Establishing a preventively effective tool as part of standard care in nursing homes by means of an easy-to-use serious game would be a relieving contribution to the weakened health system, in which there is a lack of activating offers for senior citizens in (partially) inpatient care facilities. CLINICALTRIAL German Clinical Trials Register (DRKS), DRKS00016633

BACKGROUND Exergames have shown evidence to support physical activity in the elderly, thereby supporting cognitive and motor abilities and preventing falls. While the motivation for self-regulated exercising is low, high-intensive, diverse and long-lasting exercises on a regular is most effective. Using persuasive technologies as games requires matching the skill-level and preferences of their users. This poses a big challenge for an extremely heterogeneous and at the same time less accountable and assessable target group, as the senior population in care homes includes a variety of generations in stages of mental and physical decrease. Most exergames so far neglected to take the varying skill levels and preferences for themes and activities into account enough. OBJECTIVE The aim was to develop a new care-provider assisted electronic exergame module adapted to the diversity of the target group of elderly people in care. This is considered a crucial step to enhance engagement, and therefore treatment adherence. METHODS We conducted an inclusive user-centered design (UCD) research using a multi-method approach including literature study, quantitative ratings, user testing and observations, semi-structured qualitative interviews and focus groups with the target group of seniors in care homes. We purposefully included potential users from the edges of the age and skill range, women and men, and analysed the demographic influences of age and gender. RESULTS The quantitative assessment of preferences before the development was the foundation upon which the content of the selected game modules was based. The individual differences in preferences were much larger and more practically relevant than differences between generations, genders or level of skills (|r|<.45, n=58).The gaming-module “Dancing” as the most preferred screen activity (57%) and effective music therapy was chosen to be implemented. “Music” (60%) and “Nature” (56%) as the largest interests were included in the game design. Results showed that Cognitive (73%) and physical (67%) challenges, playing in cooperation (67%) or competition (65%) were the most popular. (ii) The qualitative exploration with the target group before the development (n=12) helped to expand upon the findings from (i) and integrate those into a concrete gameplay with individually selectable content chosen for highly varying preferences in the favored playing mode, music styles and levels of difficulty in regard to movements. CONCLUSIONS The found preferences match and expand the research on common life themes of the elderly. The new module allowed users with restricted mobility, even those in a wheelchairs , to engage in gameplay. CLINICALTRIAL Deutsches Register klinischer Studien: DRKS00016633