The world ageing problem is prompting new sustainable ways to support elderly people. As such, it is important to promote personalized and intelligent ways to assure the active and healthy ageing of the population. Technological breakthroughs have led to the development of personalized healthcare systems, capable of monitoring and providing feedback on different aspects that can improve the health of the elderly person. Furthermore, defining motivational strategies to persuade the elderly person to be healthier and stay connected to such systems is also fundamental. In this work, a coaching system is presented, especially designed to support elderly people and motivate them to pursue healthier ways of living. To do this, a coaching application is developed using both a cognitive virtual assistant to directly interact with the elderly person and provide feedback on his/her current health condition, and several gamification techniques to motivate the elderly person to stay engaged with the application. Additionally, a set of simulations were performed to validate the proposed system in terms of the support and feedback provided to the user according to his progress, and through interactions with the cognitive assistant.

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Background The global percentage of older people has increased significantly over the last decades. Information and communication technologies have become essential to develop and motivate them to pursue healthier ways of living. This paper examines a personalized coaching health care service designed to maintain living conditions and active aging among older people. Among the technologies the service includes, we highlight the use of both gamification and cognitive assistant technologies designed to support older people and an application combining a cognitive virtual assistant to directly interact with the older person and provide feedback on their current health condition and several gamification techniques to motivate the older person to stay engaged with the application and pursuit of healthier daily habits. Objective This pilot study aimed to investigate the feasibility and usability of a gamified agent-based system for older people and obtain preliminary results on the effectiveness of the intervention regarding physical activity health outcomes. Methods The study was designed as an intervention study comparing pre- and posttest results. The proposed gamified agent-based system was used by 12 participants over 7 days (1 week), and step count data were collected with access to the Google Fit application programming interface. Step count data after the intervention were compared with average step count data before the intervention (average daily values over a period of 4 weeks before the intervention). A　1-tailed Student t test was used to determine the relationship between the dependent and independent variables. Usability was measured using the System Usability Scale questionnaire, which was answered by 8 of the 12 participants in the study. Results The posttest results showed significant pre- to posttest changes (P=.30; 1-tailed Student t test) with a moderate effect size (Cohen d=0.65). The application obtained an average usability score of 78. Conclusions The presented pilot was validated, showing the positive health effects of using gamification techniques and a virtual cognitive assistant. Additionally, usability metrics considered for this study confirmed high adherence and interest from most participants in the pilot.