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Published Online: 1 August 2016

Smartkuber: A Serious Game for Cognitive Health Screening of Elderly Players

Publication: Games for Health Journal
Volume 5, Issue Number 4

Abstract

Objective: The goal of this study was to design and develop a serious game for cognitive health screening of the elderly, namely Smartkuber, and evaluate its construct, criteria (concurrent and predictive), and content validity, assessing its relationship with the Montreal Cognitive Assessment (MoCA) test. Furthermore, the study aims to evaluate the elderly players’ game experience with Smartkuber.
Subjects and Methods: Thirteen older adults were enrolled in the study. The game was designed and developed by a multidisciplinary team. The study follows a mixed methodological approach, utilizing the In-Game Experience Questionnaire to assess the players’ game experience and a correlational study, to examine the relationship between the Smartkuber and MoCA scores. The learning effect is also examined by comparing the mean game scores of the first and last game sessions of each player (Delta scores).
Results: All 13 participants (mean age: 68.69, SD: 7.24) successfully completed the study. Smartkuber demonstrated high concurrent validity with the MoCA test (r = 0.81, P = 0.001) and satisfying levels of predictive and content validity. The Delta scores showed no statistically significant differences in scoring, thus indicating no learning effects during the Smartkuber game sessions.
Conclusions: The study shows that Smartkuber is a promising tool for cognitive health screening, providing an entertaining and motivating gaming experience to elderly players. Limitations of the study and future directions are discussed.

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References

1.
Boletsis C, McCallum S. Connecting the player to the doctor: Utilising serious games for cognitive training & screening. DAIMI PB 2015; 597:5–8.
2.
Persson J, Nyberg L, Lind J, et al. Structure-function correlates of cognitive decline in aging. Cereb Cortex 2006; 16:907–915.
3.
Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: The Benefits of Early Diagnosis and Intervention. London, UK: Alzheimer's Disease International (ADI); 2011.
4.
Waldemar G, Phung K, Burns A, et al. Access to diagnostic evaluation and treatment for dementia in Europe. Int J Geriatr Psychiatry 2007; 22:47–54.
5.
Connolly A, Gaehl E, Martin H, et al. Under diagnosis of dementia in primary care: Variations in the observed prevalence and comparisons to the expected prevalence. Aging Ment Health 2011; 15:978–984.
6.
Scanlon L, O'Shea E, O'Caoimh R, Timmons S. Usability and validity of a battery of computerised cognitive screening tests for detecting cognitive impairment. Gerontology 2016; 62:247–252.
7.
Ismail Z, Rajji TK, Shulman KI. Brief cognitive screening instruments: An update. Int J Geriatr Psychiatry 2010; 25:111–120.
8.
Julayanont P, Phillips N, Chertkow H, Nasreddine ZS. Montreal Cognitive Assessment (MoCA): Concept and clinical review. In: Larner JA, ed. Cognitive Screening Instruments: A Practical Approach. London, UK: Springer London; 2013, pp. 111–151.
9.
Jacqmin-Gadda H, Fabrigoule C, Commenges D, Dartigues J-F. A 5-year longitudinal study of the mini-mental state examination in normal aging. Am J Epidemiol 1997; 145:498–506.
10.
Hausknecht JP, Halpert JA, Di Paolo NT, Moriarty Gerrard MO. Retesting in selection: A meta-analysis of coaching and practice effects for tests of cognitive ability. J Appl Psychol 2007; 92:373–385.
11.
Tong T, Guana V, Jovanovic A, et al. Rapid deployment and evaluation of mobile serious games: A cognitive assessment case study. Procedia Comput Sci 2015; 69:96–103.
12.
Zucchella C, Sinforiani E, Tassorelli C, et al. Serious games for screening pre-dementia conditions: From virtuality to reality? A pilot project. Funct Neurol 2014; 29:153–158.
13.
Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53:695–699.
14.
Smith T, Gildeh N, Holmes C. The Montreal Cognitive Assessment: Validity and utility in a memory clinic setting. Can J Psychiatry 2007; 52:329–332.
15.
Luis CA, Keegan AP, Mullan M. Cross validation of the Montreal Cognitive Assessment in community dwelling older adults residing in the Southeastern US. Int J Geriatr Psychiatry 2009; 24:197–201.
16.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189–198.
17.
Gluhm S, Goldstein J, Loc K, et al. Cognitive performance on the mini-mental state examination and the Montreal Cognitive Assessment across the healthy adult lifespan. Cogn Behav Neurol 2013; 26:1–5.
18.
Zygouris S, Giakoumis D, Votis K, et al. Can a virtual reality cognitive training application fulfill a dual role? Using the virtual supermarket cognitive training application as a screening tool for mild cognitive impairment. J Alzheimers Dis 2015; 44:1333–1347.
19.
McCallum S, Boletsis C. Dementia games: A literature review of dementia-related serious games. Lect Notes Comput Sci 2013; 8101:15–27.
20.
McCallum S, Boletsis C. A taxonomy of serious games for dementia. In: Schouten B, Fedtke S, Bekker T, Schijven M, Gekker A, eds. Games for Health. Wiesbaden, Germany: Springer Fachmedien Wiesbaden; 2013, pp. 219–232.
21.
McCallum S, Boletsis C. Augmented reality & gesture-based architecture in games for the elderly. Stud Health Technol Inform 2013; 189:139–144.
22.
Boletsis C, McCallum S. Augmented reality cube game for cognitive training: An interaction study. Stud Health Technol Inform 2014; 200:81–87.
23.
Boletsis C, McCallum S. Augmented reality cubes for cognitive gaming: Preliminary usability and game experience testing. Int J Serious Games 2016; 3:3–18.
24.
Baranowski T, Buday R, Thompson D, et al. Developing games for health behavior change: Getting started. Games Health J 2013; 2:183–190.
25.
Kato PM. Evaluating efficacy and validating games for health. Games Health J 2012; 1:74–76.
26.
Yee N. The Gamer Motivation Model in Handy Reference Chart and Slides. 2015. http://quanticfoundry.com/2015/12/15/handy-reference (accessed April 14, 2016).
27.
Billinghurst M, Grasset R, Seichter H, Dünser A. Towards ambient augmented reality with tangible interfaces. Lect Notes Comput Sci 2009; 5612:387–396.
28.
Gamberini L, Fabregat M, Spagnolli A, et al. Eldergames: Videogames for empowering, training and monitoring elderly cognitive capabilities. Gerontechnology 2008; 7:111.
29.
Zhou Z, Cheok A, Pan J. 3D story cube: An interactive tangible user interface for storytelling with 3D graphics and audio. Pers Ubiquitous Comput 2004; 8:374–376.
30.
Sharlin E, Itoh Y, Watson B, et al. Spatial tangible user interfaces for cognitive assessment and training. Lect Notes Comput Sci 2004; 3141:137–152.
31.
Brox E, Fernandez-Luque L, Tollefsen T. Healthy gaming—Video game design to promote Health. Appl Clin Inform 2011; 2:128–142.
32.
Plaza I, Martín L, Martin S, Medrano C. Mobile applications in an aging society: Status and trends. J Syst Softw 2011; 84:1977–1988.
33.
Gold SC, Wolfe J. The validity and effectiveness of a business game beta test. Simul Gaming 2012; 43:481–505.
34.
IJsselsteijn W, van den Hoogen W, Klimmt C, et al. Measuring the experience of digital game enjoyment. In: Spink A, Ballintijn M, Bogers N, Grieco F, Loijens L, Noldus L, Smit G, Zimmerman P, eds. Proceedings of Measuring Behavior. Wageningen, Netherlands: Noldus Information Tecnology; 2008, pp. 88–89.
35.
Herrewijn L, Poels K. Putting brands into play. Int J Advert 2013; 32:17–44.
36.
Rothmayr C, Baumann O, Endestad T, et al. Dissociation of neural correlates of verbal and non-verbal visual working memory with different delays. Behav Brain Funct 2007; 3:56.
37.
Morey CC, Cowan N. When do visual and verbal memories conflict? The importance of working-memory load and retrieval. J Exp Psychol Learn Mem Cogn 2005; 31:703–713.
38.
McLennan SN, Mathias JL, Brennan LC, Stewart S. Validity of the montreal cognitive assessment (MoCA) as a screening test for mild cognitive impairment (MCI) in a cardiovascular population. J Geriatr Psychiatry Neurol 2011; 24:33–38.
39.
Falleti MG, Maruff P, Collie A, Darby DG. Practice effects associated with the repeated assessment of cognitive function using the CogState battery at 10-minute, one week and one month test-retest intervals. J Clin Exp Neuropsychol 2006; 28:1095–1112.

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Information

Published In

cover image Games for Health Journal
Games for Health Journal
Volume 5Issue Number 4August 2016
Pages: 241 - 251
PubMed: 27192473

History

Published in print: August 2016
Published online: 1 August 2016
Published ahead of print: 18 May 2016

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Costas Boletsis
Faculty of Computer Science and Media Technology, Norwegian University of Science and Technology, Gjøvik, Norway.
Simon McCallum
Faculty of Computer Science and Media Technology, Norwegian University of Science and Technology, Gjøvik, Norway.

Notes

Address correspondence to:Costas Boletsis, MA, MScFaculty of Computer Science and Media TechnologyNorwegian University of Science and TechnologyGjøvik 2815Norway
E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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