Feasibility and Acceptability of a Serious Mobile-Game Intervention for Older Adults

Figures & data

Figure 1. The vibrant minds mobile games. (a) Bejeweled. (b) Mahjong. (c) Whack-A-Mole. (d) Word Search.

Figure 2. Overview of study design and procedure.

MoCA = Montreal Cognitive Assessment. TMT A&B = Trails Making Test part A and B. T₀ = Assessment at pre-baseline. T₁ = Assessment right after baseline phase ends. T₂ = Assessment right after intervention phase ends. T₃ = Assessment right after withdrawal phase ends. PANAS = Positive affect negative affect schedule.

Table 1 Demographics.

Variable	Mean (SD)
Age (years)	78.30 (8.03)
Gender	n (%)
Men	7 (35)
Women	13 (65)
Setting	n (%)
Supportive living facility	9 (45)
Alzheimer Society facility	11 (55)
Maximal educational level achieved	n (%)
Elementary school	1 (5)
High school diploma	6 (30)
Trade/vocational training	2 (10)
College diploma	4 (20)
Bachelor’s degree	5 (25)
Master’s degree	2 (10)
Doctorate degree	0 (0)
Residential status	n (%)
Lives in the community alone	1 (5)
Lives in the community with others	11 (55)
Retirement home/assisted living	8 (40)
Participated in a day program for older adults	n (%)
Yes	5 (25)
No	14 (70)
Medical conditions (self-reported)	n (%)
No	6 (30)
Yes - Movement	1 (5)
Yes - Vision	3 (15)
Yes - Hearing	4 (20)
Yes - Cognitive	6 (30)
Cognitive measures at the pre-baseline	Mean (SD)
MoCA (n = 20)	22.80 (7.35)
TMT-A (n = 19)	64.00 (29.42)
TMT-B (n = 19)	202.83 (153.20)

Table 2. Individual participants’ information and values per phase per outcome variable.

Part	Gen (Age)	Game	Dem	DP BL	PANAS								Engagement
					SD BL	Means (-40 to +40)			Slopes			Sig.	SD BL	Means (8 to 32)			Slopes			Sig.
						BL	I	W	BL	I	W			BL	I	W	BL	I	W
P1	W(64)	B	N	2	0.71	17.50	16.38	18.33	2.38	−0.30	−6.00	Y (-)	1.41	27.00	22.63	24.33	4.76	−0.30	−2.00	Y (-)
P2	M(67)	M	Y	2	2.83	25.00	22.19	14.33	9.52	0.20	−28.00	N	2.12	25.50	22.31	17.67	7.14	0.00	−15.00	N
P3	W(74)	WS	Y	3	5.13	28.67	29.27	26.67	−10.00	−0.50	1.00	N	3.06	27.33	27.87	27.67	−2.00	−0.70	−3.00	N
P4	M(75)	WAM	N	3	4.04	26.33	18.25	20.00	−3.00	−0.75	0.00	Y (-)	1.15	24.67	23.33	24.33	−2.00	0.30	2.00	N
P7	W(78)	WS	N	3	5.51	11.33	11.60	16.00	−1.00	0.25	0.00	N	0.58	26.33	27.93	26.33	−1.00	−0.50	−1.00	Y (+)
P8	M(81)	WAM	Y	3	7.00	14.00	16.07	19.33	−13.00	−1.75	−20.00	N	1.00	22.00	22.40	21.33	1.00	0.50	−1.00	Y (+)
P9	M(77)	B	N	3	6.93	17.00	29.50	29.67	12.00	0.00	1.00	Y (+)	2.08	25.67	27.38	27.67	3.00	0.20	0.00	Y (+)
P10	W(76)	M	Y	3	12.70	20.33	31.13	22.33	22.00	−2.75	8.00	N	3.61	28.00	30.00	25.00	7.00	0.90	13.00	N
P13	W(59)	B	N	3	9.02	21.33	25.94	12.50	−8.00	−3.00	7.00	N	4.04	26.67	26.88	21.50	0.00	−0.85	1.00	N
P14	M(81)	M	Y	3	5.03	13.33	11.88	3.67	−4.00	1.20	3.00	N	5.29	23.00	24.44	25.00	−8.00	0.10	−2.00	N
P15	W(83)	WS	N	5	6.43	30.40	35.75	32.00	8.45	0.00	4.76	N	2.95	27.20	29.25	28.00	2.55	0.00	0.00	N
P16	M(85)	WAM	N	5	8.70	24.80	33.63	33.00	7.25	−0.80	28.57	N	2.07	28.60	30.06	29.50	1.90	0.10	−7.14	N
P17	W(81)	B	N	4	10.30	28.00	33.33	34.50	−9.40	−0.63	26.19	N	7.50	28.25	30.19	29.50	−7.30	0.30	11.90	N
P18	W(69)	M	N	4	1.71	30.75	35.19	31.00	1.30	0.30	4.76	Y (+)	1.50	26.75	30.00	26.50	1.35	0.30	2.38	Y (+)
P19	W(80)	WS	N	4	5.19	7.25	23.75	31.00	−5.00	1.25	9.52	Y (+)	3.59	28.25	29.50	30.00	4.45	0.70	0.00	N
P20	M(88)	WAM	N	4	4.12	24.50	26.13	24.00	6.75	0.00	14.29	N	2.08	25.50	24.44	21.50	3.60	−2.30	11.90	N
P21	W(78)	B	N	2	1.41	11.00	12.66	7.50	4.76	0.75	−21.43	N	1.41	20.00	20.31	20.50	4.76	−0.50	−16.67	Y (+)
P23	W(89)	WS	N	5	5.93	23.20	27.00	32.00	5.40	−0.50	9.52	N	1.41	24.00	25.06	30.00	1.35	0.20	9.52	Y (+)
P24	W(87)	WAM	N	2	4.24	17.00	32.56	23.00	14.29	0.60	NA	Y (+)	0.71	26.50	28.75	28.00	2.38	0.00	NA	Y (+)

Notes: Part = Participant code. Gen = Gender. Dem. = Participants who entered the study referring a diagnosis of Dementia. DP BL = Number of data points at the baseline. SD = Standard Deviation. BL = Baseline Phase. I = Intervention Phase. W = Withdrawal Phase. B = Bejeweled. M = Mahjong. WS = Word Search. WAM = Whack-A-Mole. Sig. = Statistically significant change according to the 2 SD band method. Y = Yes. N = No. (+) = Statistically significant change in the increasing direction. (-) = Statistically significant change in the decreasing direction.

Table 3. Results per outcome variable per game.

Game	PANAS				Engagement
	n1 ↑ Int. /n2 (%)	% Sig. ↑	n1 ↓ Int. /n2 (%)	% Sig. ↓	n1 ↑ Int. /n2 (%)	% Sig. ↑	n1 ↓ Int. /n2 (%)	% Sig. ↓
Word Search	5/5 (100)	1/5 (20%)	0/5 (0%)	0/5 (0%)	5/5 (100%)	2/5 (40%)	0/5 (0%)	0/5 (0%)
Bejeweled	4/5 (80%)	1/5 (10%)	1/5 (20%)	1/5 (20%)	4/5 (80%)	2/5 (40%)	1/5 (20%)	1/5 (20%)
Mahjong	2/4 (50%)	1/4 (25%)	2/4 (50%)	0/4 (0%)	3/4 (75%)	1/4 (25%)	1/4 (25%)	0/4 (0%)
Whack-A-Mole	4/5 (80%) 1 participant not testable	1/5 (20%)	1/5 (20%)	1/5 (20%)	3/5 (60%) 1 participant not testable	2/5 (40%)	2/5 (40%)	0/5 (0%)

Notes:.

n₁ ↑ Int. = Number of participants with an increase in the outcome variable of the mean at the intervention compared with that at the baseline.

n₂ = Total number of participants who played the game.

% Sig. ↑ = Percentage of participants whose outcome variable increased significantly at the intervention compared with the baseline according to the 2SD band method.

n₁ ↓ Int. = Number of participants with a decrease in the outcome variable of the mean at the intervention compared with that at the baseline.

% Sig. ↓ = Percentage of participants whose outcome variable decreased significantly at the intervention compared with the baseline according to the 2SD band method.

Table 4. Cognitive measures per participant.

Part	MoCA Score				TMT-B-A (sec)
	T0	T1	T2	T3	T0	T1	T2	T3
P1	30	29	29	30	49	40	47	41
P2 ^a	21	19	22	24	117	55	72	82
P3 ^a	8	11	13	8	Missing	629	494	321
P4	28	26	25	28	90	7	44	25
P7	23	30	28	28	76	62	55	72
P8 ^a	16	14	9	14	354	309	288	291
P9	22	27	27	27	28	20	24	30
P10 ^a	20	19	20	21	241	328	332	450
P13	25	28	28	29	50	40	61	44
P14 ^a	24	21	26	28	489	121	259	128
P15	30	28	29	30	37	32	49	42
P16	20	21	20	21	120	200	52	166
P17	22	27	28	29	40	25	62	58
P18	30	29	29	27	43	185	65	65
P19	19	19	16	21	328	157	224	332
P20	30	27	29	29	143	116	191	110
P21	29	28	26	29	88	93	68	73
P23	28	25	29	30	50	70	86	54
P24	28	23	29	30	197	191	161	196

Notes: Part = Participant code. T₀ = Assessment at pre-baseline. T₁ = Assessment right after baseline phase ends. T₂ = Assessment right after intervention phase ends. T₃ = Assessment right after withdrawal phase ends.

a = Participants who entered the study with a diagnosis of dementia.