Distribution of QoL ratings for each game and QoL item after regrouping and filtering the dataset (see “Preparing the dataset” section). Each bar represents number of task completions, where the sums match the numbers represented in Table 4. The ratings are skewed to one side in general: those reversed indicators (e.g. happiness and wellbeing) were generally low-valued, while the others (e.g. sadness and anxiety) were high-valued

Distribution of QoL ratings for each game and QoL item after regrouping and filtering the dataset (see “Preparing the dataset” section). Each bar represents number of task completions, where the sums match the numbers represented in Table 4. The ratings are skewed to one side in general: those reversed indicators (e.g. happiness and wellbeing) were generally low-valued, while the others (e.g. sadness and anxiety) were high-valued

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While the number of dementia cases is steadily increasing, as of today no medication has been developed to cure its underlying causes. Instead, the focus in treatment has shifted to improve quality of life (QoL) for people with dementia (PwD). To this end, some non-pharmacological treatments such as exercising, socializing, and playing games have r...

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... This argument is in line with studies suggesting that SGs enable a deeper level of learning, and result in positive short-term benefits such as well-being. SGs for health have been known to improve QoL among clinical samples (Cha et al., 2019), because users continue utilizing skills acquired from gaming beyond the gaming context (Nicholson, 2015). Likewise, the subjective experiences of absorption, interactivity, and conscious attention associated with cognitive, behavioral and affective engagement with SGs, are likely to increase the chances that the learning experience will be internalized, leading to tacit transfer of the learning experience to other domains of social life relevant to QoL. ...
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Serious games (SGs), are gaining prominence as a tool for early education at home as well as in school settings. Given the mixed effects of gamification on various aspects of users' lives, it is pertinent to study its broader effects on a child's preschool and school years. Given the lack of consensus on a comprehensive measure that encapsulates these effects on an individual's routine functioning, the present study examined whether various engagement states in SGs use influence a relatively broader measure of users' functioning across significant life domains such as Quality of Life (QoL). It is argued that it would serve scholars, teachers, and parents better to understand the broader implications of SGs on children's overall QoL rather than isolated physiological and behavioral effects. Consequently, utilizing structural equation modeling, results from 335 parents of 2-10-year-olds in a developing country showed that cognitive and behavioral engagement in gamified applications appear to influence the child's QoL, but not affective engagement. Results are discussed in terms of the consequences of using game-based technology for a child's development, with far-reaching academic, personal, physical, and social implications not only for the school-going ages, but also for early teenage years. The results are promising in relation to QoL. The findings indicate the role modern technology plays in improving individuals' lives. The findings provide scholars, parents, and creators of SGs important information for their plan of action regarding children's exposure to SGs and making SGs a frequent aspect of the learning experience early in life.
... In the same vein, we also believe that consumers' engagement in serious games may positively impact on their QoL. Our argument is in line with prior studies [46][47][48] who reported that serious games have unique attributes which in turn impacts on users' QoL. Therefore, we theorize and develop the conceptual model where consumers' engagement in serious games depending upon the context-specific environment can significantly improve their QoL, see Fig. 1. ...
Conference Paper
This study proposes a conceptual model that establishes a relationship between engagement with gamified applications, and its impact on a user’s quality of life (QoL). Since gamification is rapidly gaining popularity therefore the use of such applications has become a norm. Subjective quality of life is a mental state or an individual’s awareness of factors that impact major aspects of life, such as health, learning, creativity, socialization etc. Literature is sparse when it comes to investigating the impact of engagement with gamified applications, and its effect on quality of life. To address this research gap, we explore how consumer engagement with gamification cultivates an individual’s perception with regards to their quality of life. We posit that consumer engagement is a higher-order formative construct, comprising cognitive, affective and behavioural dimensions, is influenced by gamified applications, leading towards an increase in subjective QoL. QoL is also a higher-order formative construct involving first-order reflective constructs such as leisure time, view of life, creativity, learning, friendship and individualistic perspective of satisfaction. This study provides an important insight to avenues of academia and practitioners by developing a conceptual model where consumer engagement in serious games acts as a predictor of users’ QoL. We conclude by discussing important implications that arise from this exploration, along with its limitations and avenues for further research.
... Brain training apps hold their own unique and noticeable place within the category of nonpharmaceutical dementia therapy. In general, brain training games aim at inspiring creativity [2], improving learning ability [3], psychological well-being [4] and cognitive functions such as attention, language and memory [5], [6], as well as the ability to be self-sufficient [3] and perform daily tasks independently [5], [7]. ...
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Brain Training games are increasingly gaining attention as a non-pharmacological intervention to promote well-being and quality of life in people living with dementia. Herein we present the COSMA software and a pilot study to evaluate its impact on the emotions of people in the spectrum of dementia. The software was created in accordance to the UK National Institute for Health and Care Excellence (NICE) guidelines as a 'brain-stimulating' software for use by people with cognitive impairment i.e., mild cognitive impairment (MCI) and early dementia. The pilot study aims to investigate whether the current COSMA game designs have an impact on emotions in people with MCI and early dementia. The emotional evaluation before and after playing COSMA games was carried out using the Positive and Negative Affect Schedule (PANAS). Our findings demonstrated a small, but significant increase in positive emotions (MCI: p= 0.041; early dementia: p= 0.042) and decrease in negative emotions (MCI: p= 0.001; early dementia: p< 0.001). These preliminary results showed that people with MCI and early dementia experienced positive emotions while playing the COSMA games, suggesting that people with cognitive impairment may benefit from using the COSMA software regularly.
... double taps), or complex multi-touch gestures can also be problematic. Other studies have shown that mobile devices such as tablets can be successfully integrated into the lives of people with dementia -for example, to assess quality of life [12], to improve quality of live via cognitive training games or communication with staff and family members [6,1], or to improve outpatient dementia care by fostering guideline-based treatment [15,14]. Usability aspects should be considered early on in the development of a new instrument. ...
... DemSelf is still a rather traditional instrument as it is directly based on a validated paper-based instrument. Some potential benefits of computerized tests, such as adapting to individual performance or the use of machine-learning algorithms to interpret test performance [36,32,6], are not part of the instrument. A high level of usability is a prerequisite for successful practical use. ...
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Early detection of mild cognitive impairment and dementia is vital as many therapeutic interventions are particularly effective at an early stage. A self-administered touch-based cognitive screening instrument, called DemSelf, was developed by adapting an examiner-administered paper-based instrument, the Quick Mild Cognitive Impairment (Qmci) screen. We conducted five semi-structured expert interviews including a think-aloud phase to evaluate usability problems. The extent to which the characteristics of the original subtests change by the adaption, as well as the conditions and appropriate context for practical application, were also in question. The participants had expertise in the domain of usability and human-machine interaction and/or in the domain of dementia and neuropsychological assessment. Participants identified usability issues in all components of the DemSelf prototype. For example, confirmation of answers was not consistent across subtests. Answers were sometimes logged directly when a button is tapped and cannot be corrected. This can lead to frustration and bias in test results, especially for people with vision or motor impairments. The direct adoption of time limits from the original paper-based instrument or the simultaneous verbal and textual item presentation also caused usability problems. DemSelf is a different test than Qmci and needs to be re-validated. Visual recognition instead of a free verbal recall is one of the main differences. Reading skill level seems to be an important confounding variable. Participants would generally prefer if the test is conducted in a medical office rather than at a patient's home so that someone is present for support and the result can be discussed directly.
... Four applications (Quiz, Spelling game, Show me, Move me) targeted cognitive and functional abilities. Task di culty was adapted based on task performance: exercises became more di cult as performance improved and vice versa (Cha et al. 2019). Three applications (Interactive Cat, Picture Gallery, Color and Sound) were designed to support emotional self-regulation. ...
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Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for eight weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until collection of baseline data was completed. Data was analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95%CI: -3.54 to 2.33 for TBI and .36 points, 95%CI: -3.27 to 2.55 for CAS). Group difference in change of apathy was not statistically significant (B = .25; 95%CI: -3.89 to 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states. Funding: German National Association of Statutory Health Insurance Funds. Registry: ISRCTN98947160.
Chapter
Early detection of mild cognitive impairment and dementia is vital as many therapeutic interventions are particularly effective at an early stage. A self-administered touch-based cognitive screening instrument, called DemSelf, was developed by adapting an examiner-administered paper-based instrument, the Quick Mild Cognitive Impairment (Qmci) screen. We conducted five semi-structured expert interviews including a think-aloud phase to evaluate usability problems. The extent to which the characteristics of the original subtests change by the adaption, as well as the conditions and appropriate context for practical application, were also in question. The participants had expertise in the domain of usability and human-machine interaction and/or in the domain of dementia and neuropsychological assessment. Participants identified usability issues in all components of the DemSelf prototype. For example, confirmation of answers was not consistent across subtests. Answers were sometimes logged directly when a button is tapped and cannot be corrected. This can lead to frustration and bias in test results, especially for people with vision or motor impairments. The direct adoption of time limits from the original paper-based instrument or the simultaneous verbal and textual item presentation also caused usability problems. DemSelf is a different test than Qmci and needs to be re-validated. Visual recognition instead of a free verbal recall is one of the main differences. Reading skill level seems to be an important confounding variable. Participants would generally prefer if the test is conducted in a medical office rather than at a patient’s home so that someone is present for support and the result can be discussed directly.
Article
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Objectives To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design Cluster-randomized controlled trial. Setting Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants N = 162 residents with dementia. Intervention Participants received regular TBI ( n = 80) with stimulating activities developed to engage people with dementia or CAS ( n = 82) for 8 weeks. Measurements Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size ( Cohen’s d ) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.
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Background: Non-pharmacological interventions (NPI) can improve cognitive and non-cognitive symptoms in nursing home residents living with dementia. However, delivery of suitable NPI can be challenging in everyday nursing home settings. Internet and communication technologies (ICT) may be promising tools for supporting NPI delivery in nursing homes. Methods: A two-arm cluster-randomised controlled trial was conducted to investigate global and momentary effects of a novel ICT-based NPI for nursing home residents with dementia. Ten nursing homes were randomly allocated to the tablet-based intervention (TBI) or conventional activity sessions (CAS) group (each with five nursing homes) between April 2016 and May 2017. A total of N = 162 participants received either regular TBI (n = 80) or CAS (n = 82) over a period of eight weeks. Linear mixed models were used to analyse group differences regarding the primary outcome apathy (AES-I), and secondary outcomes quality of life (QOL-AD, QUALIDEM), neuropsychiatric (NPI-NH, psychotropic medication) and depressive symptoms (GDS). Ecological Momentary Assessments (EMA) of quality of life were also conducted in both groups before and after each activity session. Results: No significant group difference in the change of apathy (AES-I score, primary outcome) was found post intervention (mean group difference: B = .19; 95% CI: -3.90 to 4.28, p = .93). Regarding secondary outcomes, a reduction of psychotropic medication was found for TBI compared to CAS (B = .42; 95% CI: .15 to .69, p < .01). Further analyses revealed a post-intervention improvement of informant-rated quality of life across both groups (B = 3.69; 95% CI: .68 to 6.69, p = .02). Analysis of EMA also rendered short-term post-session improvements of quality of life in the CAS group (B = .43; 95% CI: .30 to .57, p < .001). Conclusions: These findings suggest that NPI involving individually tailored activities have a beneficial impact on quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, ICT have the potential to support NPI delivery and facilitate regular assessments of fluctuating momentary states in nursing home residents with dementia. Trial registration: The trial was retrospectively registered with the ISRCTN registry (Trial registration number: ISRCTN98947160) on 01/09/2016 http://www.isrctn.com/ISRCTN98947160.