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- 246 -
2022 · Retos Nº 46 / Págs.
© Copyright: Federación Española de Asociaciones de Docentes de Educación Física (FEADEF) ISSN: Edición impresa: 1579-1726. Edición Web: 1988-204 (https://recyt.fecyt.es/index.php/retos/index)
246-253
Introduction
Addressing the study of games and toys is not a simple
task, especially when in various social and academic con-
texts, they do not acquire the connotation and importan-
ce they require and deserve since the origins of humanity.
The game and toys have more research approaches from
children’s contexts and their different relationships (Heik-
kilä, 2021) and even ecological topics (Ramesh & Vatchala,
2020). These terms denominate diverse realities, which
are perhaps articulated among themselves. This multipli-
city could be understood from the varied behaviors of the
human being, and based on what Muñoz-García & Sán-
chez-Montañés (2020, p.974) “they should be very diffe-
rent depending on the type of social and economic orga-
nization, and the functions or roles that the boys and girls
who will be future members of their respective societies
will play”, which constitutes a common thread that allows
us to incorporate a historical and contextual look. Conse-
quently, games and toys are not part of the educational fra-
mework or a pastime; they transcend human nature.
The toy has primacy over the game, it is a toy that dic-
tates how the game is played, and this takes away the pro-
tagonism of the player who determines its uses. In some
ludic systems, the way of playing determines the use that
the subjects give to the toy and not the other way around,
as it happens in a diversity of contexts nowadays. The toy,
in practical terms, identifies those objects that are used for
the activity of play, being manufactured specially to play
(Komis, et al., 2021). A toy is an essential object for hu-
man beings in their different areas of development. Still,
its use increases in the infant stage given its particularities
for learning and socialization, fulfilling the role of providing
support to their development. Its use depends on the game
that is being carried out. Toys are of utmost importance in
developing individuals and communities; in contexts where
they cannot be accessed or purchased, they are made using
wood. For example, carts, sailboats, and other types of
toys that amuse the user are obtained, which allows us to
understand that “toys are a cultural legacy of customs and
values of the past, as well as a link to the social and cultural
Fecha recepción: 11-01-22. Fecha de aceptación: 19-06-22
Leonardo Andrés Aguirre-Cardona
laguirreca1@uniminuto.edu.co
Game, toy, and elderly. A necessary approach from a systematic review
Juego, juguete y adulto mayor. Un acercamiento necesario desde una revisión sistemática
Leonardo Andrés Aguirre-Cardona, Luz Elena Mendoza-Espinel
Corporación Universitaria Minuto de Dios (Colombia)
Abstract: The experience, study, enjoyment, and even the social projection of the game and the toy, permeates the different stages
of life and from the perspective of the elderly adult deserves special attention, even more so when this is a population segment that is
in constant growth and constitutes a scenario of reflections and analysis from a position of Physical Education, Recreation and Sports,
which allows us to think that, although games and toys are widely approached since childhood, this dialogue is not very clear between
game, toy and elderly. The study aims to identify the investigative approaches around games, toys, and the elderly via a literature re-
view. The studies identified in the major collections of the Scopus, Web of Science, and PubMed databases were used, with 72 articles
whose analysis started from reviewing the aspects of title, objective, design, sample, and results. The review shows that games and toys
as a strategy for health promotion and disease prevention in the elderly emerge as a possible trend that contributes to this area of study
and intervention and contributes to body maintenance, cognitive and social in the elderly.
Keywords: Game, toy, elderly, physical education, recreation.
Resumen: La vivencia, el estudio, el disfrute y la proyección social del juego y el juguete, permea las diferentes etapas de la vida y
desde la perspectiva del adulto mayor merece una especial atención, más aún, cuando este es un segmento poblacional que está en
constante crecimiento y se constituye en un escenario de reflexiones y análisis desde una postura de la Educación Física, Recreación
y Deporte, lo que permite pensar que, si bien el juego y el juguete son ampliamente abordados desde las infancias, no es muy claro
ese diálogo entre juego, juguete y adulto mayor. Como objetivo del estudio se plantea identificar desde una revisión documental las
aproximaciones investigativas en torno al juego, juguete y adulto mayor. Se utilizaron los estudios identificados en las colecciones prin-
cipales de las bases de datos Scopus, Web of Science y PubMed contando con un total de 72 artículos, cuyo análisis partió de revisar los
aspectos de título, objetivo, diseño, muestra y resultados. La revisión deja ver que los juegos y juguetes como estrategia de promoción
de la salud y prevención de la enfermedad en el adulto mayor, emergen como una posible tendencia que aporta a esa apuesta de área de
estudio e intervención, así mismo aportan al mantenimiento corporal, cognitivo y social en el adulto mayor.
Palabras clave: Juego, juguete, adulto mayor, educación física, recreación.
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Retos, número 46 · 2022 (3º trimestre)
dical and social perspectives or different contexts and coun-
tries. For example, Lin et al. (2020) address the relations-
hip between physical activity, happiness, sedentary lifestyle
in healthy older adults over 65 years; for their part, Frantál,
Klapka & Nováková (2020) provide evidence on the signifi-
cance of daily activities concerning perceptions of isolation
and loneliness in the elderly. Likewise, studies have been
conducted that builds on the conceptual debate on diversity
in old age by exploring the interaction of diversity in old
age and images of old age (Enßle & Helbrecht, 2021). Un-
der this scenario, multiple studies point to a conceptual and
empirical approach to understanding the dynamics (from
different dimensions) around the elderly, which leads to
thinking about the need to generate an approach to the path
of studies focused on this population segment.
In this sense, the academic and research literature
shows an articulation between games and the elderly. Rosa
et al. (2021) study the use of games to assess motor coordi-
nation in institutionalized elderly. The use of serious games
as a contribution to the study and treatment of cognitive
degeneration in older adults is addressed by Lau & Agius
(2021). In addition, González-Bernal et al. (2021), from
a pretest/post-test design study, investigated the impact
of using the Wii video game console® on speed, walking
balance, and risk of falls in older adults. Likewise, Santama-
ría-Guzmán et al (2015), address the learning and motor
retention of a video game in older adults, which demanded
a lot of mobility from the point of view of dance; Along
these same lines, Corregidor-Sánchez et al (2021) analyze
the usefulness of exergames played on three different video
game consoles for the prevention of functional deteriora-
tion in the elderly; taking into account the rural context,
Latham-Green et al. (2021), identify that participation in
shooting games creates a social impact through the creation
of social capital and the reinforcement of identity, which,
according to the authors, generates a statistically significant
positive impact on mental health and well-being ; likewise,
Li et al. (2020) structured a video game that combines cog-
nitive and physical training in a virtual reality environment,
demonstrating how a multitasking game, based on virtual
reality, can have a positive impact on the physical and cog-
nitive health of the elderly.
Under this panorama, the relations between games and
the elderly are evident, even more, when this population
segment is in constant growth in the different world con-
texts. However, this dialogue between games, toys, and
the elderly is not very clear, which allows us to reflect on
the importance of knowing from a documentary review
those investigative approaches around these three axes of
study, allowing us to generate an academic and investiga-
tive input for the understanding and application of games
and toys.
environment itself” (Montañes, et al., 2000, p.251). On
the other hand, the interactions generated between an arti-
fact or toy and the subject that uses it has been the subject
of study, even more so, when technologies have permeated
the different dimensions of the human being and promote
creators to dynamize interfaces and game functions. (de Al-
buquerque, et al., 2021).
Game is used, referenced, and researched in anthro-
pology, education, recreation, psychology, sociology, etc.
“Game helps to regulate and educate around the norms of
coexistence, the symbolic world, the patterns of social or-
ganization and subsistence, or the role that an individual
exercises linked to gender in their society” (Muñoz-Gar-
cía & Sánchez-Montañés, 2020, p.970). Consequently, the
game describes any activity that goes beyond the physical
and biological, transcends human reality to become an act
of social representations, an act of imitation, but that can
be interpreted as any activity to release energy in a pleasant
and relaxing way. In the same way, the game in articulation
with motor skills and other areas of a pedagogical order,
should be allowed an applicability both in the educational
and social aspects, permeated by the experience of physi-
cal education, recreation and even sports (Aguirre, et al.,
2019). It is also an exercise to acquire, improve, and eva-
luate motor skills and executive functions in adults (Rosa,
et al., 2021). Although it has been stated that the game is
manifested within time and space limitations, besides being
free, following established rules, “no biological analysis ex-
plains the intensity of the game and, precisely, in this inten-
sity, in its capacity to make people lose their minds, lies its
essence, the primordial” (Huizinga, 2019, p. 16).
The stage of life conceived as the older adult and other
stages of the human being have particular characteristics
and needs. There is a growing population in this life cycle.
As mentioned by Papalia (2012), the global population is
in the process of aging. In 2008, almost 56 million people
worldwide were 65 years or older, and the net annual in-
crease is more than 870,000 every month. Complementa-
rily, Chaves-Garcia, Sandoval-Cuellar & Calero-Saa (2017,
p.1) state that “about 15% of the world population is over
65 years and continues to grow and it is projected that peo-
ple over 65 years, which by the year 2004 were 461 mi-
llion, will become 2 billion by the year 2050”. Similarly,
Villa & Rivadeneira (1999), referenced by González, Sosa
& Reboiras (2021), state that aging in the Latin American
context goes hand in hand with a decrease in mortality and
an increase in life expectancy, which allows us to unders-
tand the significant presence of people in the so-called third
age. In this sense, the life cycle of the elderly is a topic of
special interest, and it is appropriate to take it into account.
From this premise, there are various research positions
on the elderly, both quantitative and qualitative, from me-
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Retos, número 46 · 2022 (3º trimestre)
For the selection of the publications, a screening was
carried out based on the inclusion and exclusion criteria
determined for the study, taking into account a selection
and analysis matrix structured for this purpose. The analy-
sis of the selected documents was based on identifying
which works were in line with the object of study, first re-
viewing titles and abstracts and thus expressing a thematic
affinity. Subsequently, the most relevant information was
broken down into titles, objectives, designs, population,
and results.
Results
From the tracking of information in the databases Sco-
pus, Wos, and PubMed locating the descriptors “game”
(juego), “toy” (juguete), “elderly” (adulto mayor), in the
period stipulated within the inclusion criteria for the exer-
cise, no continuity is identified in the publication. Indexing
of articles containing these descriptors resulted in 72 arti-
cles published between 2013 and 2021 (See Figure 1).
A reading was made of the objectives set out in the ar-
ticles identified. It was observed that there is a preferen-
ce to determine, evaluate and implement elements based
on games and toys to study both behaviors and processes
of motor, biophysical, cognitive, and social order in older
adults. Likewise, it was observed that there are studies that
point to the design of games whose purposes were aimed at
the motor, cognitive and social work of the elderly. From
this point of view, it was decided to generate the following
grouping to determine the number of studies according
to the objectives proposed in the 72 articles: Biophysical
processes and motor skills: 26.4%, mental and cognitive
processes: 27.8%, social processes: 25%, general health
processes: 12.5%, emotional situations: 4.2%. It is worth
mentioning that there were works whose objectives were
focused on biophysical processes and mental processes to-
Method
The work was performed using an exploratory-descrip-
tive scope (Hernández-Sampieri & Mendoza, 2018), see-
king to explore, describe and analyze the process of acade-
mic and research productions from the game as a category
of study in the elderly who may or may not be institutio-
nalized (Rosa, et al, 2022), toys as a category that allows
understanding, from their interaction with people, social
and playful elements (Ihamäki & Heljakka, 2021) ; and the
elderly as that population segment that is a fundamental
axis in families that deserve special interest from the heal-
th, social, academic and research fields (Villarreal-Ángeles,
Moncada-Jiménez & Ruiz-Juan, 2021). A literature review
was carried out following the guidelines of the PRISMA
statement for the development of studies of documentary
order (Urrutia & Bonfill, 2010; Martínez, Santaella & Ro-
dríguez-García, 2020). Three descriptors were validated
in the ERIC and UNESCO Thesaurus for the respective
search in the databases: “game”, “toy” and “older adult.” A
search for articles published between 2013 and 2021 was
carried out using the “AND” operator; these descriptors,
together with the operator, had to appear in the title, abs-
tract, and/or keywords fields. This search was carried out
in three databases of high importance: Scopus, Web of
Science (WoS), and PubMed. These databases were chosen
due to their prestige and international recognition as the
main sources of high-impact publications, their demanding
indexing protocols, and their complementarity between
disciplines (Fernández, et al., 2020).
The inclusion criteria taken into account for the selec-
tion of articles were:
1. Publications in high-quality journals indexed in
Scopus, WoS or PubMed.
2. Publications whose studies presented a general
description based on introduction, objective, me-
thod, results, discussion, and conclusions.
3. Publications in English or Spanish.
4. Publications between 2013 and 2021.
5. Publications containing the descriptors “game”,
“toy”, “elderly.”
6. Publications whose studies were conducted under
any methodological design.
7. Publications containing studies whose population
is older adults.
The exclusion criteria for the selection papers were:
1. Publications in languages other than English or
Spanish.
2. Publications such as books, reports, event procee-
dings, thesis dissertations, doctoral theses, proceedings.
3. Publications whose studies were not related to the
older adult population segment.
11
470
471
Figure 1: Number of articles according to database and year. Source: Authors
472
473
4
16
5
213
1
16
4
31123
4
5
1
2013 2014 2015 2016 2017 2018 2019 2020 2021
Quantity
Database
Number of articles according to database
and year
Scopus
11
470
471
Figure 1: Number of articles according to database and year. Source: Authors
472
473
4
16
5
213
1
16
4
31123
4
5
1
2013 2014 2015 2016 2017 2018 2019 2020 2021
Quantity
Database
Number of articles according to database
and year
Scopus
Scopus Wos P ubMed
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Retos, número 46 · 2022 (3º trimestre)
tests and measurements improved with the indoor garde-
ning planting table game. Similarly, it was observed that vi-
deo games generate a significant impact on the elderly. For
example, in older adults diagnosed with mild to moderate
Parkinson’s disease, interactive video games focused on
balance ability training contributed to the improvement of
symptoms of Parkinson’s disease in older adults (Yuan, et
al., 2020). Exergames also have a place in these identified
results. The studies suggest that they help improve functio-
nal capacity and adherence to physical exercise among the
elderly (Da Silva Júnior, et al., 2021). It is worth highligh-
ting that the emerging dynamics in the experience of games
and toys by the older adult, allows to understand that in-
terdisciplinarity, the use of technology, for example video
games, and the use of the different resources that they are
used for the creation of games and toys, they contribute sig-
nificantly to the living conditions of the elderly, regardless
of their medical or social condition.
In this order of ideas, Table 1 shows the most significant
contributions for reflection and support to the discussion
on games and toys in the context of older adults, taking into
account in the first instance that they met the inclusion cri-
teria proposed in the study method, then they were articles
derived from works directly related to games, toys and the
elderly; likewise, they made it possible to explicitly identify
elements of analysis such as title, objectives, methods and
results, which allowed us to observe a greater affinity with
the theme of this study.
Discussion
The results reveal a diversity of theoretical and experi-
mental approaches to the approach to games and toys in the
context of the particularities of the elderly. A first analysis
that can be extracted from the review is that there is no
conceptual clarity in relation to games and toys since their
use does not establish a difference between these two cate-
gories, although their use as a therapeutic tool (Moyle, et
al., 2019), as a design aspect (Mei-Yung, et al., 2013) or
socializing element (Thodberg, et al., 2016) in the elderly
are clear, in the theoretical and experiential they are used
without any distinction, which allows us to think about the
importance of establishing clear conceptual elements and
in turn articulators for its implementation, being physical
education, recreation and sports the field of knowledge that
should lead a possible academic, experiential and investi-
gative approach that facilitates conceptual and application
clarities in different population segments.
From the study conducted, high interest is identified
in approaching games and toys as resources from a clinical
and experimental point of view. Works such as that of Jan-
sang, Mickleborough & Suksom (2016) use a toy to study
gether: 4.2%. From this group, it was possible to observe
that work based on games and toys has a high preference
to be used, whether from research, academic or applied
work, in the branches of health, both mentally and emo-
tionally, as well as in physical, which allows us to infer that
games and toys constitute a fundamental tool for addressing
different situations with the elderly from physical educa-
tion, recreation and sports.
In relation to the type of study advanced in the identified
articles, there is a marked preference for carrying out works
from a quantitative route (Hernández-Sampieri & Mendoza,
2018), having experimental studies: 20.8%, quasi-experi-
mental: 43.1%, clinical studies: 15.3%, systematic reviews:
12.5%, for their part, qualitative studies have 8.3%, quali-
tative studies account for 8.3%, which allows to think that
obtaining empirical evidence against the use of games and
toys in the population segment of the elderly, constitutes
the main input for addressing various situations of a medical
nature, cognitive or social in said population.
Older adults constitute the population sample in the
identified articles directly related to the purposes of the
study, as such, being men and women over 55 years old.
Different papers characterized diseases typical of the el-
derly: Parkinson’s disease (Dauvergne et al., 2018), de-
mentia (Tseng, et al., 2020), problems related to lower
limb joints (Chen, Luo & Kang, 2020), older adults who
suffered strokes (Burdea, et al. 2020) and even older
adults with or without any disease who were at the time of
the study institutionalized in special homes or communi-
ties (Cicek, Ozdincler & Tarakci, 2020). The sample was
selected from open-access databases in studies based on
systematic reviews.
For the collection of information with this population,
the instruments and techniques varied as the purposes of
the papers. For example, the papers used different neu-
ropsychological instruments, quality of life questionnaires
as dependent measures (McCord, et al., 2020), motor
function and impairment assessment instruments (Burdea,
et al., 2020), or somewhat more specific instruments such
as the Atlanta Heart Failure Knowledge Test and the Heart
Failure SelfCare Index (Radhakrishnan, et al., 2016).
Regarding the results in some identified articles, the-
re was evidence showing that the toys stimulated the peo-
ple (older adults) to greater social interaction, showing a
correlation with cognitive functioning (Thodberg, et al.,
2016). On the other hand, the benefits of interdisciplinary
permeated by the game are recognized using the design of
an indoor gardening flower combination game suitable for
home and maintenance institutions to improve cognitive
function in older adults. This work advanced by Tseng et
al. (2020) indicates that the overall performance of elderly
patients with mild or moderate dementia in the respective
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Retos, número 46 · 2022 (3º trimestre)
and toys, allowing to support the initial idea of study from
games and toys for older adults from biophysical processes
and motor skills, and general processes in health, which is
articulated with the ideas of Salazar et al. (2015), in the sen-
se of using playable elements such as video games as a way
the improvement of pulmonary and respiratory function in
older adults, which allows us to think about the possibility
of addressing studies that articulate the analysis of physical
condition or aerobic capacity of older adults (Aguilar, Fló-
rez & Saavedra, 2020), using mediations based on games
12
474
Table 1.
Analysis of selected articl es
Journal Year
Article Author Aim Method Sample Results
Journal of
NeuroEngineeri
ng and
Rehabilitation
2013
Exergaming for balance
training of elderly: state of the
art and future developments
van Diest, M .,
Lamoth, C. J .,
Stegenga, J.,
Verkerke, G. J., &
Postema, K.
To provide an in-
depth dis cussion of
technologies and outcome measures
utilized in exergame studies.
Siste matic
review.
Thirteen pape rs were
included in the
analysis
Enjoyment and motivation for
the propo sed exercises an d
increased balance capacity after
training
Educational
Gerontology
2013
How the El derly Can Use
Scientific Knowledge to Solve
Problems While Designing
Toys: A Retrospective
Analysis of the Design of a
Working UFO
Mei-Yung Chen, Jon-
Chao Hong, Ming-
Yueh Hwang & Wan-
Tzu Wong
Identify roles and examine design
projects in order to improve the use
of materia ls and evaluate the
application of knowledge in
problem solving.
Experimental,
design-based
(DBR)
Forty -eight el ders.
The average age of the
participants was
63,091 years with a
standard deviation of
0.291.
Older adults without scientific
training could produce scientific
toys if the y worked
cooperatively, especially when
they could learn from other
people who had scientific
training.
Journal of the
Medica l
Associa tion of
Tha iland
2016
Effects of Pursed-L ip
Breathing Exercise Using
Windmill Toy on Lung
Function and Respiratory
Muscle Strength in the Elderly
Jansang, S.,
Mickleborough, T., &
Suksom, D.
To investigate whether pursed-lip
breathing exercise, using windmill
toy, can improve lung function, and
respiratory
muscle strength in the elderly.
Experimental Fifty-four older men
and women (aged 60
to 75 yea rs)
A toy is effective in improving
lung function and respiratory
muscle strength in older adults.
Antrozoos 2016
Behavioral Responses of
Nursing Home Residents to
Visits From a Person with a
Dog,a Robot Seal or aToy Cat
Thodberg, K.,
Sørensen, L. ,
Videbech, P.,
Poulsen, P., Houbak,
B., Damgaa rd, V.,
Kese ler, I., E dwards,
D. & Christensen, J.
Study whether nursing home
residents interacted differently with
a real animal/dog compared with
interactive and non-interactive fake
animals during biweekly animal-
assisted visits, measured by
quantitative measures of behavior.
Randomized
Controlled
Experimental
Design.
124 nursing home
residents from four
nursing homes in
Denm ark
The cognitive functioning of
older adults was correlated with
the level of interaction with the
toy, and this needs to be studied
further.
Trials
2017
Mobile Exergaming for
Health—Effects of a serious
game application for
smartphones on physical
activity and exercise
adherence in type 2 diabetes
mellitus—
study protocol for a
randomized controlled trial
Höchsmann , C.,
Walz, S. P., Schäfer,
J., Holopai nen, J.,
Hanssen, H., &
Schmidt-Trucksäss, A
To examine whether our
smartphone-based gaming
application can lead to increases in
daily PA in DM2 patients that are
persistent in the medium and long
term and whether these increases
are greater than those in a control
group.
Randomized
controlled trial
42 patients with DM2
Implications for the promotion of
physical activity and tre atment in
other c onic diseases .
The
Gerontologist
2019
“She Had a Smile on Her Face
as Wide as the Great
Australian Bite”: A Qualitative
Examination of Family
Perceptions of a Therapeutic
Robot and a Plush Toy
Moyle, W., Br amble,
M., Jones, C. J., &
Murfield, J. E.
to explore family members’
perceptions of the Japanese-
developed baby harp seal, Paro
(version 9), and a look-alik e,
nonrobotic Plush Toy, when used
by their relative with dementia for
15 min, 3 afternoons per week for
10 weeks.
Qualitative
descriptive,
which wa s
nested wi thin a
larger cluster
randomized
controlled trial.
A convenience sample
of 20 family membe rs
(n = 10 each of Paro
and Plush Toy
conditions)
The toys had a positive impact on
the mood from the use of toys.
Social Work in
Health Care
2019
Effect of board game activities
on cognitive function
improvement among older
adults in a dult day care centers
Ching-Teng , Y.
Test the effectiveness of board game
activities that improve cognitive
function of older adults in adult day
care centers.
Quasi-
experimental
based on pre and
post tests .
March to June
2018.
82 subjec ts 65 years
of age or older with
intac t mental
functions.
Incorporating board game
activities into social work care
can help develop long-term care
in a more diverse, unique, and
innovative direction.
Sensores 2020
Playability and Play er
Experienc e in Digital Gam es
for Elderly: A Systematic
Literature Review
Rienzo, A., &
Cubillos, C.
Carry out a systematic bibliographic
review investigating the experience
of the elderly player in digital
games.
Siste matic
review.
Thirty-four papers
were included in the
analysis
There are not many specific
studies on gameplay and player
experience applied to the
elderly, nor are there tools and
proven metrics to evaluate them.
Journal of
NeuroEngineeri
ng and
Rehabilitation
2020
Effects of interac tive video-
game–ba sed exercise on
balance in older adults with
mild-to-moderate Parkinson’s
disease
Yuan, R. Y., Chen, S.
C., Peng, C. W., Lin,
Y. N., Chang , Y. T.,
& Lai, C. H.
evaluate the effectiveness of a
customized interactive video game-
based (IVGB) training on balance in
older adults with mild-to-moderate
Parkinso n’s disease (PD).
Experimental,
randomized
clinical trial
Twenty-four
participants aged 60
to 80 y ears.
IVGB exercise training could
serve as a rehabilitation regimen
to improve physical symptoms in
older adults with mild to
moderate PD.
Internationa l
journal of
environmental
research and
public health
2020
An Indoor Gardening Planting
Table Game Design to
Improve the Cognitive
Performance of the Elderly
with Mild and Moderate
Dementia
Tsen g, W. S., M a, Y.
C., Wong, W. K.,
Yeh, Y. T., Wa ng,
W. I., & Cheng, S. H.
Improve the overall cognitive
function of patients with dementia
in Yunlin County, Taiwan, by
designing an indoor gardening
flower combination game suitable
for home and maintenance
institutions .
Mixed design 14 elderly people
with mild or
moderate dementia
The indoor gardening planting kit
could, in the future, be equipped
with senso rs and light-emi tting
elements on the base, which can
record the user's operating
duration, accuracy, and the
number of reminders, and then
upload that information to the
cloud
JMIR
Public ations
2021
A Bowling Exergame to
Improve Functional Capacity
in Older Adults: Co-Design,
Development, and Testing to
Compare the Progress of
Playing Alone Versus Playing
With Peer s
da Silva, JLA ,
Biduski, D. , B ellei,
EA , (...), Fil ho, HT ,
de Marchi, ACB
co-design and develop a new
exergame alongside older
participants
Experimental 23 participants were
divided into 2 groups
to play in dividually
The exergame developed helps to
improve functional capacity and
adherence to physical exercise
among the elderly.
Source: Authors
475
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Retos, número 46 · 2022 (3º trimestre)
health one of the problems mostly related to the elderly.
This population segment faces processes in their life cycle
that are primary and inevitable and secondary processes
that can be controlled.
The review of the identified studies shows that games
and toys as elements that contribute to the body, cognitive
and social maintenance, such as exergames for the elderly,
emerge as a means of intervention in the different dimen-
sions of the elderly. The design of higher quality tools can
improve health problems identified in this population, ba-
sed on the conceptual and practical elements in relation to
aging, as well as the comparison and requirements of the
games for their positive contribution in the development
of strategies based on games and toys that contribute to the
well-being of older adults.
From the point of view of practical applications, a re-
view around the game and the toy in terms of the elder-
ly, constitutes an academic and research reference for the
construction of toys for the elderly and their respective im-
plementation. In the same way, it allows to give clarity to
the implementation of games and toys for the maintenance
of attention, memory, physical and social activation of the
elderly.
Limitations of this review
A limited number of studies emerged from Physical
Education, Recreation, and Sport, which constitutes a point
of reflection on a possible area of study and performance.
Conceptual clarity was not identified in relation to ga-
mes and toys, since in most of the review, these categories
were used as equals, without a clear theoretical definition
in this regard.
Recommendations for future research
Physical Education, Recreation, and Sport should be
empowered by the study of games and toys, given the par-
ticularities of this field of study and the transversality that
emerges from its application and research.
Video games are a fruitful scenario for analysis, deve-
lopment, and implementation of studies and experiences
for the elderly.
To advance studies around the game and the toy based
on the transversality of study areas that promote knowled-
ge about the elderly as a vital cycle and as a scenario for the
generation of work and development alternatives.
Although games and toys constitute a dynamic axis in
physical education, it is important to approach them from
the field of leisure, taking as a starting point category such
as serious leisure, casual leisure, digital leisure and, why
not, satisfaction with leisure time (Aguirre-Cardona, et al.,
of training the skill of balance in older adults, in this sense,
the dialogue between games, toys and older adults begins
to emerge as an alternative and complement in the field of
health in its different branches, from the mental to the phy-
sical, facilitating from that ludic dimension of the human
being, a possible means of approaching and searching for
solutions to problems identified in the elderly.
It cannot be denied that one of the characteristics of
both the game and the toy is its socialization component,
which translates into that opportunity to generate spaces
and strategies for the encounter, raise relationships and
promote social habits (Campo, 2010). These aspects are re-
flected in the reviewed studies that propose the interaction
with toys and the experience of the game in and with older
adults, which in turn bet on the improvement of cognitive
function (Ching-Teng, 2019) and communication between
family members when the older adult presents mental diffi-
culties (Moyle, et al., 2019), which could provide an argu-
ment for understanding the relationships between games,
toys and the elderly from psychological processes, and in
accordance with the dynamics of the social processes cha-
racteristic of the latter.
Consequently, the discussion from and for games and
toys for the elderly should not only revolve around the
amount of studies advanced in the different disciplines of
knowledge, it should also take into account the socializing,
therapeutic, ludic and even emancipating character that
permeates the different dimensions of the human being
when he/she is already in the third age, a stage in which
the conditions of physical, mental and social health suffer
significant changes, which ultimately allows us to say that
recreation, physical education and even sports, constitute
fruitful spaces for the generation of significant contribu-
tions for the structuring of these spaces and meeting times
for the elderly in the framework of the use of toys and ga-
mes that allow maintenance of their motor skills, physical
and mental condition within the parameters for their age.
Conclusions
From its different perspectives and fields of action,
the academic and investigative literature on games and
the elderly is varied and multifaceted. However, the toy
in the framework of the dynamics of the elderly has little
approach. Previous studies were identified where the toy
contributes an important role both in the methodological
and in the results. The advanced studies fall short consi-
dering the social, cognitive, and ludic benefits that the toy
offers to the elderly.
Games and toys as a strategy for health promotion and
disease prevention in the elderly emerge as a possible trend
contributing to this area of study and intervention, being
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Retos, número 46 · 2022 (3º trimestre)
no, S., & Criado-Álvarez, J. J. (2021). Exergames to Prevent the
Secondary Functional Deterioration of Older Adults during Hos-
pitalization and Isolation Periods during the COVID-19 Pande-
mic. Sustainability, 13(14), 7932. http://dx.doi.org/10.3390/
su13147932
De Albuquerque Wheler, A. P., Kelner, J., Hung, P. C., de Souza Je-
ronimo, B., Junior, R. D. S. R., & Araújo, A. F. R. R. (2021). Toy
user interface design-Tools for ChildComputer Interaction. Inter-
national Journal of Child-Computer Interaction, 30, 100307. https://
doi.org/10.1016/j.ijcci.2021.100307.
Da Silva Júnior JLA, Biduski D, Bellei EA, Becker OHC, Daroit L, Pas-
qualotti A, Tourinho Filho H, De Marchi ACB. (2021). A bowling
exergame to improve functional capacity in older adults: co-design,
development, and testing to compare the progress of playing alone
versus playing with peers. JMIR serious games, 9(1), e23423. doi:
10.2196/23423.
Dauvergne, C., Bégel, V., Gény, C., Puyjarinet, F., Laffont, I., & Da-
lla Bella, S. (2018). Home-based training of rhythmic skills with
a serious game in Parkinson’s disease: Usability and acceptability.
Annals of physical and rehabilitation medicine, 61(6), 380-385. ht-
tps://doi.org/10.1016/j.rehab.2018.08.002.
Enßle, F. & Helbrecht, I. (2021). Understanding diversity in old age
through images of old age. Ageing and Society, 41 (10), 2396-2415.
doi: 10.1017/S0144686X20000379.
Fernández Batanero, J. M., Montenegro Rueda, M., Fernández Cere-
ro, J., & Tadeu, P. (2020). Impact of ICT on students with disabi-
lity in the field physical education: a systematic review. Challenges,
39, 849-856. https://doi.org/10.47197/retos.v0i39.78602
Frantál, B., Klapka, P. and Nováková, E. (2020). When home beco-
mes a cage: Daily activities, space-time constraints, isolation and
the loneliness of older adults in urban environments. Moravian
Geographical Reports, 28(4) 322-337. https://doi.org/10.2478/
mgr-2020-0024.
González-Bernal, J. J., Jahouh, M., González-Santos, J., Mielgo-Ayu-
so, J., FernándezLázaro, D., & Soto-Cámara, R. (2021). Influence
of the Use of Wii Games on Physical Frailty Components in Ins-
titutionalized Older Adults. International Journal of Environmental
Research and Public Health, 18(5), 2723. MDPI AG. http://dx.doi.
org/10.3390/ijerph18052723
González, D., Sosa, Z., & Reboiras, L. (2021). The dimensions of age-
ing and the rights of older persons in Latin America and the Carib-
bean: selected texts 2009-2020.
Hernández-Sampieri, R. H. & Mendoza, C. (2018). Metodología de la inves-
tigación: Las rutas cuantitativa, cualitativa y mixta. México: McGraw Hill.
Höchsmann, C., Walz, S. P., Schäfer, J., Holopainen, J., Hanssen, H.,
& Schmidt-Trucksäss, A. (2017). Mobile Exergaming for Heal-
th-Effects of a serious game application for smartphones on physi-
cal activity and exercise adherence in type 2 diabetes mellitusstudy
protocol for a randomized controlled trial. Trials, 18(1), 1-17. ht-
tps://doi.org/10.1186/s13063-017-1853-3.
Huizinga, J. (2019). Homo Ludens. Alianza editorial.
Ihamäki, P. & Heljakka, K. (2021). Robot pets as “Serious Toys”-ac-
tivating social and emotional experiences of elderly people. Infor-
mation Systems Frontiers, 1-15. https://doi-org.ezproxy.uniminuto.
edu/10.1007/s10796-021-10175-z
Jansang, S., Mickleborough, T., & Suksom, D. (2016). Effects of Pur-
sed-Lip Breathing Exercise Using Windmill Toy on Lung Function
and Respiratory Muscle Strength in the Elderly. Journal of the Medical
Association of Thailand = Chotmaihet thangphaet, 99(9), 1046-1051.
Komis, V., Karachristos, C., Mourta, D., Sgoura, K., Misirli, A. and
Jaillet, A. (2021). Smart toys in early childhood and primary educa-
tion: a systematic review of technological and educational affordan-
2021), taking into account that the older adult can more
easily take advantage of leisure time and space.
Structure research based on the design of games and
toys that lead to innovative proposals that result in oppor-
tunities for knowledge and socially meaningful contribu-
tions (Traslaviña-Espitia & Aguirre-Cardona, 2020).
Acknowledgments
The authors express their gratitude to the Corporación
Universitaria Minuto de Dios-UNIMINUTO, Colombia,
for financing the research “The game and the toy as tools for
the integral well-being of the elderly from the socio-motor
perspective”, of which this article is the result.
References
Aguilar Bolivar, A., Florez Villamizar, J., & Saavedra Castelblanco,
Y. (2020). Aerobic capacity: Musicalized physical activity, ol-
der adult, health promotion. Retos, 39, 953-960. https://doi.
org/10.47197/retos.v0i39.67622
Aguirre-Cardona, L. A., Rubio-Florido, I., & Puerto-Rodríguez, E. A.
(2021). Ocio, trabajo y estudio simultáneo de estudiantes en mo-
dalidad a distancia y virtual (Leisure, work and simultaneous study
in distance and virtual students). Retos, 42, 375–383. https://doi.
org/10.47197/retos.v42i0.86425
Aguirre, L., López, J. y Villamizar, D. (2019). Revisiones y reexiones en
la educación física: un camino de lo conceptual a lo investigativo en la es-
cuela. Bogotá D.C., Colombia: Corporación Universitaria Minuto
de Dios. https://hdl.handle.net/10656/7679
Burdea, G. C., Grampurohit, N., Kim, N., Polistico, K., Kadaru, A.,
Pollack, S., Oh-Park, M., Barrett, A. M., Kaplan, E., Masmela,
J., & Nori, P. (2020). Feasibility of integrative games and novel
therapeutic game controller for telerehabilitation of individuals
chronic post-stroke living in the community. Topics in stroke re-
habilitation, 27(5), 321-336. https://doi.org/10.1080/1074935
7.2019.1701178
Campo Sánchez, G. E. (2010). El juego en la educación física básica: Juegos
pedagógicos y tradicionales. Editorial Kinesis.
Cicek, A., Ozdincler, A. R., & Tarakci, E. (2020). Interactive vi-
deo game-based approaches improve mobility and mood in older
adults: A nonrandomized, controlled trial. Journal of Bodywork and
Movement Therapies, 24(3), 252-259. https://doi.org/10.1016/j.
jbmt.2020.01.005.
Chaves-García, M., Sandoval-Cuellar, C., & Calero-Saa, P. (2017).
Association between aerobic capacity and quality of life in older
adults in a Colombian city. Revista Peruana de Medicina Ex-
perimental y Salud Pública, 34, 672-676. doi: 10.17843/rp-
mesp.2017.344.2522.
Chen, Y. C., Luo, S. N., & Kang, T. (2020). Unity 3D Game for
Senior’s Knee Maintenance. In 2020 IEEE Eurasia Conference on
IOT, Communication and Engineering (ECICE) (pp. 269-271). IEEE.
10.1109 / ECICE50847.2020.9302011.
Ching-Teng, Y. (2019). Effect of board game activities on cogniti-
ve function improvement among older adults in adult dayca-
re centers, Social Work in Health Care, 58:9, 825838, DOI:
10.1080/00981389.2019.1656143.
Corregidor-Sánchez, A. I., Polonio-López, B., Martin-Conty, J. L.,
Rodríguez-Hernández, M., Mordillo-Mateos, L., Schez-Sobri-
- 253 -
Retos, número 46 · 2022 (3º trimestre)
Rienzo, A., & Cubillos, C. (2020). Playability and Player Experien-
ce in Digital Games for Elderly: A Systematic Literature Review.
Sensors, 20(14), 3958. MDPI AG. Retrieved from http://dx.doi.
org/10.3390/s20143958
Rosa, M., Marinho, R., Gordo, S., & Pocinho, R. (2021). Game
performance to assess elderly people in long term care - a pilot
study. Retos, 43, 370-378. https://doi.org/10.47197/retos.
v43i0.89551
Salazar Martínez, C., Villar Ortega, M., Párraga Montilla, J. A., &
Moreno, R. (2015). Effects of the use of videogames in a balance
improving programme for women of 60 or over. Challenges, 17,
93-95. https://doi.org/10.47197/retos.v0i17.34682. https://
doi.org/10.47197/retos.v0i17.34682.
Santamaría-Guzmán, K., Salicetti-Fonseca, A., & Moncada-Jiménez, J.
(2015). Learning curve and motor retention of a video game in
young and older adults (Curva de aprendizaje y retención motriz de
un juego de video en adultos jóvenes y adultos mayores). Retos, 27,
218-221. https://doi.org/10.47197/retos.v0i27.34382
Sharadha Ramesh, M.Vatchala Devi. (2020). Assessment of Knowledge
and Perceived Practice on Using Eco-Friendly Toys among Mo-
thers of Under Five Children. Indian Journal of Fo-
rensic Medicine & Toxicology, 15(1), 2773-2781. https://doi.
org/10.37506/ijfmt.v15i1.13818
Thodberg, K., Sørensen, L. U., Videbech, P. B., Poulsen, P. H., Hou-
bak, B., Damgaard, V., ... & Christensen, J. W. (2016). Behavio-
ral responses of nursing home residents to visits from a person with
a dog, a robot seal or a toy cat. Anthrozoös, 29(1), 107-121. DOI:
10.1080/08927936.2015.1089011
Tseng, W. S., Ma, Y. C., Wong, W. K., Yeh, Y. T., Wang, W. I., &
Cheng, S. H. (2020). An Indoor Gardening Planting Table Game
Design to Improve the Cognitive Performance of the Elderly
with Mild and Moderate Dementia. International journal of envi-
ronmental research and public health, 17(5), 1483. https://doi.
org/10.3390/ijerph17051483
Traslaviña-Espitia, P. & Aguirre-Cardona, L A. (2020). Game and toy
for children and older adults, a research and design process. In: C.
Rodríguez, et al. (Ed.), Technology Entrepreneurship and Innova-
tion TEMNOVA. Editorial Scientometrics E Researching.
Urrutia, G., & Bonfill, X. (2010). PRISMA declaration: a proposal to
improve the publication of systematic reviews and meta-analyses.
Clinical Medicine, 135(11), 507-511. DOI: 10.1016/j.med-
cli.2010.01.015
Van Diest, M., Lamoth, C. J., Stegenga, J., Verkerke, G. J., & Poste-
ma, K. (2013). Exergaming for balance training of elderly: state
of the art and future developments. Journal of neuroengineering
and rehabilitation, 10(1), 1-12. https://doi.org/10.1186/1743-
0003-10-101.
Villa, M., & Rivadeneira, L. (1999). El proceso de envejecimiento de
la población en América Latina y el Caribe: una expresión de la
transición demográfica. In: Encuentro Latinoamericano y Caribeño sobre
las Personas de Edad; documentos de seminario técnico-Santiago: CELADE,
1999-v. 1, p. I. 1.1-35.
Villarreal-Angeles, M. A., Moncada-Jimenez, J., & Ruiz-Juan, F.
(2021). Mejora de variables psicológicas en Adultos Mayores
mediante Pilates (Improvement of psychological variables in
Older Adults through Pilates). Retos, 40, 47–52. https://doi.
org/10.47197/retos.v1i40.74307
Yuan, R. Y., Chen, S. C., Peng, C. W., Lin, Y. N., Chang, Y. T., &
Lai, C. H. (2020). Effects of interactive video-game-based exer-
cise on balance in older adults with mild-to moderate Parkinson’s
disease. Journal of neuroengineering and rehabilitation, 17(1), 91.
https://doi.org/10.1186/s12984-020-00725-y.
ces. Applied Science, 11 (18), 8653. MDPI AG. http://dx.doi.
org/10.3390/app11188653
Latham-Green, T., Hazenberg, R., & Denny, S. (2021). Examining the
role of driven-game shooting as a psycho-social resource for older
adults in rural areas: A mixed-methods study. Ageing and Society,
1-27. doi:10.1017/S0144686X2100091X
Lau, S. Y. J., & Agius, H. (2021). A framework and immersive serious
game for mild cognitive impairment. Multimedia Tools and Applica-
tions, 1-55. https://doi.org.ezproxy.uniminuto.edu/10.1007/
s11042-021-11042-4.
Li, X., Niksirat, K. S., Chen, S., Weng, D., Sarcar, S., & Ren, X.
(2020). The Impact of a Multitasking-Based Virtual Reality Mo-
tion Video Game on the Cognitive and Physical Abilities of Older
Adults. Sustainability, 12(21), 9106. http://dx.doi.org/10.3390/
su12219106
Lin, Y.-T., Chen, M., Ho, C.-C., & Lee, T.-S. (2020). Relations-
hips between recreational physical activity, sedentary lifestyle,
physical fitness and happiness in adults aged 65 years and older
in Taiwan. International Journal of Environmental Research and Public
Health, 17 (14), 5235. MDPI AG. http://dx.doi.org/10.3390/
ijerph17145235
Martínez, N., Santaella, E., & Rodríguez-García, A.M. (2020). Bene-
fits of physical activity for the promotion of active aging in elderly.
Benefits of physical activity for the promotion of active aging in
elderly. Bibliographic review). Challenges, 39, 829-834. https://
doi.org/10.47197/retos.v0i39.74537
McCord, A; Cocks, B; Barreiros, A.R & Bizo, L.A. (2020). Short video
game play improves executive function in the oldest old living in residen-
tial care. Computers in Human Behavior, (), 106337-. doi:10.1016/j.
chb.2020.106337.
Mei-Yung Chen, Jon-Chao Hong, Ming-Yueh Hwang & Wan-Tzu
Wong (2013) How the Elderly Can Use Scientific Knowledge to
Solve Problems While Designing Toys: A Retrospective Analysis
of the Design of a Working UFO, Educational Gerontology, 39:6,
386-397, DOI: 10.1080/03601277.2012.700879.
Heikkilä, M. (2021). Boys, weapon toys, war play and meaning-making:
prohibiting play in early childhood education settings. Early Child
Development and Care, DOI: 10.1080/03004430.2021.1943377.
Montañes, J., Parra, M., Sánchez, T., López, R., Latorre, J M., Blanc,
P., Sánchez, M J., Serrano, J P. & Turégano, P. (2000). The game
in the school environment. The game in the school environment. Es-
says: Journal of the Faculty of Education of Albacete, (15), 235-260.
Moyle, W., Bramble, M., Jones, C. J., & Murfield, J. E. (2019). “She
had a smile on her face as wide as the great Australian bite”: a qua-
litative examination of family perceptions of a therapeutic robot
and a plush toy. The Gerontologist, 59(1), 177-185. https://doi.
org/10.1093/geront/gnx180.
Muñoz-García, G., and Sánchez-Montañés, E. (2020). Play and toy in
the indigenous world in North America: contributions to childhood
visibility and education. Art, Individual And Society, 32(4), 968-987.
https://doi.org/10.5209/aris.66239
Papalia, D. (2012). Desarrollo humano. Mexico D.F. McGrawHill Inte-
ramericana.
Radhakrishnan, K., Toprac, P., O’Hair, M., Bias, R., Kim, M. T.,
Bradley, P., & Mackert, M. (2016). Interactive Digital e-Health
Game for Heart Failure Self-Management: A Feasibility Study. Ga-
mes for health journal, 5(6), 366-374. https://doi.org/10.1089/
g4h.2016.0038.
Ramesh, S., & Vatchala Devi, M. (2021). Assessment of Knowledge and
Perceived Practice on Using Eco-Friendly Toys among Mothers of
Under Five Children. Indian Journal of Forensic Medicine & Toxicology,
15(1), 2773-2781. https://doi.org/10.37506/ijfmt.v15i1.13818
