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Review

Evolution and Future of Serious Game Technology for Older Adults

by
Xin Huang
,
Nazlena Mohamad Ali
* and
Shafrida Sahrani
Institute of Visual Informatics, Universiti Kebangsaan, Malaysia Bangi, Selangor 43600, Malaysia
*
Author to whom correspondence should be addressed.
Information 2024, 15(7), 385; https://doi.org/10.3390/info15070385
Submission received: 15 May 2024 / Revised: 24 June 2024 / Accepted: 27 June 2024 / Published: 1 July 2024
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Abstract

:
Serious games play a key role in the medical field, particularly in enhancing cognitive abilities in the elderly. However, the sensory organs of the elderly decline over time, and the intervention effect of traditional serious games for older adults. The objective of this study is to identify the evolution and current problems of serious game technology for the elderly by using bibliometric analysis. We selected 319 relevant documents from 2013 to 2024 from the Web of Science (WOS) database. This study uses Publish or Perish (Windows GUl Edition) and VOSviewer (1.6.20) for performance analysis and scientific charting. We deeply analyze the early trends, emerging technologies, and publication trends, including citations and journals, subject areas, and regional and institutional. Here, we identified serious games for older adults rely heavily on visual presentation, often utilizing screens for screening, rehabilitation, and therapeutic interventions. This may cause further visual impairment in older adults who are experiencing visual decline. In addition, we proposed the combination of rich tactile feedback and external devices as one of the effective solutions to the current problems for future research.

1. Introduction

The 2019 revised version of the World Population Prospects predicts that by 2050 [1], 16% of the global population, or one out of every six people, will be 65 years of age or older. This represents a significant increase from the 2019 statistics, where seniors constituted 11% of the population. Moreover, by 2050, a quarter of the populations in Europe and North America are expected to be comprised of individuals aged 65 or older. In a significant development, the United Nations World Social Report for 2023, released on 15 November 2022, revealed that the global population has reached 8 billion. As the world’s population continues to grow, the aging of the population emerges as a distinct and noteworthy trend of our era. The report estimates that there will be 761 million people worldwide aged 65 and above in 2021, with expectations that this number will increase to 1.6 billion by 2050 [2].
In an aging society, cognitive impairment and a range of cognitive diseases, such as dementia, are major age-related public health issues among the elderly population. They are the main causes of disability, dependence, and poor quality of life [3]. Serious games are a nondrug intervention to improve cognitive abilities. Some systematic reviews have demonstrated the effectiveness of serious games in improving cognitive abilities [4].
The term “serious games” was coined by Clark C. Abt [5] in the 1970s, and it is defined as a game that has a clear and well-thought-out educational purpose rather than being used primarily for entertainment. Clark emphasized that this definition does not exclude the possibility of serious games being entertaining. A more contemporary definition of serious games characterizes them as “any form of interactive computer game software that can be used by one or more players on any platform and that is developed for purposes other than entertainment” [6]. Serious games are distinct from traditional video games because they focus on problem-solving and learning rather than mere entertainment. Despite this, they use the same media and interactive elements as recreational video games, making them engaging and enjoyable. Serious games serve as a powerful tool for helping learners develop a deep understanding of specific topics and acquire complex competencies. They represent a new and innovative medium for learning, with a particular emphasis on simulation. While they are not simulations in themselves, serious game approach educational activities by integrating the value of play into the learning process. They can be applied to various forms of simulation, including immersive simulations like virtual reality (VR) and procedural simulations [7]. Serious games offer a unique and engaging approach to learning and skill development.
Serious games play a significant role in improving cognitive, social, and physical well-being among the elderly. Nostalgic Seekers [8] is a cognitively based collaborative board game that provides players with cognitive exercise and social engagement and demonstrates the positive potential of incorporating augmented reality technology into cognitive gaming for older adults. Ambient assisted living (AAL) [9] environments are specifically designed to support older adults to live independently. This study aimed to investigate the acceptability of serious games for promoting physical health in these environments. The researchers investigated the relationship between age and user diversity, performance in the games, and overall usability and acceptability assessments. It was determined that serious exergames within and outside of AAL environments can promote the health and well-being of individuals and the stability of healthcare systems.
Through the above related papers, serious games play an important role in the health of the elderly. Therefore, this study clarifies the research objectives, hoping that serious games can better serve the elderly.
This article has two main objectives: Utilizing bibliometric analysis to identify the evolutionary process of serious game technologies for the elderly. Current serious games have notable shortcomings. By employing bibliometric analysis, this study aims to identify these drawbacks, providing researchers with valuable insights to design serious games that better meet the needs and characteristics of the elderly.
However, there are fewer studies in the field of serious games for the elderly than in other fields, so bibliometric analysis can better help researchers understand this field. At present, through bibliometric analysis, a comprehensive and up-to-date review of previous research has been conducted. In this study, we focus on serious gaming for the elderly, which aims for cognitive health, such as dementia, mental health, mild cognitive impairment, physical activity, Alzheimer’s disease, and memory.

2. Methods

2.1. Bibliometric Analysis

We primarily employ bibliometric analysis methods to comprehensively retrieve relevant literature on serious games for older adults. The methodology of bibliometric analysis involves the application of quantitative techniques to bibliographic data, such as publications and citation units, specifically through bibliometric analysis, such as citation analysis [10]. Scholars utilize bibliometric analysis for various reasons, such as to reveal the performance of articles and journals, collaboration patterns, and emerging trends in research components and to explore the domain-specific knowledge structure within existing literature [11]. Figure 1 shows the steps of bibliometric analysis to help readers understand the research methods more intuitively.
In bibliometric analysis, core data are typically extensive, involving hundreds or thousands of entries, and are objective in nature, such as citation and publication counts and the frequency of occurrence of keywords and topics. Although the interpretation of these data usually relies on two objective factors, such as performance analysis and subjective elements, such as thematic analysis, these evaluations are established through informed techniques and procedures. That is to say that bibliometric analysis helps decode and map the accumulated scientific knowledge and evolutionary details of mature fields by rigorously processing large amounts of unstructured data. Thus, well-executed bibliometric research can provide a solid foundation for advancing a field in novel and meaningful ways—enabling scholars to (1) obtain a comprehensive overview, (2) discover knowledge gaps, (3) draw new research avenues, and (4) position oneself for expected contributions to the field [12].

2.2. Procedural Analysis

Web of Science (WOS) [13] serves as a globally trusted and publisher-independent third-party citation database, ranking among the most powerful search engines available. Its multidisciplinary platform connects various countries, regions, specialties, data, and patent indices to the Web of Science (WOS) Core Collection, enabling the tracking of interdisciplinary and temporal trends in research ideas.
We retrieved 319 relevant documents from the database spanning the years 2013 to 2024. The selection of this time frame is motivated by the fact that a majority of representative papers fall within this period. Another reason is to comprehensively analyze the evolution of serious game technology for older adults and identify shortcomings, necessitating a reasonable time span. In order to ensure the relevance and quality of the selected papers, when searching the Web of Science (WOS) database, the researchers chose to search by topic and used double quotes plus keywords for searching. The researchers excluded book reviews, conference papers, conference reviews, books, editorials, surveys, notes, and letters from the search results within the Web of Science (WOS) database. Apart from limiting the time frame and document types, we did not restrict citation topics, affiliations, publication names, countries and regions, publishers, research fields, funding agencies, and sustainable development goals. Various citation indices, including the Social Sciences Citation Index, Science Citation Index Expanded, Emerging Sources Citation Index, and Arts & Humanities Citation Index, were utilized for indexing.
The chosen keywords were determined based on the study’s content and cross-verification with papers from different citation indexes and collaboration with other authors. To ensure a comprehensive investigation into the field of serious games for older adults, relevant keywords were employed, as outlined in Table 1.
In Table 1, We used synonyms for older adults to broaden the search results and ensure a broader search of the literature. The language chosen for the retrieved documents was English. The age criterion was set at 65 years or older for the elderly [14], as reviewing the definition of “elderly” was deemed necessary due to the substantial cognitive challenges faced by this demographic [15].
The flowchart depicting the process of the bibliometric review is illustrated in Figure 2. The review adopted a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 24 articles were excluded from consideration as they were deemed irrelevant to the scope of this study, such as those focusing on research related to children. Figure 3 presents a query example for the terms “serious games” and “elder”, including a screenshot displaying the number of results obtained. This search process is then replicated for the additional keywords, as illustrated in Figure 2. The cumulative total of search results amounts to 343 items as of February 2024.

3. Result

3.1. Evolution of Serious Game Technology for Older Adults

3.1.1. Early Trends

In the early stage, we primarily reviewed literature on serious games for the elderly published between 2013 and 2016. We selected five early publications with abundant citations for citation data analysis, as shown in Table 2. The paper ranked first, with 130 citations, is “Kitchen and cooking”, a serious game for mild cognitive impairment and Alzheimer’s disease—a pilot study disease: a pilot study [16] published in 2015 in the Frontiers in Aging Neuroscience [17] journal. The second-ranked paper, with 104 citations and 47 references, is “Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study” [18], from the Jmir Serious Games [19] journal under Jmir Publicatios, Inc. [20]. The third-ranked paper, also from the Jmir Serious Games journal under Jmir Publications, Inc., is “A Serious Game for Clinical Assessment of Cognitive Status: Validation Study [21]”, with 67 citations and 29 references. The remaining papers are from IOS Press and the Journal of Alzheimers Disease [20] under Jmir Publications, Inc., with citation counts of 63 and 39 and reference counts of 67 and 79, respectively [22,23].
We also observed that the early citation trend peaked in 2015, with a total of 169 citations, slightly declining in 2016 to 130 citations, showing a general upward trend followed by a slight decrease. The literature from 2015 and 2016 establishes a sturdy base and reference for future research in this domain of serious games for the older population, serving as valuable resources for understanding the early development of this field.

3.1.2. Emerging Technologies

To investigate the technological evolution within the realm of serious games for the elderly, we employed co-occurrence analysis and visualized the results using VOSviewer (1.6.20) software. The analysis yielded a total of 368 sets of keywords. We filtered out keywords appearing fewer than two times and those irrelevant to the study, resulting in 55 sets of keywords for analysis.
In Figure 4, six clusters of keywords are displayed. The first cluster, highlighted in red, consists of 14 keywords, including accessibility, age-related difference, Alzheimer’s disease, cognitive assessment, cognitive impairment, ecological validity, exergames, health, impairment, performance, self-managed rehabilitation, usability, virtual reality, and working memory. This cluster indicates the contribution of serious games for the elderly in the cognitive health domain, particularly with the application of VR technology.
The second cluster, marked in green, encompasses keywords such as behavioral interventions, behavior change, digital games, e-Health, exercise, gamification, mobile phone, intervention, physical activity, psychological theory, and self-determination theory. This cluster suggests the use of gamification to promote changes and interventions in physical activities among the elderly, along with contributions to geriatric psychology. Digital games and mobile phones serve as technological platforms for electronic health data collection among the elderly. The third cluster, depicted in blue, includes keywords like acceptance, ambient assisted living, dementia, disease, exercise games, information, public health, rehabilitation, technology, and technology acceptance. This cluster indicates the impact of serious games for the elderly in public health, encouraging patient engagement through exercise games and ambient assisted living approaches. The fourth cluster, represented in yellow, comprises keywords such as decision-making, design, engagement, humanoid robots, randomized controlled trials, mild cognitive impairment, and risk. The utilization of humanoid robots in this domain, alongside advancements in technology, enhances services for patients with mild cognitive impairment, facilitating increased participation among the elderly.
The fifth cluster, denoted in purple, includes keywords like assistive technologies, balance, care, delirium, human factors, and medical education. Serious games for the elderly serve as auxiliary technologies and nursing methods, demonstrating therapeutic efficacy for patients with mental illnesses. Lastly, the blue cluster of keywords encompasses cancer awareness, cancer prevention, cancer education, health education, and video games. This cluster highlights the major role of serious games in cancer prevention through video game-based approaches. Through the analysis of these six clusters of keywords, we can clearly discern the technological evolution within the domain of serious games for the elderly, spanning from video games and digital games to mobile phones, virtual reality, exercise games, ambient assisted technologies, and the emergence of humanoid robots. These technological advancements enhance elderly participation, thereby better serving the aging population. The scope of research in this field continues to expand, extending from cognitive health to physical and psychological activities among the elderly and even into the realm of public health.

3.2. Impact Assessment

3.2.1. Citation Analysis

Table 3 presents the top 10 most cited articles in the realm of serious games for the elderly retrieved from the Web of Science (WOS) database from 2013 to 2024. Seven HCI Grand Challenges [24] tops the citation ranking with a remarkable 173 citations, containing an extensive reference list of 307 items. Published in the International Journal of Human-Computer Interaction by Taylor & Francis Inc., the paper is authored by Stephanidis Constantine. This article investigates seven key challenges posed by the rapid development of current and emerging technologies towards smarter interactive technologies: human–environment interaction; human–technology symbiosis; security, ethics, and privacy; health, welfare, and Eudaimonia; learning and creativeness; accessibility and universal access; and democracy and social organization. Moreover, this article adopts a humanistic and social value-oriented perspective to explain the effect of emerging intelligent interactive technologies on human life from the personal and social levels. The second most cited paper was Serious Games and Gamification for Mental Health: Current Status and Promising Directions [25]. This article contributes to the field by exploring the potential and opportunities for Internet-based mental health interventions. Furthermore, it describes six categories of tested mental health apps and demonstrates the feasibility of translating traditional evidence-based interventions into computer game formats and using computer games to affect therapeutic change. Authored by Fleming Theresa M, garnered 163 citations in the Frontiers In Psychiatry journal in 2017. With 130 citations, the third-ranked paper is ‘Kitchen and cooking’, a serious game for mild cognitive impairment and Alzheimer’s disease: a pilot study [16], authored by Manera Valeria, and published in Frontiers In Aging Neuroscience by Frontiers Media Sa. In this study, The acceptability of the “Kitchen and Cooking” game developed within the framework of the EU VERVE project was examined in older adults with mild cognitive impairment (MCI), Alzheimer’s disease (AD), and related diseases. This game employs a cooking scenario to evaluate and motivate executive functions and practical abilities. Self-reported outcomes, along with data regarding game performance, confirmed the overall acceptability of the “Kitchen and Cooking” game among patients with MCI, AD, and related disorders, as well as its utility for training purposes. Fascinatingly, the results also affirmed the suitability of the game for emotionally detached patients. Another notable paper, “Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study” [18], published by Tarnanas [18] and Ioannis [18], in the Jmir Serious Games journal under Jmir Publications, Inc., in 2013, also exceeded 100 citations.
The remaining articles include A Serious Game for Clinical Assessment of Cognitive Status: Validation Study [21], Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive Impairment [22], Effectiveness of a Behavior Change Technique-Based Smartphone Game to Improve Intrinsic Motivation and Physical Activity Adherence in Patients with Type 2 Diabetes: Randomized Controlled Trial [26], Engaging Elderly People in Telemedicine Through Gamification [23], Moving Real Exergaming Engines on the Web: The webFit For All Case Study in an Active and Healthy Ageing Living Lab Environment [27], and A Virtual Reality App for Physical and Cognitive Training of Older People with Mild Cognitive Impairment: Mixed Methods Feasibility Study [28]. Their citation counts range include 67, 63, 42, 39, 32, and 25. We highly recommend that researchers in this field carefully review these 10 articles. These papers comprehensively cover the mental health, cognitive issues, and physical health of the elderly, as well as the application of current technologies and the challenges posed by the rapid development of both existing and emerging technologies.
Fleming Theresa M [29] has authored a total of 114 articles, with 2748 citations and a cumulative citation count of 3461, yielding an H-Index of 28. As the first author, she accounts for 14% of the total articles. Manera Valeria [30] has authored 93 articles, with 1722 citations and a total citation count of 2170, resulting in an H-Index of 26, with a first authorship ratio of 26%. Stephanidis Constantine [31] has published 233 articles, with 1196 citations and a cumulative citation count of 1474, achieving an H-Index of 17, with 18% of the articles authored as the first author. Konstantinidis Evdokimos I [32] has an H-Index of 14, with a total of 76 published articles. We consider these four researchers to be the most influential in this field.
In Table 3, we observed that Jmir Publications, Inc. contributed 5 out of the top 10 most cited articles, which aligns with the publisher and journal analysis identified in the research analysis.

3.2.2. Publication Trends

After data research, Table 4 reflects the annual number of publications and citations in the field of serious games for the elderly from 2013 to 2024. In 2013, the number of citations in this domain was 0, and the number of publications was 6, which was at a historical low; in 2023, the number of citations was as high as 890, and the number of publications ranked second in this time period, reaching 48; in 2022, the number of publications was the highest in the entire time The year with the most articles, there were 49 papers, and the number of citations ranked second in the entire period, reaching 870 times. The years 2022 and 2023 are the two years when research in this field will explode. Both the number of citations and the number of publications are at the forefront.
Figure 5 provides a more intuitive representation of the trend in publication and citation counts over the entire period. The citation count peaked in 2023, while the publication count reached its historical high in 2022. Throughout the entire period, we observed a noticeable upward trend in citation count since 2016, indicating a generally positive trajectory. Similarly, the publication count has increased significantly since 2015, reaching its peak of 49 papers in 2022, with an overall gradual upward trend.
With the aging population worldwide, the realm of serious games for the elderly has undergone rapid growth over the past eight years. We believe that in the coming years, both citation and publication counts in this field will continue to reach historic highs.

3.2.3. Publisher and Journal Analysis

Through Table 5, we can observe that Jmir Serious Games [19] is the journal with the highest number of publications in this realm, having published a total of 52 papers. The journal’s citation indicator is 0.92, with a total citation count of 1398. In 2022, the journal’s impact factor was 4.0, and it was published by Jmir Publications, Inc. [20]. Frontiers in Aging Neuroscience [17] ranks second, having published 14 papers. The journal’s citation indicator is 0.97, with a total citation count of 10,243. In 2022, the impact factor of the journal was 4.8, and it was published by Frontiers Media Sa [33]. The third-ranking journal is the International Journal of Environmental Research and Public Health [34], with a total of 10 papers published in this field. The journal’s citation indicator is 0.93, with a total citation count of 123,105. In 2022, the impact factor of the journal was 4.6, and it was published by MDPI [35]. Jmir Serious Games [19] far exceeds other journals regarding the volume of published papers in this field.
The journal IEEE Journal of Biomedical and Health Informatics [36] has the highest impact factor among the selected journals, reaching 7.7, with a citation indicator of 1.78, making it the journal with the highest impact factor and citation indicator among all selected journals. Following closely is the Journal of Medical Internet Research [37], with an impact factor of 7.4 and a citation indicator of 1.74, ranking second. The third-ranking journal is Cyberpsychology Behavior and Social Networking [38], with an impact factor of 6.6 and a citation indicator of 1.41.
Table 5 displays the top 10 journals, with several publishers represented. Jmir Publications, Inc. [20] has four journals among the top ten, while MDPI [35] and Frontiers Media Sa [33] have three each. The publisher IEEE-INST Electrical Electronics Engineers Inc. [36] has two journals included in the top ten. We consider these publishers and their respective journals to be representative of this field of research.

3.2.4. Subject Area Analysis

Based on data from the WOS database, combined with data analysis using Microsoft® Excel (Excel 2016) software, we have identified the top 10 most active research areas in the field of serious games for the elderly, as shown in Table 6. The most active research area in this field is public environmental occupational health, with a total of 91 papers accounting for 28.5% of the total publications in this domain. Following closely is medical informatics, with 87 papers constituting 27.2% of the total literature in this field. The third-ranking research area is healthcare sciences services, with 84 papers representing 26.3% of the total literature in this field. The remaining research areas include computer science, neurosciences neurology, engineering, geriatrics gerontology, educational research, psychology, and psychiatry. Through analysis, we have found that research in this field mainly focuses on health-related areas such as healthcare, covering a wide range of diseases that elderly individuals may encounter. We have reason to believe that the domain of serious games for the elderly has made significant contributions to addressing the challenges of global aging.

3.2.5. Regional Analysis

We used Publish or Perish (Windows GUl Edition) and Microsoft® Excel (Excel 2016) software to analyze and find 10 countries that have made outstanding contributions to serious games for the elderly (Table 7). These countries are Canada [39], Spain [40], Portugal [41], the United States [42], Italy [43], Germany [44], Greece [45], Switzerland [46], England [47], and The Netherlands [48], which shows that developed countries pay more attention to research in this field.
From Table 7, we can intuitively see that Germany published a total of 47 papers in 12 years and was the country with the largest contribution, accounting for 14.7% of the total number of papers; Portugal was the second country with the largest contribution, publishing 41 papers. Accounting for 12.8% of the total number of papers, Canada and the United States ranked third, publishing 40 papers each, each accounting for 12.5% of the total number of papers.
Figure 6 is a visualization diagram of the national bibliographic coupling network drawn through VOSviewer (1.6.20) software. Such network connection helps us find the intensity of citation connections between two or more countries in the field. Figure 4 shows that there are three clusters. The first cluster is shown in red and includes Germany, The Netherlands, Greece, England, and Switzerland. These countries show stronger bibliographic coupling, indicating that the citation rates between them are higher than in other countries. The second cluster is shown in green and includes Spain, Portugal, and Italy. The third cluster is Canada and the United States, shown in blue.

3.2.6. Institutional Analysis

Table 8 presents a graphical representation of the top five contributing institutions in the field, created using data from the WOS database and Microsoft® Excel (Excel 2016) software. The institution with the most significant contribution is Aristotle University of Thessaloniki [49] in Greece, which published a total of 21 papers in this domain, accounting for 6.5% of the total 319 papers. Tied for second place are the University of Heidelberg [50] and the University of Texas System [51] in Germany and the United States, each publishing 13 papers, each accounting for 4.0% of the total literature. The University of Toronto [52] in Canada and the University of Texas Medical Branch Galveston [53] in the United States tied for third place, each contributing 11 papers, each accounting for 3.4% of the total. The remaining institutions include the Centre For Research Technology Hellas [54], Consiglio Nazionale delle Ricerche Cnr [55], Karolinska Institutet [56], University of Geneva [57], and Baylor College of Medicine [58].
Among the top five institutions, three are from the United States: the University of Texas System [51], The University of Texas Medical Branch Galveston [53], and Baylor College of Medicine [58], contributing a total of 32 papers, accounting for 13.9%. Greece has two institutions in the top five: the top-ranked Aristotle University of Thessaloniki and the fourth-ranked Centre For Research Technology Hellas, together contributing 31 papers, accounting for 9.6% of the total.
We believe that these top five institutions, as well as their peers, are passionate about research in the area of serious games for the older population.
This study was also compared to a similar research paper, “Trends in Serious Games Research from 2007 to 2017: A Bibliometric Analysis” [59]. The results of the “Trends in Serious Games Research from 2007 to 2017: A Bibliometric Analysis” paper included trends in publication time and type, most published countries and universities, prolific source titles, rich research fields, prolific authors, and the top 10 most cited publications. Due to the different time ranges and topics of the two studies, the researchers did not compare trends in publication time and type, prolific authors, and the top 10 most cited publications. We compared the remaining results with the results of this study.
1.
Comparison of the countries and universities that publish the most
The countries with the most publications in the paper “Trends of Serious Games Research from 2007 to 2017: A Bibliometric Analysis” are the United States, the United Kingdom, The Netherlands, Spain, France, China, Germany, Canada, Italy, and Australia. The results of this study are from Canada, Spain, Portugal, the United States, Italy, Germany, Greece, Switzerland, England, and The Netherlands. The United States, the United Kingdom, The Netherlands, Spain, Germany, Canada, and Italy have been focusing on the research of serious games.
The top three research institutions in this study are Aristotle University of Thessaloniki, Heidelberg University, and the University of Texas System. The top three universities in similar papers are Delft University of Technology, University of Amsterdam, and Utrecht University. Due to the differences in research time and scope, this study does not have the same university as similar studies.
2.
Journal comparison
In a similar paper, the most prolific journals are Computers Education, Computers in Human Behavior, Games for Health Journal, British Journal of Educational Technology, Games and Culture, Multimedia Tools and Applications, Journal of Medical Internet Research, Plos One, Frontiers in Psychology, and Visual Computer. After comparing this project, researchers found some common journals, such as Games for Health Journal, Frontiers in Psychology, and Journal of Medical Internet Research. This shows that these three journals have always been representatives in the field of serious games.
3.
Comparison of research fields
This study identified the top ten most active research areas for serious games in the field of seniors, which are public environment occupational health, medical informatics, medical science services, computer science, neuroscience neurology, engineering, geriatrics, educational research, psychology, and psychiatry. By comparing similar papers, the researchers found that computer science, psychology, engineering, medical science services, public environment occupational health, and psychiatry have always been the focus of serious game research.
After comparing with similar research papers, we found some similarities and differences. The research on this topic also has unique features that are not mentioned in similar research papers, such as early trends and emerging technologies, which are the unique findings and contributions of this study.

4. Discussion

Research Gaps

Through searches on the WOS search engine, we have identified a total of 319 papers on serious games for the elderly. However, serious games targeting the elderly may pose challenges for individuals who have already experienced age-related declines in physical organ function. We have summarized some of the challenges that elderly individuals may encounter when using serious games:
Visual impairment in the elderly may affect their interaction with serious games. Aging individuals often experience sensory changes that can impact their interaction with digital displays and games. These changes include reduced visual acuity (both static and dynamic), limited visual accommodation range, decreased contrast sensitivity, impaired dark adaptation, reduced color sensitivity, and increased sensitivity to glare. These impairments can make it challenging for older individuals to perceive small on-screen elements, read text, or navigate complex interfaces. To address these challenges, it is advisable to offer users control over font size, color, contrast settings, window resizing, scroll rate adjustment, and zooming while ensuring the game remains playable. Users should have an easy option to revert to default settings with a single click [60]. In the paper ‘Kitchen and cooking’, a serious game for mild cognitive impairment and Alzheimer’s disease: a pilot study [16], a serious game was installed on a tablet for flexible use by older adults at home and in nursing homes. The one-month experiment yielded positive results. The paper “A Serious Game for Clinical Assessment of Cognitive Status: Validation Study” [21] also used tablet-based technology to conduct gamified cognitive assessments on a clinical sample. Elderly people will undoubtedly be affected by some visual impairments when using tablets, such as sensitivity to color, font size, etc. In the paper “Moving Real Exergaming Engines on the Web: The webFit For All Case Study in an Ac-tive active and Healthy Ageing Living Lab Environment” [27], older adults said that the mobile screen was too small when interacting, demonstrating that vision impairment among older adults may affect their interaction with serious games.
The age-related hearing decline in the elderly may also impact their interaction with serious games. Auditory acuity, especially sensitivity to pure tones and high-frequency sounds, is also affected by age. Sound localization can be problematic due to binocular hearing issues, and understanding synthetic speech may be challenging. To address auditory challenges, it is recommended to provide superfluous data through multiple sensory modalities. For instance, if an in-game sound effect conveys important information, tactile feedback through vibration or force-feedback devices can assist. Online social gaming should support both voice communication through headsets and text messaging via a keyboard for effective player interaction [61].
Sensations of pressure, touch, and vibration diminish with age, particularly in the hands and feet. Sensitivity to pressure becomes lower when the body is in complete contact with a surface or when a small surface is pressed. The decline in sensitivity to touch, pressure, and vibration becomes evident at the age of 50 and shows exponential growth after the age of 65 or 70. The rate of decline varies across different body parts, with facial touch and vibration perception relatively stable. In contrast, sensitivity in touch for hands and feet declines rapidly, with a more pronounced effect on the lower extremities, which may reflect the longer neural pathways through which sensory input must travel [61].
The range of body movements becomes restricted, accompanied by a decline in muscle strength and flexibility, and reaction times slow down. The height of the torso and accessibility of the arms decreases, making it challenging to reach for objects. Certain conditions, such as arthritis, can cause joint pain and stiffness, making it difficult to grip a variety of surfaces [62]. The paper “Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive Impairment” [22], usability results show that the game X-Torp, played using Microsoft® Kinect™ (2.0), is a usable enriched environment (EE) for healthy subjects as well as patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, to achieve moderate- or vigorous-intensity aerobic activity, the X-Torp control mode should be adjusted to be more physically stimulating. It is reasonable to believe that the reason for this adjustment is due to the limited range of physical activity in older adults, as well as decreased muscle strength and flexibility and slower reaction times.
Instability in balance is a significant concern. Both static equilibrium and dynamic coordination are compromised with age. Balance depends on three factors: (1) vision, providing information about object position, size, and clarity; (2) the inner ear vestibular system, providing information about the body’s movement in space; and (3) proprioception, feedback from body receptors about the surfaces we come into contact with. Muscle weakness resulting from a lack of activity can also contribute to balance loss [63]. This article, “Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study” [16], assesses dementia in older adults by assessing finger tapping, grip strength, stride length, walking speed, and chair stand performance, respectively, and while performing a virtual reality out-of-home task (VR-DOT) in order to correlate performance on these indicators with VR-DOT, as performance when navigating a virtual environment is a valid and reliable indicator of cognitive decline in older adults. This article uses the fact that older adults’ pressure, touch, and vibration sensations gradually diminish, and their balance becomes unstable when playing serious games to assess whether they have dementia.
We believe that the areas that require further research mainly revolve around the need to ensure that the use of serious games by the elderly does not cause or minimize damage to the sensory organs of the elderly. We can continue to delve deeper into the field of human–computer interaction and enable users to interact with computers or virtual environments more intuitively by simulating tactile sensations, such as touch, vibration, force, etc. At the same time, the fields of information technology, virtual reality, and augmented reality are also directions worthy of research.
The study [64] proposed a design of an indoor positioning terminal for visually impaired elderly people. The interaction is based on buttons, tactile symbols, and audio feedback. The tactile symbols imitate real-world objects. The results show that the use of real-world objects and a low level of symbolic abstraction leads to a clear pairing between user expectations and actual functionality. Our final design was recognized by all participants and allowed participants to locate themselves in indoor environments.
Due to the direct manipulation, touch displays offer a wide range of interactive possibilities for consumer and investment products. In touchscreen interactions, feedback is usually only audiovisual. This can cause damage to human vision and hearing. One of the effective ways to alleviate auditory and visual damage is tactile feedback. Therefore, this study investigates the mitigation potential of the audiovisual perception channel by means of tactile feedback. For this purpose, a slider with a tactile scale was implemented on an electrotactile touchscreen. Within the framework of the test study, different scale distances and feedback intensity patterns were investigated to determine the perceptual threshold for precise adjustment of defined scale values. It can be shown that electrotactile feedback is suitable for both young and elderly people [65].
Tactile feedback can alleviate visual and hearing damage to people, especially the elderly, and can also help elderly people with visual impairments. Therefore, tactile sensations need to be integrated into serious games for the elderly. This is an area worth studying.

5. Future Directions

Through a rigorous analysis of emerging technologies in serious gaming for older adults, we find that the evolution of technology in this field, from early video and digital technologies to mobile phones, virtual reality, action games, ambient assistive technologies, and the advent of humanoid robots, is closely related to the visual engagement of older adults. Currently, in developed countries such as Germany, the United States, Spain, Portugal, and Greece, part of technology development is centered around visual presentation. These technologies strive to provide individuals with an immersive experience through sensory organs such as eyes and ears, thereby increasing productivity. The main contributions to the field of serious games for older adults are concentrated in developed countries. These emerging technologies are combined with this field to provide services for the Aristotle University of Thessaloniki in Greece, the University of Heidelberg in Germany, the University of Texas System in the United States, the University of Toronto in Canada, the University of Texas, etc., as well as public environmental occupational health, researchers in related disciplines such as medical informatics and healthcare science services such as Fleming Theresa M., Manera Valeria and Stephanidis Constantine, etc., provided the impetus for the research.
Currently, we observe a relatively monolithic approach to addressing cognitive problems in older adults, with most interventions using serious games that are visualized on mobile devices or computers. We still believe that this approach may not allow older adults to fully experience serious game training. At the same time, it can also cause certain damage to the sensory organs of the elderly. However, integrating rich tactile feedback technology with wearable devices provides an effective way to solve this problem.
The provision of rich skin stimulation, whether for individuals with disabilities or for the general population engaging in serious games, has shown remarkably therapeutic effects. Rich skin stimulation can offer diverse feedback for serious games tailored to elderly individuals. Both visually impaired and hearing-impaired elderly individuals can utilize such a device for corresponding therapeutic serious games. We believe that the widespread adoption of this device could potentially alter the trends in designing serious games for the elderly.
The ability to discern sensations on the skin through training may potentially reduce chronic pain caused by sensory motor disorders and enhance sensory motor function. Currently, there is no device available to systematically provide rich skin stimulation suitable for training programs for individuals with limb loss or severe sensory impairments. This study describes the development and validation of a noninvasive wearable device aimed at delivering tactile stimulation in a repetitive and safe manner. The objective of this research is to design and test a wearable device capable of providing rich somatosensory stimulation, ultimately intended for structured interventions in pain and/or functional rehabilitation [66].
Ensuring that these devices conform to ergonomics and usability standards is crucial. Wearable devices have been extensively utilized in virtual reality tasks, prompting researchers to continually enhance their design. Ongoing technological breakthroughs and improvements enable wearable devices to better serve the design of serious games for the elderly. This advancement allows the elderly population to have an improved experience with the content of serious games, thereby enhancing the effectiveness of therapeutic interventions.
Wearable tactile devices are used to present the sense of touch in different scenarios, including virtual reality, simulation, or remote operation. Its design must take into account ergonomic and usability constraints. A balancing effect needs to be achieved between balancing actuator size and presenting tactile stimulation characteristics. This study proposes a new approach to the design of wearable tactile devices: a micro–macro actuation concept. This has been shown to better match the output range of the actuator with the signal characteristics used in typical tactile rendering. The researchers studied the method through analytical models, numerical models, and physical experiments performed after designing and developing working prototypes. Design guidelines are defined for the development of real devices through theoretical and simulation models of the dynamic interaction of system components. The design solution employed has been implemented and evaluated in a prototype of a highly wearable fingertip device. The final experimental results show that the implementation of the method proposed in this study can effectively achieve tactile feedback [67].
Rich skin stimulation combined with wearable devices that provide tactile feedback can reduce the elderly’s dependence on screen-based visual cues. For example, when treating mild cognitive impairment in the elderly, they do not need to keep an eye on the screen to understand every step of the process. Instead, skin stimulation can remind them of errors or obstacles during the operation. Wearable devices can present a variety of tactile sensations, allowing the elderly to associate each tactile feedback with a specific operation, thereby reducing their dependence on vision and promoting treatment.
The researchers believe that combining the A-Maze-D system [68] with tactile feedback technology and external devices is a good example, such as combining the maze game design capabilities of the A-Maze-D system with tactile feedback technology, designing tactile feedback patterns based on events and objects in the game. For example, maze walls, props, etc., can have different vibration patterns. Appropriate external devices, such as gloves, vests, or special controllers, should be chosen and integrated with the game system. At the same time, software interfaces should be developed so that the external device can receive input from the A-Maze-D system and respond to events in the game in real time.
The most important aspect of this study is the identification of the shortcomings of serious games for the elderly. Serious games, which are intended to have a positive effect on the cognitive, physical, and mental health of the elderly, have been found to cause certain damage to their sensory organs, a development that researchers find concerning with society now entering an aging phase; it is imperative that such designs be urgently revised. This study proposes a solution to address this issue, aiming to improve the design direction of serious games for the elderly, provide comprehensive treatment without compromising their vision, and enhance the quality of care for the elderly.

6. Conclusions

From 2020 to 2023, the number of papers and citations in the field of serious games for the elderly increased sharply in these 4 years until reaching a peak in the past 2 years. We have every reason to believe that in order to better respond to the global aging trend, more researchers will invest in research in this field.
Developed countries like Germany, Portugal, Canada, and the United States have shown relatively strong interest in research in the field of serious games for the elderly. There are several reasons contributing to this phenomenon, including the technological advancement of developed countries, government policies and economic support, the availability of more excellent researchers and renowned publishers, and the widespread aging population. These factors have collectively propelled these countries to a leading position in this field.
Excellent publishers in this field include Jmir Publications, Inc., Frontiers Media Sa, and MDPI. Notable publications from these publishers include Jmir Serious Games, Frontiers in Aging Neuroscience, and the International Journal of Environmental Research and Public Health. Their impact factors are all equal to or greater than 4.0, and their citation indices are equal to or greater than 0.92.
The most noteworthy papers in this area include “Seven Grand Challenges in Human-Computer Interaction”. This article investigates seven key challenges posed by the rapid development of current and emerging technologies towards smarter interactive technologies. Moreover, it adopts a humanistic and social value-oriented perspective to explain the impact of emerging intelligent interactive technologies on human life from the personal and social levels. The article “Serious Games and Gamification for Mental Health: Current State and Promising Directions” contributes to the field by exploring the potential and opportunities for Internet-based mental health interventions and demonstrates the feasibility of translating traditional evidence-based interventions into computer game formats and using computer games to effect therapeutic change”. In the study ‘Kitchen and Cooking’, A Model for Mild Cognition Disorders and Alzheimer’s Disease: A Pilot Study”, the game employs a cooking scenario to evaluate and motivate executive functions and practical abilities. Self-reported outcomes, along with data regarding game performance, confirmed the overall acceptability of the “Kitchen and Cooking” game among patients with MCI, AD, and related disorders, as well as its utility for training purposes. Interestingly, the results also affirmed the suitability of the game for emotionally detached patients. The paper “Ecological Validity of Virtual Reality Activities of Daily Living Screening for Early Dementia: A Longitudinal Study” focuses primarily on cognitive health and mental health in older adults. We believe that scholars interested in researching this area will benefit from reading these papers as they provide valuable insights and perspectives.
Key figures in this field include Fleming Theresa M., Manera Valeria, Stephanidis Constantine, and Konstantinidis Evdokimos. Together, they have authored a total of 516 papers in relevant domains. Among them, Fleming Theresa M. has the highest H-Index score of 28, indicating a significant impact in this field.
The research scope of this field primarily encompasses public environmental occupational health, medical informatics, healthcare science services, neuroscience neurology, geriatrics gerontology, psychology, and psychiatry. It covers various aspects of health for the elderly population, including cognitive, physical, and psychological health, aiming to ensure the provision of excellent services for the elderly population. The institutions contributing the most to this field include Aristotle University of Thessaloniki from Greece, Ruprecht Karl University Heidelberg from Germany, the University of Texas System, the University of Texas Medical Branch Galveston from the United States, and the University of Toronto from Canada. Together, they contribute to 21.3% of the total share of papers in this field.
With the advancement of science and technology, the evolution of serious games for the elderly has shifted from simple two-dimensional displays to three-dimensional spaces, aiming not only to make the content visible but also to make the elderly feel immersed in the game. Perhaps combining rich tactile feedback technology with wearable devices can provide effective solutions to address some of the challenges encountered by the elderly when using serious games.
This study fills the gap in the problem of further visual damage to elderly people with visual impairment or those who are experiencing vision loss when using serious games.
Serious games for the elderly involve multiple fields, such as gerontology, cognitive science, and game design. The study might not fully integrate insights from all relevant disciplines, potentially limiting the comprehensiveness of the analysis. In addition, the limitation of this study is that the researchers only used the WOS database for literature search, which limited the language and time range of the literature, and these factors may affect the in-depth understanding of the research field.

Author Contributions

Conceptualization, X.H. and N.M.A.; methodology, X.H. and N.M.A.; validation, X.H., N.M.A. and S.S.; formal analysis, X.H.; investigation, X.H.; data curation, X.H.; writing—original draft preparation, X.H.; writing—review and editing, X.H., N.M.A. and S.S.; visualization, X.H.; supervision, N.M.A. and S.S.; project administration, X.H. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Dataset available on request from the authors.

Conflicts of Interest

The authors declare no conflicts of interest.

References

  1. United Nations, Department of Economic and Social Affairs, Population Division. World Population Ageing 2019: Highlights (ST/ESA/SER.A/430). 2019. Available online: https://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf (accessed on 15 December 2023).
  2. Bonnechère, B.; Van Vooren, M.; Bier, J.C.; De Breucker, S.; Van Hove, O.; Van Sint Jan, S.; Véroniqueg, F.; Bartb, J. The Use of Mobile Games to Assess Cognitive Function of Elderly with and without Cognitive Impairment. J. Alzheimer’s Dis. 2018, 64, 1285–1293. [Google Scholar] [CrossRef]
  3. Gela, Y.Y.; Fekadu, S.A.; Belsti, Y.; Akalu, Y.; Dagnew, B.; Getnet, M.; Seid, M.A.; Diress, M. Cognitive impairment and associated factors among mature and older adults living in the community of Gondar town, Ethiopia, 2020. Sci. Rep. 2022, 12, 7545. [Google Scholar] [CrossRef]
  4. Abd-alrazaq, A.; Alajlani, M.; Alhuwail, D.; Toro, C.; Giannicchi, A.; Ahmed, A.; Makhlouf, A.; Househ, M. The Effectiveness and Safety of Serious Games for Improving Cognitive Abilities among Elderly People with Cognitive Impairment: Systematic Review and Meta-Analysis. JMIR Serious Games 2022, 10, 34592. [Google Scholar] [CrossRef]
  5. Abt, C.C. Serious Games; Viking Press: New York, NY, USA, 1970. [Google Scholar]
  6. Choukou, M.A.; Syed-Abdul, S. Smart Home Technologies and Services for Geriatric Rehabilitation; Academic Press: Cambridge, MA, USA, 2021; pp. 141–204. [Google Scholar] [CrossRef]
  7. Chen, Y.F.; Janicki, S. A Cognitive-Based Board Game with Augmented Reality for Older Adults: Development and Usability Study. JMIR Serious Games 2020, 8, 22007. [Google Scholar] [CrossRef]
  8. Brauner, P.; Ziefle, M. Serious Motion-Based Exercise Games for Older Adults: Evaluation of Usability, Performance, and Pain Mitigation. JMIR Serious Games 2020, 8, 14182. [Google Scholar] [CrossRef]
  9. Wiemeyer, J.; Kliem, A. Serious games in prevention and rehabilitation—A new panacea for elderly people? Eur. Rev. Aging Phys. Act. 2012, 9, 41–50. [Google Scholar] [CrossRef]
  10. Broadus, R.N. Toward a definition of “bibliometrics”. Scientometrics 1987, 12, 373–379. [Google Scholar] [CrossRef]
  11. Donthu, N.; Kumar, S.; Pattnaik, D.; Lim, W.M. A bibliometric retrospection of marketing from the lens of psychology: Insights from Psychology & Marketing. Psychol. Mark. 2021, 38, 834–865. [Google Scholar] [CrossRef]
  12. Donthu, N.; Kumar, S.; Mukherjee, D.; Pandey, N.; Lim, W.M. How to conduct a bibliometric analysis: An overview and guidelines. J. Bus. Res. 2021, 133, 285–296. [Google Scholar] [CrossRef]
  13. Koca, T.T. Bibliometric analysis of “sarcopenia” in Web of Science. Egypt. Rheumatol. Rehabil. 2023, 50, 1. [Google Scholar] [CrossRef]
  14. Orimo, H.; Ito, H.; Suzuki, T.; Araki, A.; Hosoi, T.; Sawabe, M. Reviewing the definition of “elderly”. Geriatr. Gerontol. Int. 2006, 6, 149–158. [Google Scholar] [CrossRef]
  15. Welberry, H.J.; Chau, T.; Heffernan, M.; San Jose, J.C.; Jorm, L.R.; Singh, M.F.; Sachdev, P.S.; Anstey, K.J.; Lautenschlager, N.T.; Valenzuela, M.; et al. Factors associated with par- ticipation in a multidomain web-based dementia prevention trial: Evidence from maintain your brain (MYB). J. Alzheimers Dis. 2023, 92, 959–974. [Google Scholar] [CrossRef]
  16. Manera, V.; Petit, P.D.; Derreumaux, A.; Orvieto, I.; Romagnoli, M.; Lyttle, G.; David, R.; Robert, H. ‘Kitchen and cooking,’ a serious game for mild cognitive impairment and Alzheimer’s disease: A pilot study. Front. Aging Neurosci. 2015, 7, 24. [Google Scholar] [CrossRef]
  17. Collu, R.; Yin, Z.; Xia, W.M. Effect of the ROCK inhibitor fasudil on the brain proteomic profile in the tau transgenic mouse model of Alzheimer’s disease. Front. Aging Neurosci. 2024, 16, 2024. [Google Scholar] [CrossRef]
  18. Tarnanas, I.; Schlee, W.; Tsolaki, M.; Müri, R.; Mosimann, U.; Nef, T. Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study. JMIR Serious Games 2013, 1, 16–29. [Google Scholar] [CrossRef]
  19. Espinola, C.W.; Nguyen, B.; Torres, A.; Sim, W.; Rueda, A.; Beavers, L.; Campbell, D.M.; Jung, H.; Lou, W.; Kapralos, L.; et al. Digital Interventions for Stress among Frontline Health Care Workers: Results from a Pilot Feasibility Cohort Trial. JMIR Serious Games 2024, 12, 42813. [Google Scholar] [CrossRef]
  20. Rojo, A.; Calvillo, A.C.; López, C.; Raya, R.; Moreno, J.C. Effects of a Virtual Reality Cycling Platform on Lower Limb Rehabilitation in Patients with Ataxia and Hemiparesis: Pilot Randomized Controlled Trial. JMIR Serious Games 2024, 12, 39286. [Google Scholar] [CrossRef]
  21. Tong, T.; Chignell, M.; Tierney, M.C.; Lee, J. A Serious Game for Clinical Assessment of Cognitive Status: Validation Study. JMIR Serious Games 2016, 4, e5006. [Google Scholar] [CrossRef]
  22. Ben-Sadoun, G.; Sacco, G.; Manera, V.; Bourgeois, J.; König, A.; Foulon, P.; Fosty, B.; Bremond, F.; d’Arripe-Longueville, F.; Robert, P. Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive Impairment. J. Alzheimer’s Dis.s. 2016, 53, 1299–1314. [Google Scholar] [CrossRef]
  23. De Vette, F.; Tabak, M.; Dekker-van Weering, M.; Vollenbroek-Hutten, M. Engaging Elderly People in Telemedicine Through Gamification. JMIR Serious Games 2015, 3, 4561. [Google Scholar] [CrossRef]
  24. Stephanidis, C.; Salvendy, G.; Antona, M.; Chen, J.Y.; Dong, J.; Duffy, V.G.; Fang, X.; Fidopiastis, C.; Fragomei, G.; Fu, L.P.; et al. Seven HCI grand challenges. Int. J. Hum.-Comput. Interaction. 2019, 35, 1229–1269. [Google Scholar] [CrossRef]
  25. Fleming, T.M.; Bavin, L.; Stasiak, K.; Hermansson-Webb, E.; Merry, S.N.; Cheek, C.; Lucassen, M.; Lau, H.M.; Pollmuller, B.; Hetrick, S. Serious Games and Gamification for Mental Health: Current Status and Promising Directions. Front. Psychiatry 2017, 7, 00215. [Google Scholar] [CrossRef]
  26. Höchsmann, C.; Infanger, D.; Klenk, C.; Königstein, K.; Walz, S.P.; Schmidt-Trucksäss, A. Effectiveness of a Behavior Change Technique-Based Smartphone Game to Improve Intrinsic Motivation and Physical Activity Adherence in Patients with Type 2 Diabetes: Randomized Controlled Trial. JMIR Serious Games 2019, 7, 11444. [Google Scholar] [CrossRef]
  27. Konstantinidis, E.I.; Bamparopoulos, G.; Bamidis, P.D. Moving Real Exergaming Engines on the Web: The webFitForAll Case Study in an Active and Healthy Ageing Living Lab Environment. IEEE J. Biomed. Health Inform. 2017, 21, 859–866. [Google Scholar] [CrossRef]
  28. Hassandra, M.; Galanis, E.; Hatzigeorgiadis, A.; Goudas, M.; Mouzakidis, C.; Karathanasi, E.M.; Petridou, N.; Tsolaki, M.; Zikas, P.; Evangelou, G.; et al. A Virtual Reality App for Physical and Cognitive Training of Older People with Mild Cognitive Impairment: Mixed Methods Feasibility Study. JMIR Serious Games 2021, 9, 24170. [Google Scholar] [CrossRef]
  29. Fleming, T.M.; Gillham, B.; Bavin, L.M.; Stasiak, K.; Lewycka, S.; Moore, J.; Shepherd, M.; Merry, S.N. SPARX-R computerized therapy among adolescents in youth offenders’ program: Step-wise cohort study. Internet Interv. 2019, 18, 100287. [Google Scholar] [CrossRef]
  30. Manera, V.; Partos, C.; Beauchet, O.; Benoit, M.; Dupetit, B.; Elbaum, J.; Fabre, R.; Dindt, M.; Gros, A.; Guerchouche, R.; et al. Teleconsultations for mental health: Recommendations from a Delphi panel. Internet Interv.-Appl. Inf. Technol. Ment. Behav. Health 2023, 34, 100660. [Google Scholar] [CrossRef]
  31. Margetis, G.; Tsagkatakis, G.; Stamou, S.; Stephanidis, C. Integrating Visual and Network Data with Deep Learning for Streaming Video Quality Assessment. Sensors 2023, 23, 3998. [Google Scholar] [CrossRef]
  32. Konstantinidis, E.I.; Bamidis, P.D.; Billis, A.; Kartsidis, P.; Petsani, D.; Papageorgiou, S.G. Physical Training In-Game Metrics for Cognitive Assessment: Evidence from Extended Trials with the Fitforall Exergaming Platform. Sensors 2021, 21, 5756. [Google Scholar] [CrossRef] [PubMed]
  33. Ali, S.; Curtain, C.M.; Peterson, G.M.; Salahudeen, M.S. Exploring Australian pharmacists’ perceptions and practices towards reducing the risk of medicines-related harm in aged care residents. Front. Pharmacol. 2023, 14, 1131456. [Google Scholar] [CrossRef]
  34. Cuevas-Lara, C.; Izquierdo, M.; Zambom-Ferraresi, F.; Sáez de Asteasu, M.L.; Marín-Epelde, I.; Chenhuichen, C.; Zambom-Ferraresi, F.; Ramírez-Vélez, R.; García-Hermoso, A.; Casas-Herrero, Á.; et al. A Feasibility Study for Implementation “Health Arcade”: A Study Protocol for Prototype of Multidomain Intervention Based on Gamification Technologies in Acutely Hospitalized Older Patients. Int. J. Environ. Res. Public Health 2020, 17, 8058. [Google Scholar] [CrossRef]
  35. Hou, C.-J.; Chen, Y.-T.; Capilayan, M.; Lin, Y.-S.; Huang, M.-W.; Huang, J.-J. Analysis of Heart Rate Variability in Response to Serious Games in Elderly People. Sensors 2021, 21, 6549. [Google Scholar] [CrossRef]
  36. Konstantinidis, E.I.; Billis, A.S.; Mouzakidis, C.A.; Zilidou, V.I.; Antoniou, P.E.; Bamidis, P.D. Design, Implementation, and Wide Pilot Deployment of FitForAll: An Easy to Use Exergaming Platform Improving Physical Fitness and Life Quality of Senior Citizens. IEEE J. Biomed. Health Inform. 2014, 20, 189–200. [Google Scholar] [CrossRef]
  37. Konstantinidis, E.I.; Billis, A.S.; Mouzakidis, C.A.; Zilidou, V.I.; Antoniou, P.E.; Bamidis, P.D. Serious Gaming during Multidisciplinary Rehabilitation for Patients with Chronic Pain or Fatigue Symptoms: Mixed Methods Design of a Realist Process Evaluation. J. Med. Internet Res. 2020, 22, 14766. [Google Scholar] [CrossRef]
  38. Gamito, P.; Oliveira, J.; Alves, C.; Santos, N.; Coelho, C.; Brito, R. Virtual Reality-Based Cognitive Stimulation to Improve Cognitive Functioning in Community Elderly: A Controlled Study. Cyberpsychology Behav. Soc. Netw. 2020, 23, 150–156. [Google Scholar] [CrossRef]
  39. Junior, W.G.; Marasco, E.; Kim, B.; Behjat, L.; Eggermont, M. How ChatGPT can inspire and improve serious board game design. Int. J. Serious Games 2023, 10, 33–54. [Google Scholar] [CrossRef]
  40. De Lope, R.P.; Medina-Medina, N. A Comprehensive Taxonomy for Serious Games. J. Educ. Comput. Res. 2017, 5, 629–672. [Google Scholar] [CrossRef]
  41. Vieira, C.M.; Perrotta, A.; Pais-Vieira, C. Serious games for physical rehabilitation: Aesthetic discrepancies between custom-made serious games and commercial titles used for healthcare. J. Sci. Technol. Arts 2023, 14, 29–50. [Google Scholar] [CrossRef]
  42. You, K.L.; Delaney, R.K.; McKinley, N.; Healy, P.; Thomas, T.H. Who Engages and Why It Matters? Describing Participant Engagement in a Serious Game Intervention for Patients with Advanced Cancer. Int. J. Gaming Comput.-Mediat. Simul. 2023, 15, 316968. [Google Scholar] [CrossRef]
  43. Bernava, G.; Nucita, A.; Iannizzotto, G.; Caprì, T.; Fabio, R.A. Proteo: A Framework for Serious Games in Telerehabilitation. Appl. Sci. 2021, 11, 5935. [Google Scholar] [CrossRef]
  44. Caserman, P.; Hoffmann, K.; Müller, P.; Schaub, M.; Straßburg, K.; Wiemeyer, J.; Bruder, R.; Göbel, S. Quality Criteria for Serious Games: Serious Part, Game Part, and Balance. JMIR Serious Games 2020, 8, 19037. [Google Scholar] [CrossRef] [PubMed]
  45. Garneli, V.; Patiniotis, K.; Chorianopoulos, K. Designing Multiplayer Serious Games with Science Content. Multimodal Technol. Interact. 2021, 5, 8. [Google Scholar] [CrossRef]
  46. Suppan, M.; Stuby, L.; Harbarth, S.; Fehlmann, C.A.; Achab, S.; Abbas, M.; Suppan, L. Nationwide Deployment of a Serious Game Designed to Improve COVID-19 Infection Prevention Practices in Switzerland: Prospective Web-Based Study. JMIR Serious Games 2021, 9, 33003. [Google Scholar] [CrossRef] [PubMed]
  47. Garske, C.A.; Dyson, M.; Dupan, S.; Morgan, G.; Nazarpour, K. Serious Games Are Not Serious Enough for Myoelectric Prosthetics. JMIR Serious Games 2022, 9, 28079. [Google Scholar] [CrossRef]
  48. Kermavnar, T.; Visch, V.T.; Desmet, P.M. Games in Times of a Pandemic: Structured Overview of COVID-19 Serious Games. JMIR Serious Games 2023, 11, 41766. [Google Scholar] [CrossRef]
  49. Chaldogeridis, A.; Tsiatsos, T. Implementation and Evaluation of a Serious Game for Working Memory Enhancement. Appl. Sci. 2020, 10, 9128. [Google Scholar] [CrossRef]
  50. Zygouris, S.; Iliadou, P.; Lazarou, E.; Giakoumis, D.; Votis, K.; Alexiadis, A.; Triantafyllidis, A.; Segkouli, S.; Tzovaras, D.; Tsiatsos, T.; et al. Detection of Mild Cognitive Impairment in an At-Risk Group of Older Adults: Can a Novel Self-Administered Serious Game-Based Screening Test Improve Diagnostic Accuracy? J. Alzheimer’s Dis.s. 2020, 78, 405–412. [Google Scholar] [CrossRef] [PubMed]
  51. Cheng, X.; Gilmore, G.C.; Lerner, A.J.; Lee, K. Computerized Block Games for Automated Cognitive Assessment: Development and Evaluation Study. JMIR Serious Games 2023, 11, 40931. [Google Scholar] [CrossRef]
  52. Dimitriadou, A.; Djafarova, N.; Turetken, O.; Verkuyl, M.; Ferworn, A. Challenges in Serious Game Design and Development: Educators’ Experiences. Simul. Gaming 2021, 52, 132–152. [Google Scholar] [CrossRef]
  53. Robertson, M.C.; Baranowski, T.; Thompson, D.; Basen-Engquist, K.M.; Swartz, M.C.; Lyons, E.J. Using Behaviour Change Wheel Program Planning Model to Design Games for Health: Development Study. JMIR Serious Games 2021, 9, 29964. [Google Scholar] [CrossRef]
  54. Lazarou, I.; Stavropoulos, T.G.; Mpaltadoros, L.; Nikolopoulos, S.; Koumanakos, G.; Tsolaki, M.; Kompatsiaris, I.Y. Human Factors and Requirements of People with Cognitive Impairment, Their Caregivers, and Healthcare Professionals for mHealth Apps Including Reminders, Games, and Geolocation Tracking: A Survey-Questionnaire Study. J. Alzheimer’s Dis. Rep. 2021, 5, 497–513. [Google Scholar] [CrossRef]
  55. Capecchi, I.; Bernetti, I.; Borghini, T.; Caporali, A.; Saragosa, C. Augmented reality and serious game to engage the alpha generation in urban cultural heritage. J. Cult. Herit. 2024, 66, 523–535. [Google Scholar] [CrossRef]
  56. Dias, S.B.; Diniz, J.A.; Konstantinidis, E.; Savvidis, T.; Zilidou, V.; Bamidis, P.D.; Grammatikopoulou, A.; Dimitropoulos, K.; Grammalidis, N.; Jaeger, H.; et al. Assistive HCI-Serious Games Co-Design Insights: The Case Study of i-PROGNOSIS Personalized Game Suite for Parkinson’s Disease. Front. Psychol. 2021, 11, 612835. [Google Scholar] [CrossRef] [PubMed]
  57. Jaccard, D.; Suppan, L.; Sanchez, E.; Huguenin, A.; Laurent, M. The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study. JMIR Serious Games 2021, 9, 28674. [Google Scholar] [CrossRef] [PubMed]
  58. Thompson, D.; Baranowski, T.; Buday, R.; Baranowski, J.; Thompson, V.; Jago, R.; Griffith, M.J. Serious Video Games for Health: How Behavioral Science Guided the Development of a Serious Video Game. Simul. Gaming 2021, 41, 587–606. [Google Scholar] [CrossRef] [PubMed]
  59. Çiftci, S. Trends of Serious Games Research from 2007 to 2017: A Bibliometric Analysis. Int. Conf. Sci. Educ. Technol. 2018, 6, 1842. [Google Scholar] [CrossRef]
  60. Farage, M.A.; Miller, K.W.; Ajayi, F.; Hutchins, D. Deborah Hutchins. Design Principles to Accommodate Older Adults. Glob. J. Health Sci. 2012, 4, 2–25. [Google Scholar] [CrossRef]
  61. Dobreva, M.S.; O’Neill, W.E.; Paige, G.D. Influence of aging on human sound localization. J. Neurophysiol. 2011, 105, 2471–2486. [Google Scholar] [CrossRef]
  62. Hilz, M.J.; Axelrod, F.B.; Hermann, K.; Haertl, U.; Duetsch, M.; Neundörfer, B. Normative values of vibratory perception in 530 children, juveniles and adults aged 3–79 years. J. Neurol. Sci. 1998, 159, 219–225. [Google Scholar] [CrossRef]
  63. Howard, J.H., Jr.; Howard, D. Learning memory. In Handbook of Human Factors and the Older Adult; Fisk, A.D., Rogers, W.A., Eds.; Academic Press: San Diego, CA, USA, 1997; pp. 7–26. [Google Scholar]
  64. Gintner, V.; Macik, M.; Mikovec, Z. Perception of tactile symbols by visually impaired older adults. In Human-Computer Interaction–INTERACT 2019: 17th IFIP TC 13 International Conference, Paphos, Cyprus, 2–6 September 2019, Proceedings, Part I 17; Springer International Publishing: Cham, Switzerland, 2019; Volume 11746, pp. 325–334. [Google Scholar] [CrossRef]
  65. Schmid, P.; Maier, T. Electro-Tactile Feedback to Provide Assistance to Touchscreen Interaction of the Elderly. Advances in Human Factors and Ergonomics in Healthcare and Medical Devices (AHFE 2021). In Advances in Human Factors and Ergonomics in Healthcare and Medical Devices, Proceedings of the AHFE 2021 Virtual Conference on Human Factors and Ergonomics in Healthcare and Medical Devices, USA, 25–29 July 2021; Springer International Publishing: Cham, Switzerland, 2021; Volume 263, pp. 271–278. [Google Scholar] [CrossRef]
  66. Buist, M.; Mastinu, E.; Ortiz-Catalan, M. Development and Validation of a Wearable Device to Provide Rich Somatosensory Stimulation for Rehabilitation After Sensorimotor Impairment. IEEE Trans. Biomed. Circuits Syst. 2023, 17, 547–557. [Google Scholar] [CrossRef]
  67. Leonardis, D.; Santamato, G.; Gabardi, M.; Solazzi, M.; Frisoli, A. A parallel-elastic actuation approach for wide bandwidth fingertip haptic devices. Meccanica 2022, 57, 739–749. [Google Scholar] [CrossRef]
  68. Daggumati, S.; Revesz, P.Z.; Svehla, C. The A-Maze-D advanced maze development system for fast game design and implementation. Int. J. Syst. Appl. Eng. Dev. 2016, 10, 195–204. [Google Scholar]
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Figure 1. Bibliometric analysis steps diagram.
Figure 1. Bibliometric analysis steps diagram.
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Figure 2. The modified Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for the systematic evaluation and meta-analysis of serious game technology in older adults.
Figure 2. The modified Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for the systematic evaluation and meta-analysis of serious game technology in older adults.
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Figure 3. A query example for “serious games” and “elder”.
Figure 3. A query example for “serious games” and “elder”.
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Figure 4. Distribution scope and technological evolution of this field.
Figure 4. Distribution scope and technological evolution of this field.
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Figure 5. Analysis of the number of citations and publications over time from 2013 to 2024.
Figure 5. Analysis of the number of citations and publications over time from 2013 to 2024.
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Figure 6. Bibliographic coupling by countries in 3 clusters: cluster 1 (red), cluster 2 (green), cluster 3 (blue).
Figure 6. Bibliographic coupling by countries in 3 clusters: cluster 1 (red), cluster 2 (green), cluster 3 (blue).
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Table 1. Keywords such as serious games, older adults, and mobile.
Table 1. Keywords such as serious games, older adults, and mobile.
Serious Games“Serious Games”
Older adults“ageing” or “older” or “elderly” or “elder” or “older people” or “older population” or “older adults”
Mobile“mobile”
Table 2. Bibliometric data of early publications.
Table 2. Bibliometric data of early publications.
No.Title of PaperTC ReferenceYearSourcePublisher
1Kitchen and cooking,’ a serious game for mild cognitive impairment and Alzheimer’s disease: a pilot study130412015FRONTIERS IN AGING NEUROSCIENCEFRONTIERS MEDIA SA
2Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study104472013JMIR SERIOUS GAMESJMIR PUBLICATIONS, INC
3A Serious Game for Clinical Assessment of Cognitive Status: Validation Study67292016JMIR SERIOUS GAMESJMIR PUBLICATIONS, INC
4Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive Impairment63672016JOURNAL OF ALZHEIMERS DISEASEIOS PRESS
5Engaging Elderly People in Telemedicine Through Gamification39792015JMIR SERIOUS GAMESJMIR PUBLICATIONS, INC
Table 3. The top 10 most representative papers in the field.
Table 3. The top 10 most representative papers in the field.
No.Title of PaperSourcesPublisherReferencesTC YearAuthor
1Seven HCI Grand ChallengesINTERNATIONAL JOURNAL OF HUMAN-COMPUTER INTERACTIONTAYLOR & FRANCIS INC3071732019Stephanidis, Constantine
2Serious Games and Gamification for Mental Health: Current Status and Promising DirectionsFRONTIERS IN PSYCHIATRYFRONTIERS MEDIA SA491632017Fleming, Theresa M
3Kitchen and cooking,’ a serious game for mild cognitive impairment and Alzheimer’s disease: a pilot studyFRONTIERS IN AGING NEUROSCIENCEFRONTIERS MEDIA SA411302015Manera, Valeria
4Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal StudyJMIR SERIOUS GAMESJMIR PUBLICATIONS, INC471042013Tarnanas, Ioannis
5A Serious Game for Clinical Assessment of Cognitive Status: Validation StudyJMIR SERIOUS GAMESJMIR PUBLICATIONS, INC29672016Tong, Tiffany
6Physical and Cognitive Stimulation Using an Exergame in Subjects with Normal Aging, Mild and Moderate Cognitive ImpairmentJOURNAL OF ALZHEIMERS DISEASEIOS PRESS67632016Ben-Sadoun, Gregory
7Effectiveness of a Behavior Change Technique-Based Smartphone Game to Improve Intrinsic Motivation and Physical Activity Adherence in Patients with Type 2 Diabetes: Randomized Controlled TrialJMIR SERIOUS GAMESJMIR PUBLICATIONS, INC48422019Hoechsmann, Christoph
8Engaging Elderly People in Telemedicine Through GamificationJMIR SERIOUS GAMESJMIR PUBLICATIONS, INC79392015de Vette, Frederiek
9Moving Real Exergaming Engines on the Web: The webFitForAll Case Study in an Active and Healthy Ageing Living Lab EnvironmentIEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICSIEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC55322017Konstantinidis, Evdokimos I
10A Virtual Reality App for Physical and Cognitive Training of Older People with Mild Cognitive Impairment: Mixed Methods Feasibility StudyJMIR SERIOUS GAMESJMIR PUBLICATIONS, INC78252021Hassandra, Mary
Table 4. Annual number of publications and citations in this domain from 2013 to 2024.
Table 4. Annual number of publications and citations in this domain from 2013 to 2024.
No.YearCitationPublication
1201306
22014414
320152826
420168917
5201718728
6201825236
7201937032
8202055248
9202175639
10202287049
11202389048
1220241270
Table 5. The top 10 journals and publishers that publish the most papers in the domain of serious games for the elderly. Abbreviation: TC is Total Citations, JCI is Journal Citation Indicator, and IF is Impact Factor. The TC, JCI, and IF data in the table are all from the 2022 Journal Citation Reports™.
Table 5. The top 10 journals and publishers that publish the most papers in the domain of serious games for the elderly. Abbreviation: TC is Total Citations, JCI is Journal Citation Indicator, and IF is Impact Factor. The TC, JCI, and IF data in the table are all from the 2022 Journal Citation Reports™.
No.Journal TitlesRecord CountPublisherTC JCIIF
1JMIR SERIOUS GAMES52JMIR PUBLICATIONS, INC13980.924.0
2FRONTIERS IN AGING NEUROSCIENCE14FRONTIERS MEDIA SA10,2430.974.8
3INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH10MDPI123,1050.934.6
4JMIR RESEARCH PROTOCOLS9JMIR PUBLICATIONS, INC41040.521.7
5Applied Sciences-Basel7MDPI98,9490.572.7
6JOURNAL OF ALZHEIMERS DISEASE7IOS PRESS36,4590.854.0
7ENTERTAINMENT COMPUTING6ELSEVIER SCI LTD8920.522.8
8FRONTIERS IN PSYCHOLOGY6FRONTIERS MEDIA SA108,1181.043.8
9JMIR FORMATIVE RESEARCH6JMIR PUBLICATIONS, INC20090.572.2
10INFORMATION5MDPI64970.663.1
11FRONTIERS IN PSYCHIATRY4FRONTIERS MEDIA SA33,9170.954.7
12GAMES FOR HEALTH JOURNAL4MARY ANN LIEBERT, INC14130.983.5
13INTERNATIONAL JOURNAL OF HUMAN-COMPUTER INTERACTION3TAYLOR & FRANCIS INC58010.824.7
14JOURNAL OF REHABILITATION AND ASSISTIVE TECHNOLOGIES ENGINEERING3SAGE PUBLICATIONS INC4000.332.0
15IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS3IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC15,0551.787.7
16INTERNATIONAL JOURNAL OF COMPUTER GAMES TECHNOLOGY3HINDAWI LTD2660.842.5
17AGE AND AGEING2OXFORD UNIV PRESS18,6831.976.7
18JOURNAL OF MEDICAL INTERNET RESEARCH2JMIR PUBLICATIONS, INC43,9231.737.4
19JOURNAL OF ALZHEIMERS DISEASE REPORTS2IOS PRESS6120.573.2
20JOURNAL OF NEUROENGINEERING AND REHABILITATION2BMC88801.375.1
21CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING2MARY ANN LIEBERT, INC78811.416.6
22IEEE LATIN AMERICA TRANSACTIONS2IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC23220.251.3
23BEHAVIOUR & INFORMATION TECHNOLOGY2TAYLOR & FRANCIS LTD54140.663.7
24SIMULATION & GAMING2SAGE PUBLICATIONS INC16110.832.0
Table 6. Top 10 active subject areas.
Table 6. Top 10 active subject areas.
No.Research AreasRecord CountProportion (%)
1Public Environmental Occupational Health9128.5
2Health Care Sciences Services8426.3
3Medical Informatics8727.2
4Computer Science7423.1
5Neurosciences Neurology4915.3
6Engineering5416.9
7Geriatrics Gerontology206.2
8Education Educational Research154.7
9Psychology226.8
10Psychiatry113.4
Table 7. The 10 countries with the largest contribution to serious games for the elderly.
Table 7. The 10 countries with the largest contribution to serious games for the elderly.
No.CountryTotalProportion%
1Canada299
2Spain4012.5
3Portugal4112.8
4USA4012.5
5Italy226.8
6Germany4714.7
7Greece3310.3
8Switzerland206.2
9England185.6
10The Netherlands268.1
Table 8. Top 5 institutions with the largest contributions.
Table 8. Top 5 institutions with the largest contributions.
No.InstitutionRecord CountProportion%Country
1ARISTOTLE UNIVERSITY OF THESSALONIKI216.5Greece
2RUPRECHT KARLS UNIVERSITY HEIDELBERG134.0 Germany
3UNIVERSITY OF TEXAS SYSTEM134.0 USA
4UNIVERSITY OF TORONTO113.4Canada
5UNIVERSITY OF TEXAS MEDICAL BRANCH GALVESTON113.4USA
6CENTRE FOR RESEARCH TECHNOLOGY HELLAS103.1Greece
7CONSIGLIO NAZIONALE DELLE RICERCHE CNR103.1Italy
8KAROLINSKA INSTITUTET82.5Sweden
9UNIVERSITY OF GENEVA82.5Switzerland
10BAYLOR COLLEGE OF MEDICINE82.5USA
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Huang, X.; Ali, N.M.; Sahrani, S. Evolution and Future of Serious Game Technology for Older Adults. Information 2024, 15, 385. https://doi.org/10.3390/info15070385

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Huang X, Ali NM, Sahrani S. Evolution and Future of Serious Game Technology for Older Adults. Information. 2024; 15(7):385. https://doi.org/10.3390/info15070385

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Huang, Xin, Nazlena Mohamad Ali, and Shafrida Sahrani. 2024. "Evolution and Future of Serious Game Technology for Older Adults" Information 15, no. 7: 385. https://doi.org/10.3390/info15070385

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Huang, X., Ali, N. M., & Sahrani, S. (2024). Evolution and Future of Serious Game Technology for Older Adults. Information, 15(7), 385. https://doi.org/10.3390/info15070385

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