A Pervasive Game for Elderly People with Augmented Reality:

Description and First Validation

Álvaro Pérez

, Jesús Gallardo

, Raquel Lacuesta

and Silvia Hernández

Department of Computing and Systems Engineering, University of Zaragoza, Teruel, Spain

Pre-departmental Unit of Fine Arts, University of Zaragoza, Teruel, Spain

Keywords: Pervasive Games, Elderly People, Augmented Reality.

Abstract: The rise of videogames in our culture has caused that they are no longer seen as simple games for kids and

have spread to all the segments of population. The use of videogames by elderly people can help to improve

their quality of life, exercising their mental functions. Inside the field of videogames, the concept of pervasive

game appeared with intensity some years ago. This kind of games exceed any of the classic dimensions of

games: temporal, spatial or social. In order to achieve this evolution, pervasive games use to take advantage

of non-traditional interaction technologies and novel paradigms, such as augmented reality. In this paper we

introduce a novel pervasive game oriented towards elderly people that makes use of augmented reality. The

game has been developed following a user-centered approach with participative design. In the game, players

have to find certain elements in their environment (e.g., in a nursing home) so that they unlock memories that

they store in an album and can value. Here, we describe the game in detail and show a first validation that we

have carried out in order to test its usefulness. In that validation, users find the game useful and easy to play

with.

1 INTRODUCTION

People over 65 years old are the segment of the

population that has grown the most in recent years.

For this reason, the most significant change in the

next generation of elderly people will be their high

level of education. It is now imperative to harness

their learning capacity to engage them in initiatives

that enable their personal development (Morillas and

Martínez, 2013). In Spain, the consumption of video

games represents more than half of the total

audiovisual leisure, ranking at the top of the list. Over

the years, the taste for video games has ceased to be

the exclusive heritage of children and young people

to integrate elderly people. As consequence, more and

more video games are part of the daily life of the

population as a tool of socialization, ceasing to have

only a playful purpose and being able to be used as

educational tools for their audience.

According to AEVI (Spanish Association of

Video Games) 47% of the total turnover of video

https://orcid.org/0000-0001-9895-0837

https://orcid.org/0000-0002-4773-4904

https://orcid.org/0000-0003-3557-3442

games worldwide comes from mobile video games

and it is also observed that they are experiencing a

great growth year after year (12.8% more than in

2017) (AEVI, 2019). So right now, smartphones are

presented as the main platform for the creation and

consumption of video games.

The introduction of elderly people in Information

and Communication Technologies is also important

to eliminate the digital divide. Digital divide can be

a form of exclusion and dependency for people who

are not integrated into the information society. In the

specific case of Spain, the elderly people are

gradually entering, although much remains to be

done. One of the resources used that has shown to be

useful for improving certain aspects in the lives of

elderly people is the video games. Thus, in (Allaire et

al., 2013) a study related to video games, that was

conducted among 140 people of average age 77,5

years with different profiles concluded that those who

played video games regularly or occasionally showed

Pérez, Á., Gallardo, J., Lacuesta, R. and Hernández, S.

A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation.

DOI: 10.5220/0010532001030109

In Proceedings of the 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2021), pages 103-109

ISBN: 978-989-758-506-7

103

better values in the socio-emotional field than those

who had never played.

An emerging paradigm in video games is

pervasive games. According to Montola (2005),

pervasive games are a genre of play that breaks the

traditional boundaries of the game, defined in terms

of spatial, temporal and social dimensions. When

producing games according to this new paradigm, the

particularities of these games must be considered, and

their specific characteristics given by the pervasive

expansions in the axes of time, space and social

interaction, those that are not present in traditional

games.

Pervasive games have had a rapid growth in

different fields, as evidenced by the proliferation of

game experience designs of this type (Arango-López

et al., 2017a). There are works (Kasapakis and

Gavalas, 2014) that compile numerous developments

resulting from design experiences in context such as

education, health, entertainment and tourism, among

others. Thus, from the collection of experiences

emerged the definition that says that "A pervasive

game offers the player a game experience enriched by

an evolution of the game dynamics, expanding the

space of the game according to the context in which

it is played. In this way, the boundaries of the game

world are broken, making reality a part of it and the

elements present in that reality can have an influence

on the game" (Arango-López et al., 2017b). This

definition was presented based on the identification

of the main elements present in this type of games,

which are: devices, context, social interaction, time,

space, multi-reality and crossmedia. All linked by

means of a pervasive narrative.

Taking all this into account, we have designed and

developed a pervasive game oriented towards elderly

people, with the aim of improving their quality of life,

both physically (since they will have to move around

their environment to play, which stimulates physical

activity) as at a cognitive level (since the game

involves unlocking memories, which will stimulate

your memory). The game consists of looking for

certain objects (usually photos) that, when detected,

generate virtual objects through augmented reality.

Touching that item will unlock a memory that will

become part of an album, and advance the player in

his progress. Our game will be pervasive on a spatial

level, having to move to be able to complete it and

potentially have any location, temporary, as it could

be played at any time, and also social, as people who

play can interact in the meantime with other people

who are not players.

In order to test the usefulness of our game, we

have carried out an initial validation in which we have

worked on the technological acceptance of the game.

Therefore, we have used a questionnaire based on

TAM (Davis, 1989), the most popular model for

technological acceptance. By means of this

questionnaire, we have asked about the perceived

usefulness of the game and its perceived ease of use.

The rest of the article is organized as follow.

Section 2 collects related work on pervasive games

for elderly people. Section 3 describes in detail the

game presented. Section 4 explains the initial

validation that we have carried out. And finally, in

Section 5 we gather the conclusions on the work

carried out and some lines of future work.

2 RELATED WORK

In recent years, there is a lot of activity in the

development of games for elderly people. In addition,

the authors of these works have drawn interesting

conclusions as to what should be taken into account

when developing video games for adults. Several

relevant works in this area will be mentioned below.

In (Cota et al., 2015), the authors conducted a study

on aspects that lead elderly people to play games for

the mobile phone. The study consisted of developing

a catalogue of games, so that the preferred genres of

elderly people were identified. From there, the

authors developed a game called Traveling the

World, with several mini-games of the genres

preferred by the elders. Through this work, the

authors identified several elements of motivation

relevant to the elderly people, such as, for example:

the interaction of the player always has an associated

result, the difficulty increases gradually, the

mechanics are simple, information about the benefits

of playing, or aspects of usability, such as color

contrast or large, clear images.

Another interesting example of game, which has

certain similarities with the one we will present later,

is the one described in (Mubin et al., 2008). This

game, also designed for mobile phones, combines a

classic game of looking for identical cards with the

search for specific physical locations. In this way, we

could say that there is also something pervasive about

it. It is a game that can be collaborative, and thus

enhance the social aspect. After the evaluation of the

game, called Walk2Win, the authors drew certain

recommendations, such as: this type of games should

reach as wide an audience as possible (even if certain

elders participate passively), rules should be

minimized, it is interesting to introduce elements of

familiar games, gender distinctions should be

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

104

eliminated, and the environment should be

customizable.

Another type of games is that in which, using

devices such as Microsoft Kinect or other similar, the

elderly people are sought to perform some type of

exercise, either within the scope of a rehabilitation

plan or simply to keep them active. An example

would be described in (Gerling et al., 2011). In that

case, the authors used Nintendo Wii to develop a

game called SilverPromenade that simulated virtual

rides while posing certain mini-games to older

people. From the experience, the authors drew three

useful conclusions for developers of this type of

game: the capabilities of the target audience should

be carefully explored, the right choice of metaphors

is fundamental to making it easy to enter the game,

and games should be designed to suit a wide range of

players and situations.

Lastly, we are going to mention another example

of activity for adults which shares with the game that

we will introduce some points such as the use of

virtual or augmented reality and the aim of

stimulating players’ memory. This is the Virtual

Maze Task (Cárdenas-Delgado et al., 2017). This

activity is not presented by their authors as a game,

but it includes some aspects that we may understand

as gamification elements, as users have to learn routes

in a maze. In this work, authors studied the difference

in performing this activity with an immersion

approach or with physical activity, regarding

satisfaction, interaction and other aspects.

Thanks to this study of related work, we have been

able to obtain valuable ideas that have subsequently

resulted in the design of our application. In the section

dedicated to the design of the application we will

detail the points that we have taken into account.

3 THE GAME ENCUÉNTRATE

In this section, we are going to explain in detail the

process of design and development of EncuéntraTe, a

pervasive game oriented towards elderly people that

makes use of augmented reality technology so that

players can move in a given environment searching

for memories to be unlocked.

3.1 Analysis

Our first intention when facing this project was to

develop a pervasive game that might help improving

life quality in elderly people, influencing on aspects

as keeping them active, getting their mind exercised

or boosting their social abilities. For the design and

development of the game we had the support of a

residential complex for elderly people that includes

apartments for non-dependent people, a residential

center for dependent people and a senior day center.

We followed a user-centered design approach from

the very beginning of the development process, so

that the final idea of game got generated among the

development team, the staff in the residential

complex and a group of elderly people. Thus, two

meetings in which the idea of the game was thought

through were organized. The first meeting included

members of the development team and members of

the staff of the complex. In this meeting, participants

generated the idea of the game consisting on locating

certain elements placed in the complex and unlocking

memories when doing that, so that the memories got

stored in an album and they made the game to

advance. By using augmented reality, the elements of

the game that allow the memories to get unlocked

would appear.

Later, a second meeting was organized. This

meeting was a focus group in which some residents

of the complex participated, together with some staff

members and members of the development team. In

this meeting, the approach decided in the first meeting

was validated, and a list of categories in which the

memories got classified was elaborated. The

categories chosen were culture, sports, history, music

and cinema, and personalities. It was decided that in

the election of the memories special interest would be

given to memories from the region of Aragon, where

the residents live.

Together with the first meeting and the focus

group, the user-centered analysis included a process

of observation of the elderly people in the residential

complex. From this observation we could conclude

that a great disparity of profiles exists in the complex,

as residents that are dependent in a higher or lower

degree live together with other residents with a high

level of autonomy.

Specifically, these were the goals defined for the

design of the app:

 To develop a pervasive mobile videogame

adapted for its use by elderly people.

 That the game uses augmented reality for

integrating it with the environment in which it

will be played (i.e., the residential complex).

 To elaborate an album of memories with which

the user gets identified. Those memories will

get unlocked when playing the game.

 To develop the game experience in a way in

which players get encouraged to keep

exploring their environment in search of more

memories to unlock.

A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation

105

3.2 Design and Implementation

Next, we are going to explain in detail the features of

the design of the app. We are going to start with its

architecture. The game will work over the Android

operating system, the most popular one nowadays in

the field of mobile devices. The environment chosen

for the development of the game has been Unity, an

engine for multiplatform videogames that is widely

used nowadays by the community of videogame

developers. Inside Unity, the platform Google

Firebase has been chosen to support programming by

means of its APIs, which make easier to handle

authentication and other features. Lastly, regarding

augmented reality, the platform that we have chosen

has been Vuforia, which SDK allows tracking a great

diversity of both 3D and 2D objects using almost any

kind of camera integrated in a mobile device. This

implies a great level of compatibility with most actual

devices. In Figure 1 it can be seen a schema of the

architecture of the app.

Figure 1: Architecture of the system.

Regarding user interface design, as this is an

application oriented towards elderly people, we have

chosen a design with big and clear buttons, simple

fonts and no complex gestural navigation. The

application starts with a welcome screen and another

one for user login. Next, the game screen is shown. In

this screen is where augmented reality is deployed.

Therefore, it is not necessary to navigate through

menus or other screens that may make interaction

more complicated. The game screen is made up of the

images provided by the camera of the device,

enriched by the augmented reality elements, as we

will explain now.

The way in which the game works implies that the

player has to locate certain images in the real world

so that, when the mobile device focuses on them, a

virtual object appears on the screen. These images are

photographs that are stored in the game database. The

object that appears is a button that belongs to a certain

category. When this button is touched in the screen, a

memory from that category gets unlocked. This

implies that a screen with the information about that

memory appears. This screen includes an image a

brief description and the possibility to listen to the

narration of the description. Also, some memories

have a video instead of an image. When the player

exits this screen, a positive support will be shown so

that the player gets encouraged to keep on searching

for memories. In this point, if the player has achieved

a certain number of memories of this category, a

medal will be awarded to him/her. Also, he/she will

be asked about his/her opinion on the memory

unlocked. This is made with a thumbs up/thumbs

down system. In any moment, the player can see all

memories unlocked by touching the album button in

the game screen. Also, in that screen it is possible to

go to a ranking screen where he/she can compare with

other players.

Regarding the visual design of the application, we

chose to provide it with the appearance of an old

album in which paper and leather would be the

textures that would predominate. Icon are quite

simple, so that they can be identified in an easy way.

All this work of visual design was carried out by a

professional graphical designer. A more modern

design was discarded as we understood that our

audience preferred a more traditional appearance, and

it would have not fitted well with the theme of

memories and albums that supposes the common

thread of the app.

Specifically, the following points, which were

identified in the study of related work as beneficial in

a work of this kind, have been taken into account in

this design:

 Simple mechanics: the only interaction that is

needed for progressing in the game is to move

all around the environment searching for the

goals and touching the virtual buttons that

appear.

 Minimize the rules: in order to achieve goals, it

is only needed to unlock memories, with no

other rule.

 Big and clear images: all the elements that

appear in the game have a big size in order to

avoid usability problems in elderly people.

 Elimination of gender discrimination: there is

no element in the game that may discriminated

depending on the player’s gender.

 Reaching a broad audience: as we will explain

later, we have chosen a set of memories that

cover a wide period of time so that players of

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

106

different ages can find some memories to get

identified with.

 Elements of other games: the categories of

memories can recall the ones in popular quiz

games.

Next, we are going to show some screens of the

app as examples of its user interface and visual

appearance. To start with, in Figure 2 it can be seen

an example of the game screen. In it, three fixed

buttons appear. The one in the upper part of the screen

is used to go to the screen in which the player can see

the awards that he/she has achieved when unlocking

memories. The two buttons in the lower zone of the

screen are for going to the ranking of the game and to

go the album with all the memories already unlocked,

respectively. Regarding the central button in the

figure, it is the virtual object that has appeared in the

augmented reality when focusing the mobile device

on an image that the game database identifies as an

object to find. In this specific case, this virtual button

will unlock a memory of the sports category.

Figure 2: Game screen.

As a second example of screen in Figure 3 we

depict an example of memory, specifically a memory

of the personalities category. This memory has been

shown directly after it has been unlocked. It can be

seen how the user interface includes an image of the

memory (in this case, the image is a person’s photo),

a description, and audio controls for handling the

narration of the description. This way, the description

can be read, listened, or both, depending on the

player’s preference.

Lastly, in Figure 4 another example of memory is

shown. This time we have chosen a memory of the

music category, and we have accessed it through the

album. It can be seen how the user interface is similar

to the one in the previous memory, but with a video

Figure 3: Memory of the personalities category.

of the song instead of the image of the person that we

had before. The video has its own playing controls,

which are shown over the video itself so that it is clear

that they refer to it, and not to the narration of the

description. Also, as we have reached this memory

through the album (i.e., it was previously unlocked

and now we are reviewing it), we have some controls

for navigating through the album.

Figure 4: Memory of the music category.

3.3 Design and Implementation

As it has been mentioned previously, a critical

component of the application is the collection of

memories that the elderly people will unlock during

their progress in the game. They should be attractive

so that players get encouraged to keep on playing and

find new ones. The categories were defined in the

analysis phase, thanks to the focus group with

potential players, and then the development team

selected the specific memories. The goal was to create

a collection of memories recognizable for the

A Pervasive Game for Elderly People with Augmented Reality: Description and First Validation

107

residents, which help them to remember moments of

their life and to learn curiosities of their environment.

Thus, memories from the 50s until our days were

chosen. The total number of memories for each

category goes between 15 and 20.

4 FIRST VALIDATION

In order to validate the application, it was tested by

six people over 45 years of age (the age threshold had

to be lowered to achieve a larger population). Each of

these people was provided with a device with the

game installed and the necessary targets (printed

images) to unlock the memories. After each person

used the application long enough, they filled a

validation questionnaire in based on the

questionnaires used in the TAM model (Davis, 1989)

to verify technological acceptance. In this way, we

verified the interest of the participants in having an

application of this type in their daily lives We

measured the perceived usefulness and the perceived

ease of use. The questions that were asked were the

following:

 Question 1: I think playing “EncuéntraTe”

would improve my qualities such as physical

condition or memory.

 Question 2: I find “EncuéntraTe” game useful

to me.

 Question 3: Playing “EncuéntraTe” would be

easy for me.

 Question 4: I see that the game “EncuéntraTe”

is flexible enough to interact with it.

 Question 5: It would be easy for me to master

“EncuéntraTe” game.

Thus, questions 1 and 2 refer to perceived

usefulness, while questions 3, 4 and 5 refer to

perceived ease of use. These questions were answered

by the study participants, giving each one a numerical

value between 1 and 5, being 1 the worst score and 5

the best. Survey results are shown in Table 1; we

reflect score averages in Figure 5.

Table 1: Results of the first validation.

Quest.

User

#1 5 5 5 4 3 4

#2 4 4 5 4 4 5

#3 4 4 3 3 3 5

#4 5 4 3 4 3 4

#5 5 3 2 5 4 4

Figure 5: Questions average for the first validation.

As we have tested the application with a small

population we can just show the first impressions

based on these results. In the case of the questions

related to perceived usefulness, the answers average

is 4.33 out of 5. This seems to indicate that the

participants in the study perceived the application as

useful for the purposes for which it was designed.

However, the result when calculating the average of

the answers to the questions on perceived ease of use

drops to 3.78. Thus, we could infer that the

participants in the study did not perceive the

application so easy of use, despite they evaluate well

its usefulness. This should lead us, in future more

exhaustive studies, to identify specific usability

problems and correct them in order to improve this

perception of ease of use of our application.

5 CONCLUSIONS AND FUTURE

WORK

In this work we have presented “EncuéntraTe”, a

pervasive mobile game aimed at elderly people. The

game makes use of augmented reality and has been

developed to be played in nursing homes for elderly

people or similar centers. The game consists of

locating in the real world a series of real images. Once

found, the application is used to see different virtual

objects that appear by means of augmented reality.

Tapping on these virtual items users unlock memories

which are displayed and can also be narrated to the

player. Memories are also stored in an album. The

game has an achievement and ranking system to

encourage the player to keep playing. Therefore, with

this game we have contributed to the development of

a novel game for elderly people that uses current

technologies and consider specific requirements

proposed in the literature as positive in the

development of games aimed at the elderly. Our game

includes the ideas behind pervasive games together

ICT4AWE 2021 - 7th International Conference on Information and Communication Technologies for Ageing Well and e-Health

108

with the aim of stimulating the elders’ memory and

having them performing physical activity. In this

sense, this is a novel way in which such aspects are

tackled.

We have carried out a very preliminary validation

of the game. The game seems to be valued positively

in terms of its usefulness, but has aspects to improve

in terms of its ease of use. Therefore, it is necessary

to carry out more complete studies to help us to

identify the points for improvement that would

change that perception. Such new studies will imply

a larger number of users with a higher average age.

As future work, in addition to the aforementioned

studies, we will add new functionalities to the

application. Specifically, we will include some help

or tutorial functionality that allows to improve the

game usability. We also will intend, based on the

evaluations that players make of memories, that the

game can be adapted to their tastes, promoting the

appearance of memories that are in line with their

preferences. For example, if it is observed that the

preferred memories of a user refer to a certain time

period, the application would work on showing more

memories in that same period. Also, the possibility

for family members to include personalized

memories and rewards will be also considered.

ACKNOWLEDGEMENTS

Work partly funded by the Spanish Science and

Innovation Ministry, the National Research Agency

(AEI) and the EU (FEDER) through the contract

RTI2018-096986-B-C31, by Fundación Bancaria

Ibercaja through the contract JIUZ-2020-TEC-04,

and by the Aragonese Government (Group

T60_20R).

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