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Improving Cognitive Function for the Elderly
(Development of Serious Games for Cognition Improvement for the Elderly)
Aug. 22, 2013
KyungSik Kim Dept. of Game Development, Hoseo University
Rep. of Korea (kskim@hoseo.edu)
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Hoseo University
DigiPen/ KeyMyung
SGSC14 IlSan,Kintex
Background
• 2008.11-2012.10 Hoseo 2030 projects for world class (100,000 USD/yr for 4 years)
• Title: A Research on Serious Games for the Elderly toward Human Service
• 4 Dept. joined: Game, Senior Welfare, Electronics, Nersury (12 professors)
• Result: walking games ‘Paldokangsan’ • Win(2011): 1M USD government project to
develop arcade games to improve cognition functions for the elderly
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Content
1.Need for Serious Game
2.Elderly Cognitive Problem
3.Proj#1. Rejuvenesce Village
- Game Design & Experiments
4.Proj#2. Paldokangsan
- Game Design & Experiments
5.Conclusion
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Introduction
Fast Aging Society:
-Social alienation
-Biological aging
-Lower cognition with depression
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Serious Game:
-Effective for repeated training
-Provoke active participation
-Customizable to the player
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Dementia Ratio in Korea (ages>=65) / B.Statistics (2011)
2005
2010
2020
8.3%
8.6%
9%(E)
Improving Cognitive Function and Satisfaction of Life
Healthy Life Without Dementia
Qualified Life with Entertainment
Development of Silver Game Improving Cognitive Function
Health and Entertainment
Government Project
• Province of Seoul and KOCCA announced to support to develop a serious game to improve cognition related to ‘dementia’ on arcade platform with 1 Million USD in 2011.
• Uniana – Hoseo consortium with Seoul Asan Hospital won the competition.
• Finished successfully at Dec. 2012.
• The machines produced were installed in 25 senior community centers in Seoul.
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Rejuvenesce Village
Game Overview Improving Cognitive Function
9
Objective Improvement of cognitive function and life satisfaction as well as remission of depression
Control Screen touch , Ball button touch
Target user
Main Over 65 years old, risk of dementia, mild cognitive impairment in elderly
Sub middle-age who wants cognition training
Expect
Improvement of cognitive function and hand-eye
co-ordination exercise function game treatment - remission of depression
Player 1 Person
Playtime 60 minutes when full-functional training
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Rejuvenesce Village
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Training Cognitive Elements Using touch interface
with the vision and sound
Arcade game with coincidence reaction
Game Contents
GUI(Game User Interface)
Difficulty Level
5 Levels in 9 stages for repetition
Improve or Maintain Cognitive Function (To avoid dementia & activate brain)
Game Design Concept
Familiar visual with colors, traditional elements
Rejuvenesce Village – Game Contents
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Rejuvenesce Village – Game Preview
Attention - Agility
1 Hide and Seek
1.Reads word on the speaker to remember 2.Push button for the following words If it was the remembered one, press “green” Else press “red”.
Auditory Reaction
Effectness Activate the sense of hearing
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When the traffic light gets on, the player should press the same colored button before the light disappear.
2 Traffic Light Vision Reaction
Rejuvenesce Village – Game Preview
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Attention - Agility
Effectness Activate the sense of sight
3 Sugar Cookie
Touch the same shape in left side
among other 3 shapes in right side
2D Operation
Rejuvenesce Village – Game Preview
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Visuo-Spatial Attention
Effectness Recognition of 2D plain
Select the same cracker of the left side
among
3 ones of the right side
(those of the right side were in rotated
shape.
scracker of the left side can be rotated
by finger)
4 Correct Cracker Space Control Cognition
Rejuvenesce Village – Game Preview
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Visuo-Spatial Attention
Effectness Recognition of 3D object
5 Picture Cards Sorting
3 pictures and sequences of the right
side should be revived after being
collected with no sequence on the left
side. Move picture of the left side
with finger to right side.
Topological Memory
Rejuvenesce Village – Game Preview
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Memorization
Effectness Improve phase memorization
Remember things in upper area in a
few sec.
After being disappeared, anything
appear in lower area moving from left
to right.
If it was in the first upper area, press
“green” button, else “red” button.
6 Stuff Reminder Figural Memory
Rejuvenesce Village – Game Preview
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Memorization
Effectness Improve figural memory
Fill the box with the number to
satisfy the sequence
7 Word Memory
8 Linking Numbers (A.I. Game) Digital span test
Effectiveness Improve memory of words
Improve memory of digital span
Memory of Words
Rejuvenesce Village – Game Preview
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Memorization
Effectiveness
Remember words in upper area in a few sec.
After being disappeared, a word appears in lower area
moving from left to right.If it was in the first upper
area, press “green” button, else “red” button.
9 Shopping at Market
Looking the shopping lists, player should buy them in time limit.
The player can move arround by pressing arrows as well as stairs
Effectiveness Combination of attention and memorization
Exercise Function
Rejuvenesce Village – Game Preview
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Judgement (Executive)
• Location: Seoul Asan Hospital Clinical Examination Center • Period: Jul. ~ Nov. in 2012 • Permission: Seoul Asan Hospital IRB
100 elderly people (>=65) with no problem in hearing, vision and conversation - Score of Cognition (test: MMSE-K) >= 24
Questionaire Survey before and after the game (about 1 Month) to get cognition score as well as depression, vitality and satisfaction
t-test and ANOVA test
Analysis of interpolation with multiple regression (다중공선성 진단 후 회귀분석)
Target
1
2
Statistics
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Experiments
Pre-test
(Before)
Treatment (two
1-hr work/week)
Post-test
(After 1 Month)
Group1 (Jul): 20명 E X F
Group2 (Aug): 20명 E X F
Group3 (Sep): 20명 E X F
Group4 (Oct): 20명 E X F
Group5 (Nov): 20명 E X F
Tests
E(Entering test): Cognition, Depression, Satisfaction, Vitality
F(Finishing test): Cognition, Depression, Satisfaction, Vitality
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Experiments
Analysis
Score of MMSE-K(average of 100 elders): (before the game) 27.6 (± 1.70) (after the game) 28.1 (± 1.75) significant (t=-3.32, p=.001).
range Before – After the Game
t p Average SD
MMSE-K
men -0.48 1.62 -1.61 .119
women -0.51 1.47 -2.90 .005
total -0.5 1.51 -3.32 .001
-Satisfaction of Life: statistically significant relationship to the game -Depression, Vitality by Tool: not significant relationship to the game
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Experiments
IRB Photos
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IRB Photos
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Installation of Final Products on 25 sites in Seoul
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Purpose To provide the elderly with game-aided lifestyles and entertainment
Controller Hand buttons and footboards as game controllers
Target User
Main Elderly individuals wishing to walk
Other Individuals wishing to exercise with visual effects
Expected
Effect
1. Vicarious satisfaction
2. Game therapy for the elderly
Player Two individuals (2 sets of controllers )
Play Time Approx. 7-10 minutes
Hoseo University Game Eng. Kyung Sik Kim
27 / 15
Paldokangsan 1 (2011)
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Title: “Paldogangsan”
enjoy favorites in house = Sightseeing on foot
Focus: Game-Aided Human Life
The most popular leisure activity
of more than 50s in Korea:
-walking around
-hiking mountains
(survey of 1st year of WC2030)
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Paldogangsan1 – Game Design
1-1. Armrest / hand button to control arms of avatar
2. Foodboard / smart shoes to control legs of avatar
Mixed Reality Interface (combination of chair + shoes)
Paldogangsan1 – Game Design
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Winner of Korean Gaming Award in Academic Area
Paldogangsan1
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● Average age was 75.1 year.
● Men / Women ratio: 22.5%, 77.5%
● Optimal play time(survey): 7.6 min.
(full course required about 1,200 steps)
309 people participated (for 8 days in Sept. 2011)
Paldogangsan 1– experiment
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Easiness: Footboard, display, and play
[ Total] [ Men ] [ Women ]
•Footboard: 52% answered easy to use (men: 40%, women: 56%)
•Many answered to change the location of sensor and its sensitivity.
•Total play: 76% felt no problem (men: 71%, women: 77%)
Experiments
(Green: positive, Red: normal, Blue: negative)
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Response from their physical condition
[Total] [ Strong ]
[ Normal] [ Weak]
Experiments
(Green: positive, Red: normal, Blue: negative)
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Fun of the game
Intention to play again?
3.83.853.93.95
44.054.14.154.2
평균 남자 여자
흥미도 4.14 3.94 4.19
게임의 흥미도 (5점 만점)
91.7%
Fun of the game: 4.14 average (full: 5)
Intention to play the game again: 91.7%
Reason: “can forget trivial thought”, “interesting”, “effective physical
exercise”
Experiments
Objective senior entertainment and welfare
Controller hand buttons and foot boards
Target User main
50’s and later who needs walking and improving me
morization ability
sub all who needs walking with vision attention
Expected
Effects
1. physical exercise (walking)
2. memorization abilities of good foods for 5 diseases
(Osteoporosis, Melancholia, Dementia, Hypertension, Diabetes)
Player 1 player
Play time
1. main: 5-10min. (3 levels)
2. healing game: 2-5 min.
3. mini games: 5-10 min.
Paldokangsan 2 (2012)
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‘Paldogangsan (Season 2)’
Field Of View Game
• For the game to improve the multi-signal processing capabilities within a field of view
Merit of FOV Game
• Select enhance the reaction rate
• Position memory speed improvements
• Distributed memory improve concentration
• Selective focus > Processing speed
Feature of FOV Game
• For the game to improve the multi-signal processing capabilities within a field of view for exercise
Paldogangsan2 – Game Design
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Two objectives combined to “mall walking”
1. Brain-training
2. Exercise
Paldogangsan2 – Game Design
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Game interface (3 kinds)
Paldogangsan2 – Game Design
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Walking in 60th ~ 70th market place in Korea
Mission: remembering good foods
Buy those items for the foods
Paldogangsan2
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Healing game – upgrading of ver. 1
As 2 players walk on, grass and tree grows fast
Sound: classic music with bird sound
Paldogangsan2
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2 Minigames for players who can’t walk
Memorizing good and bad foods for 5 diseases
Select foods for some period (30 ~ 50 sec)
Score: good choice with bad choice
Paldogangsan2
309 people participated (for 4 days in Sept. 2012)
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● Average age was 74.9 year old.
● Men / Women ratio: 32%, 68%
● Optimal play time(survey): 13.1 min.
Experiments
Comparison of proper walking time for ages
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Experiments
Comparison of memorization effects for ages (unit: %)
Memorization negative neutral positive
M
a
i
n
I can remember good foods
after game
total 19.2 18.7 61.6
< 75 11.2 20.6 68.2
>=75 27.0 17.1 55.9
It’s helpful for my memory
total 18.8 18.8 62.4
< 75 11.2 19.6 69.2
>=75 26.1 18.0 55.9
M
i
n
i
I can remember good foods
for deseases
total 21 20.5 58.4
< 75 14 25.2 60.7
>=75 27.7 16.1 56.3
I can remember good foods
for me
total 21 21 58
< 75 13.1 24.3 62.6
>=75 28.6 17.9 53.6
Experiments
Comparison of concentration effects for ages (unit: year, %)
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Concentration negative neutral positive
M
a
i
n
I could
concentrate
while playing
game
total 7.8 8.7 83.1
< 75 3.7 11.2 85
>=75 11.7 6.3 82
I could erase
other thoughts
via game play
total 11 9.6 79.5
< 75 7.5 9.3 83.2
>=75 14.3 9.8 75.9
Experiments
Comparison of vitality effects for ages (unit: year, %)
Vitality negative neutral positive
M
a
i
n
I feel tired and
exhausted
after playing
game(reverse
coded)
total 10 12.3 77.6
< 75 9.3 14 76.6
>=75 10.7 10.7 78.6
I feel
refreshed after
playing game
total 6.4 22.8 70.3
< 75 4.7 26.2 69.2
>=75 8.1 19.8 72.1
Experiments
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•Serious games for cognition training:
-One of good solutions to improve cognitive function
-Satisfaction of life to the elders
•Rejuvenesce Village:
- Showed improvement of cognition with the game
- Satisfactory participation of the testing volunteers
-25 Senior Community Centers are under operation
•Paldokangsan 1, 2:
-Looking for business out of Korea
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Conclusion
Many thanks for attending
Serious Games & Social Connect (SGSC14) May 23rd-25th, 2014 KINTEX, IlSan, Korea
www.seriousgamesconference.org
Serious Game Center in Hose University: http://seniorgame2030.hoseo.ac.kr
Prof. KyungSik Kim
Dept. of Game Development, Hoseo University Rep. of Korea (kskim@hoseo.edu)
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SGSC2014: Kintex (Korea) 23rd(Fri)~ 25th(Sun) May, 2014