KyungSik Kim-Department of Game Dev, Hoseo University, Korea

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 ([email protected])

2013-08-22 1 Improving Cognition(Hoseo Univ)

2013-08-22 Improving Cognition(Hoseo Univ) 2

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


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

4 2013-08-22 Improving Cognition(Hoseo Univ)

Introduction

Fast Aging Society:

-Social alienation

-Biological aging

-Lower cognition with depression


Serious Game:

-Effective for repeated training

-Provoke active participation

-Customizable to the player


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.



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

2013-08-22 Improving Cognition(Hoseo Univ)

Rejuvenesce Village


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


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


When the traffic light gets on, the player should press the same colored button before the light disappear.

2 Traffic Light Vision Reaction



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



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



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



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



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



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



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


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


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


Experiments

IRB Photos


25

Installation of Final Products on 25 sites in Seoul


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)

- 28 -

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)


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)


- 30 -

Winner of Korean Gaming Award in Academic Area

Paldogangsan1

- 31 -

● 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

- 32 -

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)

- 33 -

Response from their physical condition

[Total] [ Strong ]

[ Normal] [ Weak]

Experiments

(Green: positive, Red: normal, Blue: negative)

- 34 -

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)

- 36 -

‘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


- 37 -

Two objectives combined to “mall walking”

1. Brain-training

2. Exercise


- 38 -

Game interface (3 kinds)


- 39 -

Walking in 60th ~ 70th market place in Korea

Mission: remembering good foods

Buy those items for the foods

Paldogangsan2

- 40 -

Healing game – upgrading of ver. 1

As 2 players walk on, grass and tree grows fast

Sound: classic music with bird sound

Paldogangsan2

- 41 -

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)

42

● 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

43

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


for deseases

total 21 20.5 58.4

< 75 14 25.2 60.7

>=75 27.7 16.1 56.3


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, %)

45

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

47

•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


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 ([email protected])

2013-08-22 48 Improving Cognition(Hoseo Univ)


SGSC2014: Kintex (Korea) 23rd(Fri)~ 25th(Sun) May, 2014

KyungSik Kim-Department of Game Dev, Hoseo University, Korea

Technology

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