Gamification for elderly well-being: Effects on experience and engagement

The aging population and need for elderly health management pose significant global challenges. Emerging technologies such as health tracking applications (HTAs) play a crucial role in promoting smart senior care and improving elderly health management. To enhance motivation and engagement among the elderly in using HTAs, incorporating game elements or ‘gamification’ has attracted growing attention. However, concerns have also emerged regarding the high cognitive demands and potential biases against games, particularly among the Chinese elderly, who represent about 25 % of the global aging population and are deeply influenced by low indulgent culture. Due to a lack of empirical evidence from both research and practice, it remains uncertain whether gamification can bring optimal experiences and enhance elderly engagement with health services, in the same way that it does for younger users. Therefore, we designed and conducted a controlled between-subjects vignette-based experiment among the Chinese elderly (N = 312). Specifically, this study evaluated how three primary types of gamified health HTAs interactive interfaces (i.e., achievement-oriented, social-oriented, and immersion-oriented gamification) lead to a gameful experience (i.e., comfort, engagement, stimulation, dependability, perspicuity, novelty, sociality, and immersion), and how the experiences further affect elderly engagement behaviors such as continued use and word-of-mouth. The overall results indicate that the different types gameful HTAs were able to bring about different mixtures of gameful experiences, and that the improved experiences were positively associated with intentions to use and recommend the application. Peculiarly, but partly expectedly, the perception of novelty, was negatively associated with continuance intentions in the context of elder users.