Acceptability of a custom-designed game, CityQuest, aimed at improving balance confidence and spatial cognition in fall-prone and healthy older adults

Virtual reality or video games show great potential as low-cost and effective interventions for improving balance and cognitive function in older adults. This research describes the design and acceptability of a serious game (CityQuest) aimed at improving balance confidence, spatial navigation, and perceptual function in older adults with the use of a virtual environment and a balance board. Community-dwelling healthy (N = 28) and fall-prone (N = 28) older adults were pseudo-randomly assigned to train with CityQuest or one of two control games developed to evaluate the specific effects of the CityQuest game. Following completion of 10 training sessions, participants completed questionnaires measuring their acceptability of the game as a falls-related intervention, game experience, and subjective cognitive or balance confidence changes associated with the game. The results revealed high acceptance scores of the game and positive game experiences for all three game conditions. Older adults prone to falls reported a greater reduction in fear of falling and greater improvement in vigilance following training, compared to healthy older adults. These findings suggest that a serious game based on VR technology that trains both motor and cognitive processes is perceived to be beneficial and acceptable to healthy and fall-prone older adults.