Using a Gamification Approach to Enhance Continued Use of Assistive Technology Intervention in Persons Living with Dementia

Assistive technology (AT) interventions have shown promising results in supporting cognitive, social, and physical activities in persons living with dementia (PLWD) and their caregivers. Despite strong evidence of the effectiveness of AT, PLWD and their caregivers can disengage with the technology after it is used for a time – i.e., the “stickiness challenge”. Diminished use of AT reduces the opportunity for it to have optimal impact. We asked whether the opportunity to engage in cognitive games may enhance continued use of AT in PLWD and their caregivers. We investigated whether gamification used in conjunction with a well-established AT commercial product, the MapHabit System (MHS), enhanced stickiness of the intervention. The MHS uses a series of visual maps incorporating step-by-step images and videos to help PLWD and their caregivers complete activities of daily living. Using a randomized control trial (RCT), we determined the number of visual maps accessed daily by a group of PLWD using the MHS with gamification in comparison to a control group using the MHS plus viewing health-related informational videos. The study lasted six months, with changes-in-quality-of-life and net-promoter questionnaires being administered at the end. We found no differences in scores between the two groups with respect to the number of maps accessed nor duration-of-use of the MHS. Notably, both groups reported scores reflecting improved quality of life as well as high user-satisfaction ratings. The findings here report the first RCT study in PLWD using a “stickiness” approach to enhance AT engagement. Our findings suggest that it is likely that gamification used as an adjunct, as we did here, has little impact on “stickiness”. A more promising approach may be to use gamification conditionally as an incentive reward for continually using an AT intervention. Between-group imbalances in gender and ethnicity could also have contributed to outcomes. This study sets the stage for exploring all these possibilities as AT becomes more integrated into healthcare practice and research.