The main purpose of this research is to evaluate the differences in the reaction time and accuracy rate of three categories of subjects using our serious games. Thirty-seven subjects were divided into three groups: normal (n₁ = 16), MCI (Mild Cognitive Impairment) (n₂ = 10), and dementia—moderate-to-severe (n₃ = 11) groups based on the MMSE (Mini Mental State Examination). Two serious games were designed: (1) whack-a-mole and (2) hit-the-ball. Two dependent variables, reaction time and accuracy rate, were statistically analyzed to compare elders’ performances in the games among the three groups for three levels of speed: slow, medium, and fast. There were significance differences between the normal group, the MCI group, and the moderate-to-severe dementia group in both the reaction-time and accuracy-rate analyses. We determined that the reaction times of the MCI and dementia groups were shorter compared to those of the normal group, with poorer results also observed in accuracy rate. Therefore, we conclude that our serious games have the feasibility to evaluate reaction performance and could be used in the daily lives of elders followed by clinical treatment in the future.

As the proportion of elderly people continues to grow, so does the concern about age-related cognitive decline. Serious games have been developed for cognitive training or treatment, but measuring the activity of the autonomic nervous system (ANS) has not been taken to account. However, cognitive functioning has been known to be heavily influenced by the autonomic nervous system (ANS), and ANS activity can be quantified using heart rate variability (HRV). This paper aims to analyze the physiological response in normal elderly people as they play two types of serious games using HRV features from electrocardiography (ECG). A wearable device designed in-house was used to measure ECG, and the data from this device was pre-processed using digital signal processing techniques. Ten HRV features were extracted, including time-domain, nonlinear, and frequency-domain features. The experiment proceeds as follows: rest for three minutes, play a cognitive aptitude game, rest for another three minutes, followed by two reaction time games. Data from thirty older adults (age: 65.9 ± 7.34; male: 15, female: 15) were analyzed. The statistical results show that there was a significant difference in the HRV between the two types of games. From this, it can be concluded that the type of game has a significant effect on the ANS response. This can be further used in designing games for the elderly, either for training or mood management.

Cognitive decline is one of the primary concerns in the elderly population. Serious games have been used for different purposes related to elderly care, such as physical therapy, cognitive training and mood management. There has been scientific evidence regarding the relationship between cognition and the autonomic nervous system (ANS) through heart rate variability (HRV). This paper explores the changes in the ANS among elderly people of normal and impaired cognition through measured HRV. Forty-eight subjects were classified into two groups: normal cognition (NC) (n = 24) and mild cognitive impairment (MCI) (n = 24). The subjects went through the following experiment flow: rest for 3 min (Rest 1), play a cognitive aptitude game (Game 1), rest for another 3 min (Rest 2), then play two reaction-time games (Game 2&3). Ten HRV features were extracted from measured electrocardiography (ECG) signals. Based on statistical analysis, there was no significant difference on the HRV between the two groups, but the experiment sessions do have a significant effect. There was no significant interaction between sessions and cognitive status. This implies that the HRV between the two groups have no significant difference, and they will experience similar changes in their HRV regardless of their cognitive status. Based on the game performance, there was a significant difference between the two groups of elderly people. Tree-based pipeline optimization tool (TPOT) was used for generating a machine learning pipeline for classification. Classification accuracy of 68.75% was achieved using HRV features, but higher accuracies of 83.33% and 81.20% were achieved using game performance or both HRV and game performance features, respectively. These results show that HRV has the potential to be used for detection of mild cognition impairment, but game performance can yield better accuracy. Thus, serious games have the potential to be used for assessing cognitive decline among the elderly.

For decades, scientists have been trying to solve the problem of dementia, with no cure currently available. Semantic–lexical impairment is well established as the early critical sign of dementia, although there are still gaps in knowledge that must be investigated. In this study, we used fMRI to observe the neural activity of 31 subjects, including 16 HC (Healthy Control) and 15 AD (Alzheimer’s Disease), who participated in the naming task. The neuropsychology profile of HC (Healthy Control) and AD (Alzheimer’s Disease) are discussed in this study. The involvement of FG (Fusiform Gyrus) and IFG (Inferior Frontal Gyrus) shows dominant activation in both of the groups. We observed a decrease in neural activity in the AD group, resulting in semantic deficit problems in this preliminary study. Furthermore, ROI analysis was performed and revealed both hyperactivation and hypoactivation in the AD group. The compensatory mechanism demonstrated during the task, due to the effort required to identify an animal’s name, represents the character profile of AD.

Background: Muscle strength, endurance, and muscle quality are important determinants of upper-limb function. Although surface electromyography (sEMG) characterizes muscle activation and fatigue, its integration with bioelectrical impedance analysis (BIA) for muscle quality assessment remains limited. Objective: This study investigated neuromuscular responses during graded handgrip contractions and evaluated an exploratory muscle quality (MQ) index integrating sEMG and BIA measures in healthy adults. Methods: Fifty-three healthy adults (35 males and 18 females) performed maximal voluntary contraction (MVC) followed by graded handgrip contractions at 0%, 20%, 40%, 60%, 80%, and 100% MVC. Surface EMG was recorded from the biceps brachii, triceps brachii, brachioradialis, and flexor carpi ulnaris. Root mean square (RMS) and frequency-domain features were extracted, with median frequency ( f _median ) selected as the representative frequency-domain outcome for nonparametric analyses and linear mixed-effects analysis. The MQ index integrated grip strength, muscle mass, body fat, and RMS and was evaluated using Spearman correlation. Results: RMS increased with contraction intensity, whereas f _median increased to a peak at 60% MVC and then gradually declined with the lowest values at 100% MVC. Significant fixed effect and interaction indicated that neuromuscular responses varied by gender, muscle, contraction stage, and muscle mass. The MQ index correlated moderately with right-arm muscle mass and phase angle but weakly with the conventional muscle quality index. Conclusion: Integrating sEMG and BIA provides complementary information on muscle activation, fatigue, and tissue characteristics beyond conventional strength-based measures, supporting assessment of upper-limb neuromuscular function and muscle quality.