A Drum-Based Serious Game for Physical and Cognitive Training in Older Adults: Development and Mixed Methods Usability Study

Physical and cognitive decline significantly affects seniors' quality of life. To address this, our interdisciplinary team developed a drum-based serious game tailored for older adults. The game features culturally adapted interfaces and nostalgic songs, incorporating rhythmic gameplay where players strike a drum in sync with on-screen visual cues matching musical beats. 72 participants (female = 73.6%, age: 85 ± 8.7) completed our two-week intervention program with four 30-minute game sessions. We assessed game performance metrics (hit rates, scores and wrong hits) and User Engagement Scale (UES) across three cognitive profiles groups (Normal, Mild/Major neurocognitive disorders). Results indicated significant improvements in pre- and post-game scores (p = .003) and high engagement levels (UES: M = 4.2/5). Thematic analysis revealed participants felt engaged, experienced benefits, attracted, and achieved a sense of success. However, some older, frailer individuals reported frustration due to challenges keeping pace. Overall, our findings support the game's feasibility and usability.