Original research Attitudes of older adults toward shooter video games: An initial study to select an acceptable game for training visual processing Sandra M. McKay PhD Centre for Studies in Aging, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada Brian E. Maki PhD, PEng Centre for Studies in Aging, Sunnybrook Health Sciences Centre; Institute of Medical Science, Institute of Biomaterials and Biomedi- cal Engineering, Department of Surgery, University of Toronto; Toronto Rehabilitation Institute, Ontario, Canada E: [email protected] S.M. McKay, B.E. Maki. Attitudes of older adults toward shooter video games: An initial study to select an acceptable game for training visual processing. Geron- technology 2010; 9(1):5-17; doi:10.4017/gt.2010.09.01.001.00 A computer-based ‘Useful Field of View’ (UFOV) training program has been shown to be effective in im- proving visual processing in older adults. Studies of young adults have shown that playing video games can have similar benefits; however, these studies involved realistic and violent ‘first-person shooter’ (FPS) games. The willingness of older adults to play such games has not been established. Objectives To determine the degree to which older adults would accept playing a realistic, violent FPS-game, compared to video games not involving realistic depiction of violence. Methods Sixteen older adults (ages 64-77) viewed and rated video-clip demonstrations of the UFOV program and three video-game genres (realistic-FPS, cartoon-FPS, fixed-shooter), and were then given an opportunity to try them out (30 minutes per game) and rate various features. Results The results supported a hypothesis that the participants would be less willing to play the realistic-FPS game in com- parison to the less violent alternatives (p’s<0.02). After viewing the video-clip demonstrations, 10 of 16 participants indicated they would be unwilling to try out the realistic-FPS game. Of the six who were willing, three did not enjoy the ex- perience and were not interested in playing again. In contrast, all 12 subjects who were willing to try the cartoon-FPS game reported that they enjoyed it and would be willing to play again. A high proportion also tried and enjoyed the UFOV training (15/16) and the fixed-shooter game (12/15).Discussion A realistic, violent FPS video game is unlikely to be an appropriate choice for older adults. Cartoon- FPS and fixed-shooter games are more viable options. Although most subjects also enjoyed UFOV training, a video-game approach has a number of potential advantages (for instance, ‘addictive’ properties, low cost, self-administration at home). We therefore conclude that non-violent cartoon-FPS and fixed-shooter video games warrant further investigation as an alternative to the UFOV program for training improved visual processing in seniors. Keywords: aging, attention, useful field of view, video games, visual training An impaired ability to rapidly process vis- strophic consequences. Studies have, in fact, ual information is common in many older shown strong links between impaired ability 1,2 adults , and can limit mobility and activi- to rapidly extract information from the pe- 3,4 5,6 ties of daily living . Moreover, an impaired ripheral visual field and car-accident risk . ability to monitor one’s surroundings dur- It is also likely that impaired ability to moni- ing activities such as driving can have cata- tor one’s surroundings may increase risk of Winter 2010 5 Vol. 9 No 1 G9(1)Original-McKay-v2.indd 5 2-3-2010 18:58:49 Attitudes toward video games falling. This could arise as a consequence on visual-attention tests after only ten hours of reduced awareness of hazards that may of training with a first-person-shooter (FPS) 16,17 increase the risk of slipping or tripping, but video game . Such games require the could also occur as a result of an impaired player to shoot ‘enemies’ while maneu- ability to execute balance-recovery reac- vering through a virtual environment that tions involving rapid compensatory step- is viewed through the eyes of the shooter. 7-10 ping or reaching movements . For such The video-game skills of quickly detecting, reactions to be effective in re-stabilizing the identifying and tracking targets in cluttered body, the hand must be directed very rap- visual displays and the rapid switching of at- idly toward an appropriate object that can tention between targets are believed to be be grasped or touched for support, while fundamental to the observed improvements 16,18 stepping reactions must be directed so as to in visual processing . avoid obstacles and to land the foot at an appropriate landing site7-10. Video-game-based training offers a number of compelling advantages, compared to There is now substantial evidence that age- more traditional training approaches such related visual-processing deficits can be as the UFOV program. For example, the countered via suitably-designed training enjoyable and “addictive” nature of video 19 programs. Specifically, it has been shown gaming would be expected to promote that the ability of older adults to rapidly compliance with the training program, and process visual information can be improved features intrinsic to video-game design (rep- by means of a computer-based program that, etition, progression in difficulty, augmented in effect, increases the ‘useful field of view’ feedback, provision of rewards) should help (UFOV). The UFOV training involves identi- to ensure effective learning. In addition, vid- fying targets that are displayed on a compu- eo games are widely available and relatively ter screen for very brief intervals (for instance, inexpensive, and the fact that they can be 17-500 ms) under increasingly challenging self-administered in the home, rather than in conditions (i.e. shorter target display times, a clinical setting, should lead to further cost more peripheral locations, addition of visual savings. Whereas the development of a new distracters). A series of studies have shown game-like training program could be a very that a moderate degree of UFOV training expensive undertaking, use of an existing (10 one-hour sessions) can lead to a persist- commercially-available video game to train ent (>1 year) increase in visual-processing improved visual processing in older adults 11-13 speed , and that the training benefits can would take advantage of the huge market- 14 transfer to safer driving and more rapid driven efforts that have been, and continue 20 execution of instrumental activities of daily to be, devoted to video-game development . 15 living . At present, older adults are far less likely to While UFOV training is clearly an effective play video games in comparison to younger intervention to improve visual processing, persons. For example, a survey conducted recent research suggests that off-the-shelf in 2007 found that 81% of 18- to 29-year- video games may be a useful alternative. olds play video games, while only 23% of 21 Studies of young adults have shown that adults age 65 or older report doing so . video-game ‘players’ outperform ‘non-play- However, older adults who do play video ers’ (defined as persons who had not played games tend to be among the most active 22 any action video games within the prior 6 gamers . Furthermore, it appears likely that months) in visual and spatial processing the numbers of older persons playing video tasks, and are more flexible and efficient games will increase dramatically over the 16 at distributing attention . Moreover, young coming years due to the computer-literacy adults were able to improve performance of the aging ‘baby-boom’ generation, the Winter 2010 6 Vol. 9 No 1 G9(1)Original-McKay-v2.indd 6 2-3-2010 18:58:49 Attitudes toward video games burgeoning numbers of older adults who ance with ethics approval granted by the are learning computer skills, and the rapidly institutional review board. Although gender increasing tendency of video-game com- differences were not a focus of the study, an panies to target a traditionally non-gaming effort was made to balance the gender dis- 22-24 older adult population . tribution (9 female, 7 male). All participants were independent community-dwellers There are, however, potential concerns with no substantive cognitive impairments about the suitability of FPS video games for (Mini-Mental-State-Examination scores: 27- an older-adult population. The games used 30, mean=29) or uncorrected visual deficits in the previous young-adult visual-process- (Snellen-chart acuity: 20/40 or better, wear- 16,17 ing studies have involved realistic com- ing corrective lenses if applicable). Most of bat scenarios, which could trigger undue the participants were familiar with using stress, particularly in older adults who may a computer (14/16 reported using a home have lived through a war or similar traumatic computer for tasks such as email and inter- 25,26 events . The problem is likely to be ex- net access); however, none had any substan- acerbated as technological advances in im- tive prior video-gaming experience (only age quality and sound fidelity increase the four participants reported any such expe- player’s sense of presence and immersion in rience, and this was limited to a single in- 27 the virtual world . Although there has been stance of playing a video game with a grand- some previous work examining the suitabil- child). One of the subjects reported a strong 28 ity of video games for older adults , we are dislike of video games (complaining that his not aware of any such studies that have ex- grandchildren played them too much); none amined highly realistic FPS games utilizing of the other participants reported either a recent advances in computer technology.