Gamification of cognitive assessment and cognitive training: A systematic review of applications and efficacy

ReviewBackground: Cognitive tasks are typically viewed as effortful, frustrating and repetitive, which often leads to participant disengagement. This, in turn, may negatively impact data quality and/or reduce intervention effects. However, gamification may provide a possible solution. If game design features can be incorporated into cognitive tasks without undermining their scientific value, then data quality, intervention effects and participant engagement may be improved. Objectives: This systematic review aims to explore and evaluate the ways in which gamification has already been used for cognitive training and assessment purposes. We hope to answer three questions: 1) Why have researchers opted to use gamification? 2) What domains has gamification been applied in? 3) How successful has gamification been in cognitive research thus far? Methods: We systematically searched several online databases, searching the titles, abstracts and keywords of database entries using the search strategy (gamif* OR game OR games) AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*). Searches included articles published in English between January 2007 and October 2015. Results: Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a range of disorders and cognitive domains. We identified seven reasons for researchers opting to gamify their cognitive training and testing. We found that working memory and general executive functions were common targets for both gamified assessment and training. Gamified tests were typically validated successfully, although mixed-domain measurement was a problem. Gamified training appears to be highly engaging and does boost participant motivation, but mixed effects of gamification on task performance were reported. Conclusions: Heterogeneous study designs and typically small sample sizes highlight the need for further research in both gamified training and testing. Nevertheless, careful application of gamification can provide a way to develop engaging and yet scientifically valid cognitive assessments and it is likely worthwhile to continue to develop gamified cognitive tasks in the future.The authors are members of the United Kingdom Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excellence. Funding from British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The UK Medical Research Council and the Wellcome Trust (092731) and the University of Bristol provide core support for ALSPAC. This work was supported by the Medical Research Council (MC_UU_12013/6), a PhD studentship to JL funded by the Economic and Social Research Council and Cambridge Cognition Limited and a NIHR funded academic clinical fellowship to EE. The funders had no role in review design, data extraction and analysis, decision to publish, or preparation of the manuscript