Exergames for Older Adults with Subthreshold Depression: Does Higher Playfulness Lead to Better Improvement in Depression?

Objective: The use of exergames is increasingly prevalent in the healthcare promotion among older adults. The current study aimed to examine whether the playfulness may influence the antidepressant effect of exergames on older adults. Method: Two experimental conditions, high playfulness (Wii™ Sport games) and low playfulness (Wii Fit™ training), were implemented in a 6-week randomized controlled study. A manipulation check was conducted first to confirm the significant difference in playfulness between the two conditions. A total of 49 community-dwelling older adults diagnosed with subthreshold depression have finished the study. Their depression, positive emotions, and self-efficacy were measured at both pre- and post-test. A multivariate analysis of covariance (MANCOVA) was then conducted between two conditions, with age and gender as the covariates. Results: Findings suggest that older adults in both two exergame conditions have improvements in subthreshold depression [t(48) = 9.48, P < 0.001], positive emotions [t(48) = -12.04, P < 0.001], and self-efficacy [t(48) = -9.78, P < 0.001]. Significant effect of playfulness in exergames was found on positive emotions among older adults [F(3, 47) = 20.82, P < 0.001], although not on subthreshold depression and self-efficacy. Conclusion: Results gained from the study will assist in the future implementation and development of exergames that aim to improve mental health among older adults.