In the Future, Senior Citizens Will Play Video Games All Day

By Jack Crosbie

The raid to destroy Ragnaros started after dark. It was 10 p.m. on the East Coast, and behind his keyboard, Drakenwulf knew his role. He was a warlock, one of four in the raiding party. The group had been planning all week. If they failed, they’d have to wait another week to try again; it wasn’t easy to get 40 players online at once to make a run at the Molten Core. The entire group had to work as a unit. Hunters — masters of beast and bow — used mighty wolves and boars to lure fearsome enemies into traps set by the main group. Drakenwulf kept other foes at bay with spells meant to instill fear. When they finally reached Ragnaros, the strongest warriors in the party took turns absorbing blow after blow from the elemental lord of fire while Drakenwulf and the core of sorcerers and rogues rained down damage upon him.

It was one of the most memorable experiences Jack Labout — known as Drakenwulf online — has ever had, and he’s had a lot. A programmer who has done stints at NASA and Tandem Computers, Labout is one of the true old guard online, a group of players who remember far beyond Ragnaros, one of the original bosses of Blizzard’s pivotal World of Warcraft game.

He’s also 79, retired, and lives alone near Dallas. He’s at an age when social interaction often wanes, and that can have devastating health effects. A 2011 study, for instance, found that the rate of cognitive decline was decreased by 70 percent in older adults who were socially active.

Labout doesn’t have many family members or close friends nearby. So every day, he goes online and plays games. He’s particularly active in the Old Timers Guild, a loosely organized group of some 10,000 gamers who want to take a more mature approach to gaming. He plays with a small core of friends, bouncing around between a variety of games. And for Labout and other OTG members, these relationships are just as real as any made offline.

“You spend 20 or 30 hours a week gaming with the same people, night after night, year after year,” says David Board, one of the administrators of the Old Timers Guild. “They become your friends. You may not meet them in person, but they’re your friends.”

Video games’ negative effects have gotten a lot of press over the years. Like television before it, there’s a contentious debate over the association between violent video game play and aggression. Gaming can also be habit-forming, and the World Health Organization now — controversially — recognizes “gaming disorder” as a real-world affliction. These attention-grabbing associations, however, belie a different side of games, one that enhances lives and could even help treat some of the more devastating symptoms of age.

In 2015, Gregory West, an associate professor at the University of Montreal, started posting flyers around campus for a series of psychological studies. Participants would be questioned, screened, and then receive an MRI to study the levels of grey matter in various regions of their brain. Then, they would be paid $9 an hour play Super Mario 64 for two to four hours a day, three times a week, for a total of 90 hours each. A separate group played an assortment of “action video games,” mostly shooters like Call of Duty and Killzone. In a related earlier study, other control groups took piano lessons or did nothing at all. West and his co-authors’ hypothesis, building from a slightly more limited German study in 2014, was that certain types of games could have effects on grey matter in the hippocampus. The hippocampus is the part of the brain that stores spatial memory — the sense of direction that lets us navigate the world. It’s also one of the first regions to show damage from diseases like Alzheimer’s and dementia, whose first symptoms are often disorientation and short-term memory loss.

There’s a realistic chance that playing games that test our spatial memory could help preserve or even restore grey matter in healthy adults as they age.

Super Mario 64 is not an easy game to navigate. In it, the player works through a labyrinth of different levels accessed through portal-paintings in a central hub of Peach’s castle. Its mechanics and layout are complex enough that groups of players have spent years competing with one another to find the quickest way through the game’s mazes and challenges. To beat it, players have to use their spatial memory to remember how to navigate through the game’s stages levels.

What they found was that people in the groups that played Super Mario 64, in both studies, had an increase in grey matter in their hippocampus. The results, West was careful to point out, don’t mean that Super Mario 64 is a cure for Alzheimer’s but rather that there’s a realistic chance that playing games that test our spatial memory could help preserve or even restore grey matter in healthy adults as they age, helping cut down their risks of neurological decay later in life, something he calls a “cognitive intervention.”

“At this point, we simply have a proof of concept,” West said. “We don’t really have the data to show that this is the case yet.”

Other studies have had complimentary results. In 2014, for instance, a study by education psychologists at the University of Florida found that the popular 3D-puzzle game Portal 2 improved respondents’ scores at basic cognitive tests more than the heavily marketed “brain trainer” Lumosity. Not all games, however, have the same effect. West’s research indicates that the “action video game” players were encouraging “response learning strategies” that rely on a different portion of the brain called the caudate nucleus. Over-reliance on the caudate nucleus can be detrimental to the hippocampus, which supports spatial memory — the goal is a balance between the two. And many modern games, action or otherwise, often furnish players with a mini-map and guided waypoint markers, creating a spatial situation where “the game’s doing the cognitive work for you,” he said.

In clinical settings, advances in video game technology could also make researching and applying these techniques much easier. Roger Anguera is the director of interactive media at Neuroscape, a neuroscience center at the University of California, San Francisco, that focuses on using “cutting edge technologies” to assess people’s brains. Anguera’s specialty is virtual reality, which is widely seen as the future of video games. One of the most practical applications of VR, Anguera says, is in simulations and games that precisely target and train the parts of the brain that West’s Super Mario 64 studies focused on. In one simulator, Anguera uses VR and motion-tracking to create an immersive VR “neighborhood” that patients can walk around in and observe. The subject is given 10 minutes to explore the neighborhood, taking note of landmarks and “errand” locations, like a coffee shop or post office. Then, Anguera spawns their digital avatar in a different location and asks them to complete a task, like picking up a coffee or delivering a letter, and then tracks how efficient their path is around the environment, adjusting the complexity of assignments and neighborhoods to test the subject’s recollection.

“The game will constantly adapt its difficulty to how well you’re doing, so that it’s always pushing you,” Anguera said, but unlike Super Mario 64, it allows researchers to control every variable and tailor the subject’s experiences, keeping them challenged but not overtaxed in order to improve the brain’s plasticity and vigor. Neuroscape works with patients and participants of all ages, but the core idea behind its therapies could have dramatic effects on how we deal with age. Dr. Adam Gazzaley, Neuroscape’s founder and executive director, said that he sees interactive experiences like Anguera’s closed-loop, adaptable video games as a way to change our brains for the better without relying on molecular-based therapies like drugs.

“We think it’s going to be an entirely new type of medicine,” Gazzaley said. Experiential treatments, he said, are ideally preventative care rather than cures but, if applied correctly as we age, could drastically increase our quality of life.

“All of it is on the table as far as I’m concerned,” Gazzaley said. “Depression, dementia, the host of cognitive impairments that are associated with aging as well as the other factors of purpose and loneliness also have potential for solutions with this approach.”

“That’s a really empowering experience, to master something, even though society doesn’t expect you to be good at anything anymore.”

Turning digital entertainment into clinical therapy may be a fledgling science, but games can already address the questions of purpose and loneliness that Gazzaley mentions. As people age, it’s also common to feel like parts of your life are slipping away. Joints get stiff, making sports harder; common tasks become more difficult. The psychological toll that these struggles can take is steep. Kathrin Gerling, Ph.D., an assistant professor of computer science at KU Leuven in Belgium whose work focuses on human-computer interaction, including accessible game design for older adults, says that gaming can help restore a sense of agency and accomplishment to aging adults.

“If you think about [an elder] care facility, we remove any kind of challenge from that environment,” Gerling said. “If we can give someone the opportunity to be competent, or even competitive at something… Say you have someone in their eighties who plays games for the first time, and they find out they’re actually good at something [again], that’s a really empowering experience, to master something, even though society doesn’t expect you to be good at anything anymore.”

Labout has been retired for years now, but as Drakenwulf, there’s plenty for him to do. He enjoys working in a group and helping out. The other night, he spent a couple hours helping another member of the guild assemble her new gaming PC. “She said, ‘Have you ever been a teacher? You’re so patient,’” he said, laughing. “I’d never really considered myself a patient person, but I’ve certainly more tolerant, and less of a fucking know-it-all… You need a group of people that’s not selfish, and you better not be a greedy bastard yourself. That’s when the gaming relationships that really last start to form.”

In the future, we may have entire worlds to form those relationships. Anguera, the VR researcher, said he’s particularly excited about the promises of projects like High Fidelity, an immersive social VR game from the creator of Second Life, one of the internet’s first and most popular role-playing games. In the future, Anguera said, these games will most likely play an important part in all our lives.

“I hope that I don’t forget to go out to nature and hike and climb mountains in the real world,” he joked. “But the more stimulated we get, the better, in a way.” As graphics and immersion into the digital world improves, he said, “There’s going to be so many things to see that would be hard to see in the default world.”