Beyond Clinical Outcomes: A Systematic Review of Gameful Artefacts for Mild Cognitive Impairment Assessment

Gameful artefacts are increasingly used to assess Mild Cognitive Impairment (MCI), offering a potential complement to the limitations of traditional screening tools. However, while current research emphasises functional outcomes, the quality of gameful design and experience often receives comparatively less systematic attention. This systematic review analyses 43 gameful artefacts for MCI assessment, focusing on gameful design and experience. Our analysis yields three main insights: first, a “transparency gap” exists in reporting; studies primarily rely on static textual descriptions and screenshots. Expanding documentation to include videos or playable demonstrations represents a significant opportunity to better capture the gameful experience. Second, we deconstructed gameful artefacts using a formal game design element framework, providing a theoretical foundation and reference point. Third, we identified a “user gap” indicating that older adults are less involved in the early stages of development, and user evaluations tend to focus primarily on functional outcomes, indicating room for broader integration of player experience metrics. We conclude that gameful experience is not merely an additive feature but is essential to gameful artefacts. This paper calls for standardised reporting protocols, greater involvement of older adults during the early stage of design, and an integrated approach to cognitive assessment within gameplay.