Background: To create games that target older adults' interests in engaging in cognitively-boosting activities is a rising trend [1,2]. But, the novelty of the digital me-dium of play, and the implicit expectation of cognitive performance can create stressful experiences for them [3]. We have previously proposed an empirical framework, Affective Game Planning for Health Applications (AGPHA) based on Lazarus's Transactional Theory of Stress Appraisal and Coping [4], to study interactions between primary appraisal (PA) and secondary appraisal (SA) of game challenge in relation to individual beliefs, and their cognitive and physiological abilities, to predict whether players will adopt the intervention in their lifestyle. 

Objective: The current study aimed to examine the sensitivity of the AGPHA framework to detect a relationship between PA of the health-benefits of digital play and subsequent physiological responses to the game experience, in predicting SA factors that modulate stress and the desire to replay.

Material and Methods: 18 healthy older adults (65+) participated in a repeated-measures study involving playing three types of presumably cognition-benefiting games (brain training, car racing and exercise game), while monitoring their physiological (EDA, HR, cortisol), and administering game-experience and STAI questionnaires after each session.

Results: PA had a significant effect on physiological measures during play. Physiological variations explained differences in SA variables of games benefits in terms of mental health and cognitive stimulation, but not with subjective perception of game difficulty. Finally, interactions between physiological and SA factors were more sensitive predictors of the desire to replay than were physiological factors or SA alone.

Conclusion: Our findings show that AGPHA provides a suitable framework for investigating the interactions between appraisal of interventions, and physiological and experiential responses to them.