From <scp>eSports</scp> to “Gam Saan Songs”: Prioritizing Cultural Fit in Digital Interventions for Older Adults

We read with interest the randomized controlled study by Hayashi et al. [1] investigating the effects of electronic sports (eSports) on cognitive function and psychiatric symptoms in older adults with mild cognitive impairment (MCI). While the exploration of novel digital engagement is timely, the reported null results regarding cognitive outcomes underscore a critical challenge: the necessity of “cultural fit” in digital therapeutics for older populations. The lack of significant improvement in the eSports trial may be attributed to a generational and cultural mismatch. While eSports offer high-energy engagement for younger cohorts, they often fail to align with the historical and linguistic frameworks of the current generation of older adults. Successful digital interventions for this demographic rely on “cultural tailoring” rather than mere “gamification.” [2] An example is the use of “Gam Saan Songs” (Songs of Gold Mountain), which are traditional oral narratives used by early Chinese migrants to the United States, to deliver health education [3]. Recent research has shown that integrating these songs into modern platforms like YouTube significantly improves education reach and outcomes for conditions like insomnia among older Chinese Americans [4]. This suggests that for this specific generation, the rhythmic and narrative familiarity of a heritage-based song is a more potent vehicle for clinical impact than a culturally foreign digital game. Furthermore, the efficacy of any digital tool is predicated on “dementia literacy.” Previous study has emphasized that a vast majority (up to 75%) of the older general public view cognitive decline as a natural part of aging rather than a medical condition [5]. When literacy is low, participants may engage with a digital intervention as a peripheral leisure activity rather than a therapeutic exercise. Previous successful models have shown that platforms like YouTube and WhatsApp are most effective when they serve as conduits for culturally tailored psychoeducation that respects the lived experiences and historical communication styles of the participants [6-8]. In conclusion, the findings of Hayashi and colleagues emphasize that tackling the cognitive determinants of dementia requires a shift from “generic” digital tools to those that prioritize cultural resonance. Future trials would benefit from a mixed-methods approach that captures not just cognitive scores, but also digital self-efficacy and “cultural fit”—domains where heritage-based interventions like Gam Saan songs have already proven their utility in bridging the gap between ancient traditions and modern medicine. The authors have nothing to report. This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study, formal consent is not required. The authors declare no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.