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This study examined the effects of playing video games (Super Tetris) on the reaction time, cognitive/perceptual adaptability, and emotional well-being of 22 noninstitutionalized elderly people aged 69 to 90. Volunteers in an elderly community in the Netherlands were randomly assigned
to a videogameplaying experimental group or a nonplaying control group. The televisions of the 10 videogame players were provided with Nintendo SuperNes systems. Participants played Super Tetris 5 hours a week for 5 weeks, and maintained a log of their play. Before and after this play period,
measures of reaction time (Sternberg Test; Steinberg, 1969), cognitive/perceptual adaptability (Stroop Color Word Test; Stroop, 1935), and emotional well-being (self-report questionnaire) were administered. Playing video games was related to a significant improvement in the Sternberg reaction
time task, and to a relative increase in selfreported well-being. On the Stroop Color Word Test, both the experimental and control groups improved significantly, but the difference between groups was not statistically significant. The videogame-playing group had faster reaction times and felt
a more positive sense of well-being compared to their nonplaying counterparts. Consistent with previous research on video games and the elderly, the present study finds the strongest effects on measures of reaction time, and the weakest effects on cognitive performance measures. Explanations
and alternative interpretations of these findings are discussed.

First published in 1985, the programme described in this book had developed over 25 years at the Royal Newcastle Hospital, Australia. It grew in response to the practical needs of patients who, having been treated by conventional means, were left with residual disabilities to a degree that their return to the community was jeopardised.

Western values have long emphasized an interventionist approach to problems of health and health care. Yet, as medical technology becomes increasingly expensive and as the number of older people grows, proposed changes often are now governed more by considerations of cost than by quality of services. This tension between cost and quality also affects public willingness to invest in social components of health care despite their importance in enhancing quality of life. The tension emerges in sharpest contrast as scarce resources are allocated by gatekeepers in health maintenance organizations and in the arrangements for long-term care. With respect to financing, what seems to be needed is a creative mix of voluntary inputs from the community, private initiatives, and new programs of public entitlements. With respect to quality of care, what has often been overlooked is the recognition that gains in the quality of life require programs that encourage older people's continued involvement and participation in social life and in active and healthy life-styles. This article discusses the evolving balance between these two types of interventions: the medical and the social.

With the increasing expense of medical technology & the growing number of older people, proposed changes in health care tend now to be governed more by considerations of cost than by quality of services. This tension between cost & quality also affects public willingness to invest in social components of health care despite their importance in enhancing quality of life. The tension emerges in sharpest contrast as scarce resources are allocated by gatekeepers in health maintenance organizations & in the arrangements for long-term care. With respect to financing, what seems to be needed is a creative mix of voluntary inputs from the community, private initiatives, & new programs of public entitlements. With respect to quality of care, it must be recognized that gains in the quality of life require programs that encourage older people's continued involvement & participation in social life & in active & healthy lifestyles. The evolving balance between medical & social interventions is discussed. Modified HA