65 isn't old—not when most of us hope to push into our eighties. That's why designer Gaz Bushell of developer Fayju and Dr. Jody Mason, a biochemist at the University of Essex in London, are turning to video games to raise awareness for Alzheimer's disease. Today it affects one in 20 people over 65. A decade from now, that number will be even bigger.
The two are developing Cascade, a tower-defense game due in June for the Android microconsole Ouya. The game explores the amyloid cascade hypothesis, a theory about why Alzheimer’s happens, through easy-to-understand concepts for the young generations that the disease will be hitting later in life. Players work alone or together in the same room to defend brain cells from the disease.
"We were showing it at the Big Bang festival, and kids would get straight into the idea that they're flying a spaceship around and shooting at things," Bushell tells us. "And they’d be like, 'Great! This is exciting.' And then a group of parents would be standing behind them, sort of looking at it thinking, ‘Ugh. They’re playing games again.'"
Their reaction changed once they understood what was really happening onscreen—and that kids were learning. Cascade is intentionally cloaked in the fun, sci-fi language of spaceships and planets.
"If you say to people, 'Play our game, it's about Alzheimer's disease,' I think that could be quite off-putting, even if it’s a great game," says Mason. "We always said from the outset that we would try to make this game tasteful and sensitive and not try to be glib about the subject matter."
Fayju's last game was as far from serious as you get. Amazing Frog had players running around Bushell's own Swindon, England, as a frog that flopped around and farted as he shot out of cannons and got tossed about by speeding cars. Bushell says he’d been making both games at the same time, first contacting Mason back when he was still working at advertising agencies.
"I always considered that they were both based on something real in a way," he says. "I know that's strange, but when me and [artist Hal Jackson] went independent, we were talking about what kind of games we were going to make. I always found it was important to have some form of fixed point that you build around for your game, otherwise you just go off. So for Amazing Frog, we're looking at the view outside our window and turning that into a real experience."
When Mason cracked open biochemistry textbooks to explain the science—the core of the game—Bushell says he was like an "infant" with it. He started to visualize it in programming metaphors.
"It's like a perfect metaphor for a planet that is generating something on its surface, which is then destroying itself, and your role in the game is to try to stop that from happening."
Cascade mirrors not only the pathology of Alzheimer's but also leading therapeutic strategies. Enzymes like "molecular scissors" cut the big amyloid precursor protein on the surface of brain cells, and the middle section that pops out sticks to itself and forms amyloid plaques—the same thing Alois Alzheimer saw down his microscope over 100 years ago. "For example, you can lock the scissors that come in and cut the big protein," said Mason. "If you can block those, then the small protein doesn't come out. So that's what the big drug companies are doing. They're trying to create inhibitors that can block the enzymes and stop those scissors from cutting, and that’s one of the things that you'll be doing in the game. Or if that doesn't happen, and you allow the sticky protein, the middle section, to become released, then you can stop it from becoming sticky. That's one of the things that my group here at Essex are trying to do, and it’s something that a number of different groups across the globe are trying to do.
"So if you can do that and look down your microscope and the plaques are gone, then in principle you could have cured the disease."
Mason stressed that Alzheimer’s is more expensive in health care terms than heart disease and cancer combined—the two big killers—yet it receives a sixth of the funding of cancer alone. "So in the U.K., it’s costing 23 billion pounds a year, and that’s just not sustainable. In the U.S., these numbers are even more serious, but we’ve got 800,000 people with dementia, and the lion’s share of that, maybe 65%, is Alzheimer’s. And we’ll have a million with dementia by 2025, and that’s going to double every 20 years from there."
Bushell wants Cascade to be a positive influence. Talk about the game, and you often end up talking about the disease. "And that side of things is very intensive because obviously, we’re all human beings, we’ve all suffered loss in one way or another.
"Everything that I’ve done in my career up to this point is I’ve been maybe making games to sell cameras or sell cars, and raising awareness for some product or something like that, which is part of my career history. So it makes more sense to me to take those skills or take the idea of bringing focus onto something onto something that actually needs focus."