Copyright © 2020 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved Gamification and Serious games techniques have been accepted as an effective method to strengthen the performance and motivation of people in education, health, entertainment, workplace and business. Concretely, exergames have been increasingly applied to raise physical activities and health or physical performance improvement among elders. To the extend of our understanding, there is an extensive research on gamification and serious games for elderly in health. However, conducted studies assume certain issues regarding context biases, lack of applied guidelines or standardization, or weak results. We assert that a greater effort must be applied to explore and understand the needs and motivations of elderly players. Further, for improving the impact in proof-of-concept solutions and experiments some well-known guidelines or foundations must be adopted. In our current work, we are applying exergames on elderly with frailty condition in order to improve patient engagement in healthcare prevention and intervention. We suggest that to detect and reinforce such traits on elderly is adequate to extend the literature properly.