Two technology trends address the rising costs of healthcare systems in aging societies: Serious Games for Healthcare and Ambient Assisted Living Environments. Surprisingly, these concepts are rarely combined and the users’ perception and use of Serious Games in Ambient Assisted Living environments is insufficiently understood. We present the evaluation of a serious game for stimulating cognitive abilities for elderly with regard to technology acceptance (based on the UTAUT2 model), performance and preference for an interaction device (tablet, table, wall). The results suggest that acceptance of serious games is independent of gender, technical expertise, gaming habits, and only weakly influenced by age. Determinants for acceptance are perceived fun and the feeling that the users can make playing the game a habit. Performance within the game is explained by age and previous gaming experience. All investigated interaction devices were rated as useful and easy to learn, although the wall-sized display had lower approval levels. The article concludes with guidelines for successfully introducing serious games for healthcare to residents in ambient assisted living environments.