The elements of game exist as that of a system for which participants make choices and a system responds for that to award them a victory or defeat. The definition of a game usually limits the interactions to exist therein such that like you cant say the act of ordering food at a resturaunt is a game etc, however the elements do not rely on a visual medium. There are many games I know that can be played with only the use of audio, whether it be people speaking, or other such things.