Commercially Available Mobile Apps for Caregivers of People With Alzheimer Disease or Other Related Dementias: Systematic Search

Abstract

Background More than 15 million Americans provide unpaid care for persons with Alzheimer disease or other related dementias (ADRD). While there is good evidence to suggest that caregivers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group format. Alternatively, offering electronic health (eHealth) interventions may assist caregivers in providing quality care while remaining in good health. Research to date has generated little knowledge about what app features support ADRD caregivers’ behavioral changes and how developers might optimize features over the long term. Objective There is an evident knowledge gap in the current landscape of commercially available apps, their integration of behavioral techniques, content focus, and compliance with usability recommendations. This paper systematically reviews and inventories the apps caregivers might typically be exposed to and determines the support integrated into the apps and their functionality for older adults. Methods The search strategy was designed to mimic typical Web-based health information-seeking behavior for adults. Apps were included based on their explicit focus on ADRD caregiver knowledge and skill improvement. Two coders with expertise in behavioral interventions and eHealth pilot-tested the data extraction. One coder retained app characteristics and design features. Techniques used to promote change were determined, and 2 questions from the Mobile App Rating Scale were used to assess the app credibility and evidence base. Content topics were evaluated using a thematic framing technique, and each app was assessed using a usability heuristic checklist. Results The search results generated 18 unique apps that met the inclusion criteria. Some apps were unavailable, and only 8 unique apps were reviewed. Of the 8, 7 (88%) apps did not state which scientific orientation was followed to develop their content. None of the apps made clinical claims of improving caregivers’ and care recipients’ overall health. All apps relied on textual information to disseminate their contents. None of the apps was trialed and evidence based. Apps included on average 7 out of 10 behavioral change techniques, 5 out of 10 C.A.R.E. (Caregivers, Aspirations, Realities, and Expectations) features, and 10 out of 18 features on the usability heuristics checklist. Conclusions Our findings suggest that caregivers are likely to discover apps that are not actually accessible and have low or no evidence base. Apps were found to be largely static, text-based informational resources, and few supported behaviors needed to maintain caregivers’ health. While apps may be providing a high volume of information, caregivers must still navigate what resources they need with limited guidance. Finally, the commercial marketplace is addressing some of the major usability elements, but many design elements are n...

Quality of Mobile Apps for Care Partners of People With Alzheimer Disease and Related Dementias: Mobile App Rating Scale Evaluation

“…Similarly, the findings of both Choi et al [ 22 ] and Guo et al [ 45 ] reported that apps scored lowest on engagement, reporting just-below minimally acceptable quality and above minimally acceptable quality, respectively. These findings further confirm previous research that evaluated 8 commercially available apps for ADRD care partners and found that the majority provided mostly text-based information [ 48 ]. Below acceptable engagement scores are concerning, as engagement issues can lead to technology abandonment, reduced acceptance, or failure to use the app to its full potential [ 49 , 50 ].…”

Mindfulness-Based App to Reduce Stress in Caregivers of Persons With Alzheimer Disease and Related Dementias: Protocol for a Single-Blind Feasibility Proof-of-Concept Randomized Controlled Trial

“…This modality addresses barriers to caregiver participation (eg, in-person, synchronous format, time commitment, and cost) for a more feasible, scalable, and cost-effective intervention to reduce stress among this high-need population. The HMP app adapted for caregivers of persons with ADRD seeks to address this clinical gap by testing a no-cost mobile app to reduce stress, emotional distress, and sleep difficulties [ 40 ]. This protocol describes an entirely remote, single-blind feasibility, proof-of-concept RCT of HMP versus a time- and dose-matched educational control (WA) in stressed caregivers of persons with ADRD.…”

“…In qualitative studies, caregivers express interest in using mobile apps for stress management and health information [ 35 ] including to learn mindfulness meditation for stress management [ 36 - 39 ]. To the best of our knowledge, there are no consumer-based mobile apps with proven efficacy in decreasing stress, emotional distress, and sleep difficulties among caregivers of persons with ADRD [ 40 ]. Although mindfulness-based mobile apps show promise for helping caregivers of persons with ADRD decrease stress, emotional distress, and sleep difficulties, additional research is needed to establish feasibility and efficacy before widespread dissemination.…”

Cuidador-Pro: Desenvolvimento de um aplicativo para apoiar o cuidado de idosos com demência

“…Deve-se esperar que uma plataforma informativa para o cuidado de idosos com demência apresente padrão de uso fácil e intuitivo, principalmente considerando a heterogeneidade de seus usuários, para que seja simples e acessível para todos aqueles que se dispuserem a utilizá-la. Segundo Wozney et al (2018), as questões relacionadas aos recursos de acessibilidade como tamanho da fonte, cores, contraste, comando de voz, feedback tátil (vibração), aviso sonoro, bem como uma interface amigável, vem sendo apontadas como condições básicas para que o uso de uma plataforma digital seja implementada no cotidiano de um cuidador. Segundo o autor, cerca de 40% dos cuidadores utilizam algum tipo de aplicativo para auxiliar na gestão do cuidado.…”

“…Por isso, cuidar da fonte das orientações disponibilizadas no Cuidador-Pro foi uma preocupação para garantir a qualidade do conteúdo. Em estudo desenvolvido por Wozney et al (2018), os autores analisaram os aplicativos com foco no cuidado da pessoa com demência e, entre os dados discutidos, está a falta de declaração de quais orientações científicas os desenvolvedores seguiram para a concepção do conteúdo, o que se torna essencial ao considerarmos a realidade dos dias de hoje.…”