360°-Based Cognitive-Motor Training System for Older Adults With Cognitive Impairment: User-Centered Design and Evaluation Study

TL;DR

This study designed a 360° technology-based training system for older adults with memory issues, focusing on user needs and app usability.

Contribution

A user-centered design approach was used to develop and evaluate a mobile app for cognitive-motor training in older adults with cognitive impairment.

Findings

Participants showed high interest in cognitive training but low digital literacy.

Preferred training frequency was 2-3 days per week with 10-20 minute sessions.

Usability issues included icon identification and navigation challenges in the app prototype.

Abstract

Evidence suggests that older adults can improve dual-task (DT) performance through specific motor-cognitive training programs. Recent technological advancements have facilitated the development of novel rehabilitative DT methodologies. In particular, the DUAL-REHAB project exploits 360° technology to develop ecological, cost-effective DT exercises for clinical and home settings.

This study aimed to comprehensively understand the DUAL-REHAB project’s end users (older adults with subjective memory complaints [SMC] and mild cognitive impairment [MCI]) and obtain feedback on an initial DUAL-REHAB mobile app prototype using a user-centered design approach.

The study used a 2-phase procedure. In the first phase (user requirements), we investigated end users’ lifestyles, habits, perceived well-being, technology adoption, and cognitive and cognitive-motor DT training expectations. In the second phase (prototype evaluation), we developed and tested a DUAL-REHAB mobile app prototype to assess its functionality with end users.

Overall, 14 participants were initially recruited for the study. The sample included 7 women with a mean age of 79 (SD 3.79) years and 7 men with a mean age of 82.43 (SD 5.65) years. One female participant was excluded for not meeting the criteria for either group; accordingly, the final sample study included 13 participants, with 8 categorized as MCI and 5 categorized as SMC. Participants reported structured daily routines with high autonomy, although some faced challenges with social connections. Perceived well-being was moderate across physical (mean 2.79, SD 0.97), psychological (mean 3.14, SD 0.86), and cognitive (mean 3.14, SD 0.53) domains. The perceived technology skills were low (mean 2.57, SD 0.94), with low digital literacy (mean 2.21, SD 0.89). Interest in cognitive training was high, with 92.31% (12/13) participants aware of its benefits and demonstrating strong interest (mean 4.15, SD 1.34) and perceived use (mean 4.15, SD 1.28). While only 46.15% (6/13) were aware of the possibility of DT training with technology, 92.31% (12/13) were willing to participate, and 84.61% (11/13) were open to home-based training. The preferred frequency was 2-3 days per week (63.64%, 7/11), with 10-20 minute sessions (8/11, 72.72%). Prototype evaluation revealed specific usability issues related to icon identification, device interaction, and navigation between training days.

We obtained valuable insights into the lifestyles, habits, and technological needs of older adults with MCI and SMC, which will guide DUAL-REHAB training development to align with user needs and capabilities. Our findings emphasize the importance of simplified technological processes with intuitive interfaces. Additionally, structured interaction opportunities during clinical and at-home training could enhance motivation, facilitate timely problem resolution, and address participants’ social needs.