JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) applications offer a promising approach to support the safety and community mobility of persons living with dementia (PLWD) or mild cognitive impairment (MCI). However, many digital health technologies fail to achieve sustained adoption because acceptance and usability challenges emerge during real-world use.

Objective:

This pilot study evaluated the technology acceptance and usability of the GuardIO mobile application, a smartphone-based location-monitoring system for persons living with dementia or MCI, and their care partners.

Methods:

We conducted a multi-method pilot usability evaluation with 12 persons living with dementia or MCI and their 12 care partners (N = 24), who used the GuardIO application in their everyday activities for 1 month. The V3+ framework for usability validation of digital health technologies guided the study. We collected quantitative data using questionnaires based on the Unified Theory of Acceptance and Use of Technology (UTAUT) before and after application use. We obtained qualitative data through semi-structured interviews and analyzed them using conventional content analysis.

Results:

Overall acceptance and usability scores were high among both persons living with dementia or MCI and their care partners. In exploratory analyses, performance expectancy correlated significantly with behavioral intention among persons living with dementia or MCI (rs = .576, P < .05) and care partners (rs = .865, P < .01). Actual use correlated significantly with behavioral intention in both persons living with dementia or MCI (rs = .711, P < .01) and care partners (rs = .733, P < .01). Qualitative findings indicated that the application's primary value was providing care partners with peace of mind through real-time location monitoring while supporting independent community participation among persons living with dementia or MCI. However, user-related issues, system design factors, and usability challenges hindered sustained use, including battery drain, location inaccuracies, and concerns about data transparency and privacy. Participants also reported that the application was most suitable during the early stages of cognitive decline when independent smartphone use remained feasible.

Conclusions:

GuardIO demonstrated strong perceived usefulness, but usability, reliability, and data privacy barriers constrained sustained use. Taken together, these findings suggest that persons living with dementia or MCI and their care partners were willing to use the application when they could, particularly if developers resolved usability issues.