JMIR Publications

ABSTRACT

Background:

Background:

The accelerated aging process in Latin American countries, along with the lack of effective public health strategies to control risk factors, has led to an increased prevalence of non-communicable diseases (NCD) like cardiovascular diseases and dementia, raising the number of older adults living with a disability. Mobile health (mHealth) applications offer promising opportunities to encourage healthy lifestyles to bridge the implementation gap in prevention programs. Currently, there are no available mHealth applications that integrate multimodal lifestyle interventions adapted to the Chilean population, nor are they specifically designed for older adults. Evidence supporting their effectiveness in this population remains scarce.

Objective:

Objective:

This study aims to describe the design, development, and validation of NeoMayor, a mHealth application designed to promote healthy lifestyles, cardiovascular and brain health in Chilean older adults.

Methods:

Methods:

NeoMayor was developed iteratively, including feedback from users, a multidisciplinary team of clinicians, researchers, software developers, and designers. We used Lean UX methodology to ensure user involvement throughout the design and validation process. The research was conducted in two phases: I. Design & Development, and II. Validation. In the first phase, we conducted a literature review and adapted and validated evidence-based recommendations to improve cardiovascular and brain health in older adults. During this stage, we held 26 co-creation sessions with users and consulted clinical and research experts in neurology and geriatrics. This iterative process led to the development of a functional prototype of the NeoMayor app for Android devices. In the validation phase, we implemented a pilot study to assess the usability, adherence, and effectiveness of NeoMayor. Sixty functionally independent and cognitively normal participants used the NeoMayor app for two months. Clinical and cognitive assessments were conducted before and after app use, to measure the app's effectiveness in improving cardiovascular and brain health.

Results:

Results:

The mean age of the participants was 71 ± 15, 83% were women, with an average of 9.8 ± 3.6 years of education According to the Framingham risk score, most of them (86.67%) had moderate to high cardiovascular risk. After two months of intervention, participants showed significant cardiovascular health improvements, with a mean increase in the Life´s Essential 8 cardiovascular health (CVH) index score from 64 ± 10 to 68 ± 11 (p<0.001), with significant reductions in systolic blood pressure (10 mmHg), and waist circumference (7 cm), and increase in HDL cholesterol levels. Also, improvement in the International Physical Activity Questionnaire score from 1.8 ± 0.6 to 2.4 ± 0.6, and the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay food score from 1.8 ± 0.6 to 2.4 ± 0.6. Additionally, physical performance showed improvements, with an increase in the Short Physical Performance Battery (SPPB) score from 11.3± 1. to 11.9± 0.5), and gait speed improved, with a decrease in the Timed Up and Go test (TUG) from 10±2 to 8±2.. Usability testing indicated high engagement of the participants, with an average app use of 400 seconds per day. The app was optimized for broad compatibility with Android devices, safe data collection and storage, and compliance with data privacy regulations following good clinical practices. The final product is now ready for a randomized controlled trial.

Conclusions:

Conclusion: This study represents the first initiative in Chile to develop and validate a mHealth tool to promote healthy lifestyles, and cardiovascular and brain health in older adults. NeoMayor employs a comprehensive, multidisciplinary, and person-centered approach, Given the widespread availability, low cost, and ease of implementation of mHealth technologies, NeoMayor offers an effective, accessible, and affordable solution for promoting healthy aging in Chile.