JMIR Publications

ABSTRACT

Background:

Behavioral and psychological symptoms of dementia are common and negatively impact both individuals with dementia and their families. Although nonpharmacological interventions are recommended as the first-line treatments, their use in community settings is limited by access and caregiver resources. Existing approaches are often not individualized and rely on institutional or clinician-led delivery.

Objective:

To address these gaps, we developed a caregiver-initiated, individualized multimodal mobile app that delivers tailored nonpharmacological interventions—such as music therapy, exercise, and reminiscence therapy—based on each user’s preferences and functional status. This study evaluated the effectiveness of the mobile app-based intervention for addressing behavioral and psychological symptoms of dementia in community-dwelling persons living with dementia.

Methods:

A single-blinded randomized controlled trial. An outpatient clinic at a tertiary hospital, a dementia care center, and five home care service centers. Thirty-six dyads (community-dwelling persons living with dementia aged ≥60 years and their primary family caregiver). The dyads were randomly allocated to either the experimental or control group. The experimental group received a caregiver-initiated, multimodal mobile app-based individualized intervention for four weeks, while the control group continued with usual care. The primary outcomes were overall behavioral and psychological symptoms of dementia, agitated behavior, and depression. The secondary outcomes were sleep efficiency and caregiver competency in managing behavioral and psychological symptoms of dementia. Assessments were conducted at baseline, immediately after the intervention, and at a 2-week follow-up.

Results:

Of the 36 randomized dyads, 33 were included in the final analysis. Although both groups showed reductions in overall behavioral and psychological symptoms of dementia, agitated behavior, and depression after the intervention, no significant group × time interaction effects were observed in the total sample. However, subgroup analysis of participants with clinically significant baseline behavioral and psychological symptoms of dementia revealed a significant reduction in these symptoms in the experimental group (β = –12.885, 95%CI= –24.530, -1.240, P = .03). No significant effects were observed for either sleep efficiency or competence in the management of behavioral and psychological symptoms of dementia.

Conclusions:

A mobile app-based individualized intervention may offer a flexible, caregiver-initiated approach to managing behavioral and psychological symptoms of dementia in home-care settings. While overall effects were limited, subgroup findings indicate potential benefits for those with higher baseline symptom severity. The results highlight the need for further research on adaptive personalization and optimized intervention delivery to enhance the clinical effectiveness of digital dementia care. Clinical Trial: This study was registered on August 18, 2023, with the Clinical Research Information Service in South Korea (CRIS No. KCT0008713), and participant recruitment began on October 17, 2023.