JMIR Publications

ABSTRACT

Background:

Global demographic transitions have created an unprecedented crisis in cognitive care delivery, with over 55 million individuals worldwide living with dementia while traditional caregiving infrastructures face critical capacity limitations. China, facing one of the most severe aging crises, offers a critical context for examining DAT adoption in cognitive care. Digital assistive technologies (DATs) represent a transformative solution to bridge this care gap, yet systematic evidence regarding their real-world acceptance and implementation barriers remains limited.

Objective:

This study aimed to investigate caregivers' acceptance and adoption patterns of DATs in cognitive care settings, applying the Technology Acceptance Model (TAM) framework to understand adoption determinants and barriers that influence successful technology integration in caregiving environments.

Methods:

This study aimed to investigate caregivers' acceptance and adoption patterns of DATs in cognitive care settings, applying the Technology Acceptance Model (TAM) framework to understand adoption determinants and barriers that influence successful technology integration in caregiving environments.A purposive sampling strategy recruited 15 primary caregivers of individuals with cognitive impairment across varying decline stages. Caregivers were strategically selected as study participants given their role as crucial decision-makers and implementers of technology adoption in cognitive care contexts, where declining cognitive abilities often limit patients' capacity for independent technology evaluation and use. Semi-structured interviews systematically explored TAM constructs including perceived usefulness, perceived ease of use, behavioral intentions, and contextual adoption factors. Thematic analysis was conducted to identify adoption determinants and barriers in DATs integration.

Results:

DATs served five primary functional domains in cognitive care: safety support, emotional and social engagement, daily living assistance, health monitoring, and cognitive function support. Caregivers identified perceived usefulness and ease of use as primary acceptance determinants. However, systematic barriers emerged across three dimensions: technological design limitations (interface complexity, insufficient personalization, functional misalignment with care needs), psychosocial user barriers (technology anxiety, technology burden), and external environmental constraints (cultural value conflicts, high costs). Caregivers demonstrated stage-specific technological needs that evolved with cognitive decline progression, prioritizing pragmatic solutions with simplified interfaces and minimal training requirements.

Conclusions:

This research extends TAM application in healthcare by revealing that traditional constructs require expansion to include emotional dependency, family attitudes, and social support systems in cognitive care. Technology needs evolve dynamically across cognitive decline stages. Human caregivers remain irreplaceable for emotional support, personalized judgment, and crisis management, positioning optimal care as human-technology collaboration rather than replacement. Successful DATs integration requires coordinated actions among technology developers, social workers, and policymakers to address design, support, and accessibility challenges, providing evidence-based guidance for adaptive digital intervention strategies. Clinical Trial: /