JMIR Publications

ABSTRACT

Background:

Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI) represent critical windows for early neurocognitive intervention, although access to timely, personalized rehabilitation remains limited. Digital health technologies offer opportunities to deliver scalable and individualized cognitive care; however, their successful implementation depends on a deep understanding of users’ needs, expectations, and potential barriers.

Objective:

This study explores the lived experiences, perceptions, and challenges of individuals with SCD and MCI regarding cognitive rehabilitation, focusing on digital formats

Methods:

: The study is framed within a Human-Centered Design (HCD) perspective, aiming to inform the user-centered development of digital rehabilitation solutions. A mixed-methods approach was adopted to integrate qualitative and quantitative data. A semi-structured interview, developed through a targeted literature review, focused on four thematic domains: Neurocognitive Abilities, Network Support, User Experience and Engagement, and Digital Divide. The interview was administered to individuals with SCD or MCI. Quantitative measures included Cognitive Failures Questionnaire (CFQ), Montreal Cognitive Assessment, and an ad-hoc Technological Expertise questionnaire. Qualitative data were analyzed using Applied Thematic Analysis, including transcription, double-blind coding by two psychologists, theme identification, and peer review.

Results:

Twenty-three participants (16 females; age: 74.3 years) were included. Participants reported low-to-moderate perceived cognitive difficulties (CFQ: 22.4±9.48) and moderate technological familiarity. Qualitative findings revealed frequent difficulties in memory, attention, and language during everyday activities, alongside the use of compensatory strategies. Emotional vulnerability, social withdrawal, and feelings of being misunderstood also emerged. Despite concerns about technological barriers and reduced supervision, participants expressed openness toward home-based telerehabilitation, appreciating its flexibility, autonomy, and comfort when adequate support is available.

Conclusions:

These findings highlight that effective digital rehabilitation solutions must emerge from iterative, user-informed processes capable of addressing both functional and emotional dimensions of early cognitive decline. The present findings will inform the further development of engaging, inclusive, and adaptable digital rehabilitation tools.