Quality of Mobile Apps for Care Partners of People With Alzheimer Disease and Related Dementias: Mobile App Rating Scale Evaluation

Abstract

Background Over 11 million care partners in the United States who provide care to people living with Alzheimer disease and related dementias (ADRD) cite persistent and pervasive unmet needs related to their caregiving role. The proliferation of mobile apps for care partners has the potential to meet care partners’ needs, but the quality of apps is unknown. Objective This study aims to evaluate the quality of publicly available apps for care partners of people living with ADRD and identify design features of low- and high-quality apps to guide future research and user-centered app development. Methods We searched the US Apple App and Google Play stores with the criteria that included apps needed to be available in the US Google Play or Apple App stores, accessible to users out of the box, and primarily intended for use by an informal (family or friend) care partner of a person living with ADRD. We classified and tabulated app functionalities. The included apps were then evaluated using the Mobile App Rating Scale (MARS) using 23 items across 5 dimensions: engagement, functionality, aesthetics, information, and subjective quality. We computed descriptive statistics for each rating. To identify recommendations for future research and app development, we categorized rater comments on score-driving factors for each MARS rating item and what the app could have done to improve the item score. Results We evaluated 17 apps. We found that, on average, apps are of minimally acceptable quality. Functionalities supported by apps included education (12/17, 71%), interactive training (3/17, 18%), documentation (3/17, 18%), tracking symptoms (2/17, 12%), care partner community (3/17, 18%), interaction with clinical experts (1/17, 6%), care coordination (2/17, 12%), and activities for the person living with ADRD (2/17, 12%). Of the 17 apps, 8 (47%) had only 1 feature, 6 (35%) had 2 features, and 3 (18%) had 3 features. The MARS quality mean score across apps was 3.08 (SD 0.83) on the 5-point rating scale (1=inadequate to 5=excellent), with apps scoring highest on average on functionality (mean 3.37, SD 0.99) and aesthetics (mean 3.24, SD 0.92) and lowest on average on information (mean 2.95, SD 0.95) and engagement (mean 2.76, SD 0.89). The MARS subjective quality mean score across apps was 2.26 (SD 1.02). Conclusions We identified apps whose mean scores were more than 1 point below minimally acceptable quality, whereas some were more than 1 point above. Many apps had broken features and were rated as below acceptable for engagement and information. Minimally acceptable quality is likely to be insufficient to meet care partner needs. Future research should establish minimum quality standards across dimensions for care partner mobile apps. Design features of high-quality apps identified in this study can provide the foundation for benchmarking these standards.

A Survey of Mobile Apps for the Care Management of Patients with Dementia

“…First, we included 99 apps. The three previous studies using MARS to evaluate quality included 14 [ 31 ], 36 [ 32 ], and 17 [ 29 ] apps. Second, this is the first study investigating the difference between English and Chinese apps for dementia care.…”

“…In this study, two well-trained authors (Hsiao-Lun Kuo and Chun-Hung Chang) independently performed a systematic literature search from the study’s inception until 15 June 2022. The search terms were (Dementia OR Alzheimer disease) AND (Caregivers AND Mobile applications) [ 27 , 29 ]. We searched PubMed, Cochrane Collaboration Central Register of Controlled Clinical Trials, Cochrane Systematic Reviews, Google Play Store, Apple App Store, and Huawei App Store for mobile applications for dementia care.…”

“…Increasing applications have been developed to relieve caregivers’ burden. Six studies have evaluated the content and quality of applications for caregivers [ 27 , 28 , 29 , 30 , 31 , 32 ]. However, the difference between English-language and Chinese-language apps remains unclear.…”

Advance Planning for Technology Use in Dementia Care: Development, Design, and Feasibility of a Novel Self-administered Decision-Making Tool

“…Dementia care apps have the potential to improve quality of life for people living with dementia and care partners [46], but their development requires consideration of a range of needs [48]. The research on usability and needs with regard to apps to support dementia caregiving or dyads is at an early stage [16,[49][50][51]. The development of Let's Talk Tech was informed by the limited research on human-computer interaction-related best practices and techniques to support people living with dementia through online interventions [52].…”

Text Messages to Support Caregivers in a Health Care System: Development and Pilot and National Rollout Evaluation

“…Reviews of web-based interventions for caregivers of older persons and of persons with dementia show that support by a peer group [7][8][9], contact with a provider [7,10], assistance with decision-making and problem-solving [7,10], support [7][8][9][10], and information [7][8][9][10] included as part of a multicomponent intervention have the most positive outcomes. Mobile apps for caregivers also provide them ways to learn [11,12], interact with clinical experts [12], take care of themselves [11,12], and manage the care of their care recipient [12].…”