Effectiveness of Support Monitoring and Reminder Technology for Mild Dementia on Persons with Mild Cognitive Impairment and Their Caregivers

Abstract: Abstract Background: As the population ageing increases, the dramatic rise in cognitive disorders such as mild cognitive impairment and dementia has become a public health priority. Mobile health technology is a unique non-pharmacological intervention for dementia and cognitive disorders. A digital platform (Support Monitoring and Reminder for Mild Dementia: SMART4MD) is created for persons with mild cognitive impairment (MCI) and informal caregivers. A randomized controlled trial was conducted on the SMART4MD application. Objective: The objective was to study the effects of the SMART4MD compared to standard care in Sweden and Spain over an 18-month follow-up period. Methods: One thousand and seventy-eight dyads were enrolled: 537 dyads in the intervention group and 541 dyads in the control group. The primary outcome measure was health-related quality of life using the European Quality of Life 5 dimensions, 3 Levels, (EQ-5D-3L) index. Mean differences were analyzed with independent samples T-test. Simple and multiple linear regression analyses were conducted for continuous outcomes and logistic regression analyses for the categorical outcomes. Age, gender, education, living arrangements and baseline scores were adjusted for. Results: There were no significant difference observed in the health-related outcomes between the intervention and the control group at follow-up. For PwMCI, the mean differences of the outcomes were: EQ-5D-3L (EVAS) = 0.00 (p = 0.84), total QALYs gained = 0.01 (p = 0.77), composite QoL-AD = 0.42 (p = 0.30), MMSE scores = 0.40 (p = 0.22). For the informal caregivers, the mean differences were EQ-5D-3L (EVAS) = 0.02 (p = 0.13), total QALYs gained = 0.03 (p = 0.12), ZBI = 0.31 (p = 0.61). Conclusion: The effect of the SMART4MD for PwMCI and the caergivers was insignificant and inconclusive. Further studies are needed to add on the evidence. Trial registration: ClinicalTrials.gov: NCT03325699