A research team from FAU Erlangen-Nuremberg and the Bavarian Digital Dementia Register (digiDEM Bayern) has, for the first time, evaluated German-language apps for people with dementia and for caregivers based on scientific evidence and user quality, and has arrived at two sobering conclusions. For most dementia apps available on the so-called direct-to-consumer market, there is no scientific evidence of their effectiveness. Furthermore, many dementia apps do not offer more than a mediocre user experience.
Germany has a massive backlog when it comes to digitizing its healthcare system. At the same time, Digital Health Applications (DiGAs) are growing in popularity. They can be conveniently downloaded from app stores and used anytime, anywhere. „Many of the dementia apps do not go beyond mediocre overall quality,“ says Michael Zeiler, medical informatician at FAU Erlangen-Nuremberg and research associate in the DigiDEM Bavaria project (Digital Dementia Registry Bavaria). The goal of the study was to evaluate the benefits of German-language mobile health applications for people with dementia (PwD) and their caregivers.
User quality was assessed using the internationally recognized rating tool MARS-D („Mobile App Rating Scale,“ German version). Criteria for user quality included functionality, aesthetics, information content, and questions about patient safety and the quality of the therapeutic offering. „The area of patient safety even received the lowest, and therefore worst, rating,“ explains Michael Zeiler. „This relates to questions about possible risks and harmful effects, such as incorrect feedback and inaccurate information.“
The effectiveness of many apps is not scientifically proven.
Furthermore, researchers around Michael Zeiler examined the scientific evidence of a total of 20 health apps. Here, too, many of the supposed „digital helpers“ were disappointing. „The effectiveness of most dementia apps is not scientifically proven at all. If money is charged for such dementia apps without proof of effectiveness, then that is „digital quackery“," explains neurologist and health economist Prof. Dr. med. Peter Kolominsky-Rabas. Studies were available for only six apps, meaning 30 percent. Conversely, the scientists found that scientific articles were often published about applications that achieved a good score in the quality assessment.
For greater transparency and public awareness
„The better health apps are researched, the better healthcare will be and the more transparent the market for digital health applications will become,“ knows Michael Zeiler. With a few exceptions, health apps are not considered medical devices. An app must first undergo a testing process to be included in the relevant directory by the Federal Institute for Drugs and Medical Devices (BfArM) as a digital health application. This is intended to increase transparency in the market regarding which applications actually meet the requirements for safety, functionality, quality, data protection, and data security. „The positive effect on care is not always proven. We therefore urgently call for regular quality checks of health apps based on strict scientific criteria in accordance with international standards,“ emphasizes the study's co-author, Prof. Dr. med. Peter Kolominsky-Rabas.
Dementia Apps in Four Categories
The apps that were examined were categorized by the scientists into four groups. The Category Information Includes apps that provide people with dementia and their caregivers with various information about the illness. In the Cognitive Training & Games Category applications are found whose main goal is to promote the cognitive abilities of people with mild cognitive impairment (MCI) and thereby slow down cognitive decline. Caregivers and relatives sometimes receive training ideas that can be carried out together without digital applications. The apps of Screening Category have the goal of identifying cognitive impairments with the help of various tests and recommending a doctor's consultation to users if such a suspicion exists. In the Category Support Measures applications are summarized that support people with dementia or their caregivers in everyday life, for example, by allowing photos and events to be shared in a chat room.
The study was published on March 6, 2023, in the Journal for Evidence, Education, and Quality in Healthcare (ZEFQ).
Here is the study by Michael Zeiler, Christina Chmelirsch, Nikolas Dietzel, and Peter Kolominsky-Rabas:
Our webinar tip:
For everyone interested in dementia apps, there will be a presentation on Tuesday, March 28, 2023, from 11:00 AM to 11:45 AM, titled App Store Help – Evidence of Apps for People with Dementia and Their Caregivers A digiDEM Bavaria Science Watch LIVE webinar will take place. Michael Zeiler, the lead author of the study, will be presenting.
We ask for registration at https://attendee.gotowebinar.com/register/4200407526891056989
Update:
Do you like watching the webinar recording App Store Help – Evidence of Apps for People with Dementia and Their Caregivers a. Here you can access the recording.
