The effects of a mobile application-based dementia care intelligent recommender system on caregivers of people with dementia: a randomized controlled trial

BACKGROUND: Health recommender systems offer new opportunities to meet the personalized needs of people with dementia and their caregivers, but evidence on their effectiveness remains limited. OBJECTIVE: This study aimed to evaluate the effectiveness of a mobile application-based dementia care intelligent recommender system (DCIRS) among caregivers of people with dementia. METHODS: We conducted a RCT among family caregivers of people with dementia in China. Participants were randomly assigned to either the intervention group or a waitlist control group (n = 125 per group). Caregivers in the control group received no intervention during the study period, whereas those in the intervention group received access to a remote, mobile application-based DCIRS. Outcomes were assessed at baseline (T0), week 6 (T1), and week 12 (T2). The outcomes included distress related to care problems, caregiver burden, depressive symptoms, and the occurrence of safety-related events. Generalized estimating equations were used for analysis. RESULTS: The caregivers in intervention group showed significant reductions in distress scores for dressing, personal hygiene, communication, and behavioural and psychological care problems at both the 6th and 12th week assessments. Caregiver burden scores in the intervention group showed a continuous decline from baseline to week 6 (MD = -1.61) and further to week 12 (MD = -3.43) (P < .05). Within-group analyses showed that depressive symptom scores remained largely stable from baseline to week 6 and week 12 in both the intervention and control groups, with no significant pre-post changes detected. A significant between-group difference was found in the total number of safety-related events (P = .037). CONCLUSION: In summary, this RCT showed that the DCIRS may reduce caregivers' distress related to care problems and lessen caregiver burden. Although depressive symptoms did not improve significantly, further research is needed to assess long-term effects and clarify the mechanisms underlying remote, personalized interventions such as the DCIRS. REGISTRATION: The trial was registered at the Chinese Clinical Trials Registry (ChiCTR2200066087).