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Alzheimer's Association International Conference 2026

July 12-15, 2026 | London, United Kingdom, and Online

6218

Determinants Of Completion And Dropout In A Community-based Smartphone Cognitive Intervention For Older Adults

Title : Determinants of Completion and Dropout in a Community-Based Smartphone Cognitive Intervention for Older Adults

Background :

Smartphone-based cognitive interventions can support cognitive health in older adults [1], but adherence is inconsistent, often depending on digital familiarity and available assistance [2].
Education and household composition might shape engagement, yet evidence from large community-based samples remains limited [3,4].
This study compared completers and droppouts across two community-based mobile cognitive intervention studies (2022, 2024).

Methods :

349 adults aged 55–85 completed a 3-month mobile-based dementia prevention program via local welfare centers in Korea (two studies, 2022/2024); 258 completed,91 dropped out.
Compared between groups: demographics (age, sex, education, household composition — living alone/spouse/family), cognitive function (K-MMSE), and social support (MOS-SSS).
Analysis: chi-square/Fisher’s exact tests (categorical), independent-samples t-tests (continuous).

Results :

1) Completion was associated with education and household composition, but not sex or age.

Sex and age did not differ between completers and dropouts (41.2% vs. 46.7%; p=0.371; mean age: 69.98 vs. 69.72 years; p=.819).
Completers had higher educational attainment: more college-educated (16.5% vs. 4.4%) and fewer with ≤elementary education (34.4% vs. 45.6%) than dropouts (p<.05).
Living alone was strongly linked to dropout: only 5.0% of completers lived alone vs. 42.9% of dropout; family co-residence occurred only among completers (24.8% vs. 0%) (p<.01).
Caveat: household composition data available only from the 2022 cohort; limits generalizability.

2) Completion was not associated with baseline K-MMSE and MOS-SSS.

Baseline cognitive function and social support did not differ by completion status. K-MMSE: 25.43 vs. 25.54 (p=.870); MOS-SSS: 71.38 vs. 76.27 (p = 0.136) — neither reached significance.
Caveat: baseline data lost to first-visit no-shows/withdrawal before assessment.

Conclusions :

Higher education and supportive household arrangements were associated with intervention completion, consistent with prior work [5,6] — likely reflecting greater digital literacy and learning motivation among higher-educated participants [12,14], and practical support (reminders, app setup help, troubleshooting) from spouses, children, or grandchildren [5-8].
Age and baseline cognitive function were not significant predictors, despite prior evidence linking older age and lower cognition to higher dropout [9,10] — likely reflecting the sample: few participants had cognitive impairment, and recruitment criteria (community-dwelling, monthly center visits) may have excluded those with mobility limitations, narrowing the range represented.

Implication :

Participants living alone may benefit from structured adherence support — initial and ongoing guidance, weekly check-ins, and coaching — to reinforce a sense of responsibility for completion [11-13].
Participants with lower education may need onboarding designed for low digital literacy, including step-by-step tutorials and repeated hands-on guidance [14,15].
Task difficulty should be tailored to educational level, with graded difficulty (easy → hard) to support achievable challenge and reduce frustration [16,17].
Future studies should recruit more cognitively impaired and older (≥75) participants, and use baseline screening to identify high-risk profiles (living alone, older age, lower education) for targeted onboarding and adherence support.

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