Cognitive Training Mobile Apps for Older Adults with Cognitive Impairment: App Store Search and Quality Evaluation (Preprint)

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BACKGROUND As the population ages, cognitive impairment is becoming increasingly prevalent. Mobile applications offer a scalable platform for delivering cognitive training interventions. However, their variable quality and lack of rigorous evaluation underscore the need for further research to guide optimization and ensure their effective application in improving cognitive health outcomes. OBJECTIVE This study aimed to evaluate the characteristics and quality of cognitive training apps designed for older adults with cognitive impairment. METHODS A comprehensive search of the Google Play Store and Apple App Store was conducted using predefined terms and inclusion criteria, with the search completed on July 13, 2024. Eligible apps were assessed for quality by two independent reviewers using the Mobile App Rating Scale (MARS), with interrater reliability evaluated via quadratic weighted kappa (К). The Kruskal-Wallis test analyzed differences in MARS scores across subgroups for each dimension, and Spearman correlation was applied to examine the relationship between user star ratings and overall mean scores. RESULTS A total of 4,822 potential apps were identified, of which 24 met eligibility criteria. Among these, 13 (54%) were available on both platforms, 5 (21%) were exclusive to Google Play, and 6 (25%) to the Apple App Store. Five (20.8%) offered user-tailored training modules; 8 (33%) involved medical professionals in development. Interrater agreement was high (k = 0.87; 95% CI, 0.80-0.95). Global quality scores based on the MARS dimensions ranged from 2.38 to 4.13, with a mean (SD) of 3.57 (0.43) across 24 apps, indicating generally acceptable quality. The functionality dimension received the highest score, while engagement scored the lowest. Brain HQ and Peak had scores above 4 and were rated as good, whereas Memory Trainer, Cognitive Skill Training, and Ginkgo Memory & Brain Training scored below 3 and were rated as insufficient. Spearman correlation showed no significant association between mean score and app rating. CONCLUSIONS Current cognitive training apps for older adults with cognitive impairment demonstrate moderate quality with considerable variability. Improvements are needed in the Engagement and Information dimensions. Future development should prioritize enhancing user engagement, incorporating personalized features, and involving healthcare professionals and experts to align with evidence-based guidelines.