Turning apathy into action in neurodegenerative disease: Development and pilot testing of a goal-directed behaviour app.
Dawn Mechanic-Hamilton, Sean Lydon, Sharon X Xie and 5 others
PMID 37128648WHAT IT FOUND
Patients with mild dementia used a goal-setting app for four weeks and achieved significantly more self-identified goals, particularly in brain health and housework.
However, this did not translate to improved daily functioning or reduced caregiver burden, and the study lacked a control group.
Key findings
01Participants achieved significantly more goals overall, specifically in brain health and housework, but not in body health or personal care.
02Goal attainment was not associated with improvements in patient anxiety, depression, or activities of daily living, nor with reduced caregiver burden.
03The study was a single-arm pilot without a control group or blinded raters, limiting the ability to attribute changes to the app.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study had no control group, so improvements in goals could be due to natural variation, placebo effect, or increased attention from researchers rather than the app itself. Raters were not blinded to the intervention, introducing potential bias in outcome assessment. The sample size was small (24 in Phase II) and heterogeneous (MCI, AD, and bvFTD combined), making it difficult to draw conclusions for any single diagnosis. Participants used dedicated study phones, not their personal devices, which may not reflect real-world engagement. The intervention lasted only four weeks, so long-term sustainability of behavior change is unknown. Participants were well-educated and recruited from a specialized academic center, limiting generalizability to the broader dementia population.
Declared interests
The authors declared no conflicts of interest. The study was funded by the National Institute on Aging (NIA) and the National Institute of Nursing Research (NINR).
The easy way to misread this
Do not interpret the significant goal attainment as evidence that the app improves daily functioning or reduces caregiver burden. The study found no association between achieving app goals and improvements in standard measures of activities of daily living, apathy, depression, or caregiver stress. The primary positive finding was limited to the specific, personalized goals set at baseline, not broader clinical outcomes.