Study: mHealth Chatbots Fail to Meet Demands in Dementia Care

mHealth apps that function as chatbots may have great potential in engaging with patients living with dementia, but they aren’t there yet, according to a new study.

Researchers from the University of California at Riverside, working with colleagues from the University of Alabama and Florida International University, tested six mHealth apps with chat functions for productivity, effectiveness, functionality and humanity and overall satisfaction, including affect, ethics and behavior. None of them passed the test, according to a study published in the Journal of Internet Research.

“Dementia care is complex and no two cases of dementia are alike,” Nicole Ruggiano, a professor of social work at the University of Alabama and the study’s co-first author, said in a new release published by UC Riverside. “Chatbots have the potential of providing caregivers with instant support that is evidence-based and personalized. While it was promising to find some advancements in this area, it was disappointing to learn that more hasn't been done.”

The study points to the challenges of measuring functionality against hype. Chatbots like Amazon Alexa and Apple’s Siri might seem commonplace in smartphones and smart homes these days, but they’re still trying to find their place in connected health services. The potential for boosting patient engagement and medication management and allowing patients to access online healthcare resources is there – and in some instances those tools are being used - but the chatbots now on the market haven’t yet proven their value in dementia care.

“Artificial intelligence chatbots have great potential to improve the communication between patients and the healthcare system, given the shortage of healthcare staff and the complexity of the patient needs,” corresponding author Vagelis Hristidis, a professor of computer science in UC Riverside’s Marlan and Rosemary Bourns College of Engineering and founder of SmartBot360, a healthcare chatbot company, said in the release. “This is especially important for dementia patients and caregivers, who keep increasing as the population ages, and face care challenges daily.”

“In regards to the use of a chatbot by dementia caregivers, there are many content areas family caregivers may find helpful,” added co-first author Ellen Brown, the Erica Wertheim Zohar Endowed Chair in Community Mental Health at Florida International University. “Caregivers are confronted by increasing care coordination challenges, and a decline in function and overall well-being of the person living with dementia. Additionally, a new caregiver may look for very different resources and information than a more experienced caregiver.”

Ruggiano and her colleagues found that the apps they tested focused more on interaction and access to resources than caregiving skills, but few had adequate privacy and ethics safeguards in place. In all, they found that the apps didn’t offer enough content to be attractive or useful, and they weren’t helpful at all for caregivers.

The researchers said the apps’ limited program content “made it hard to have extended or varied conversations between users and chatbots.” This could limit the effectiveness of the app or the support they provide to patients and their caregivers, especially in a field as vast and complex as dementia care. They also said it wasn’t clear where the information offered by the apps came from.

“Although chatbot technologies are well established and commonly used by the public, their development for people with dementia and their caregivers is in its infancy,” the study concluded. “Given the successful use of chatbots in other health care settings and for other applications, there are opportunities to integrate this technology into dementia care. However, more evidence-based chatbots that have undergone end user evaluation are needed to evaluate their potential to adequately educate and support these populations.”