Exploring the health benefits of a mobile-based multidomain lifestyle program for older adults living in assisted living facilities: a qualitative study

BACKGROUND: Cognitive decline stands as a significant factor contributing to disability and dependency among older adults. Multi-domain lifestyle (MDL) interventions are widely recognized for their effectiveness in preserving cognitive functioning in older adults with dementia. However, little is known about MDL interventions using technology-based approaches in older adults residing in assisted living facilities. This qualitative study aimed to explore both the perceived health benefits and challenges of using a mobile-based multidomain Silvia Program among older adults residing in assisted living facilities. METHODS: We conducted semi-structured, in-depth interviews to capture the health-related benefits and perspectives of the Silvia Program after a 12-week period. Ten participants (70% female; age range 66-93), all at risk of dementia (with MoCA scores between 18 and 25), were recruited from two local community assisted living facilities in the Midwestern area. Interviews were transcribed and analyzed by using Creswell's five-step qualitative data analysis. A constant comparative method was used to refine themes and ensure data saturation. Synthesized Member-Checking (SMC) and expert reviews were employed to validate findings. FINDINGS: We identified five salient themes resulting from Silvia Program participation. Participants reported three categories of perceived benefits: (a) Cognitive benefits, (b) psychological wellbeing, (c) Health-related behavior management, and two categories of challenges (d) Technology anxiety, and (e) Content issues. CONCLUSIONS: The present study provided suggestive evidence for supporting cognitive engagement, activities supporting psychological wellbeing, and health behavior regulation among residents in ALFs. Early technology anxiety and content-related challenges highlight the need for program refinement and tailored support to enhance usability and engagement in ALF settings. These findings addressed a critical gap in literature by demonstrating the feasibility and perceived value of a mobile-based MDL intervention for ALF residents and providing insights to inform future controlled trials.