A digital programme to prevent falls and improve wellbeing in people living with dementia in the community: Quantitative results from the KOKU-LITE feasibility study.

Background: Falls are common and costly among people living with Dementia (PLwD). Keep on Keep up (KOKU) is a UK National Health Service (NHS) approved tablet-based, digital gamified programme with strength and balance exercises and health literacy games, designed with and for older people at risk of falls. KOKU-LITE is a dementia-friendly accessible version of KOKU that has been co-developed with PLwD to meet their needs. This study aimed to assess the feasibility, usability and acceptability of KOKU-LITE among community dwelling PLwD in terms of recruitment, retention and user experience of the intervention. Methods: This is a two-arm, parallel, non-blinded, feasibility randomised controlled trial. Sixty people aged 55 years and over living with dementia were recruited across Greater Manchester, UK, and randomised to either intervention group (KOKU-LITE plus dementia falls prevention leaflet) or control group (dementia falls prevention leaflet). Intervention participants were asked to use KOKU-LITE for 30 minutes a day, three times per week for six weeks. Both groups were followed up to six weeks. Primary outcomes were feasibility, usability and acceptability assessed using recruitment and retention rates, and user experience measured by user experience questionnaire. Trial registration: https://clinicaltrials.gov/study/ NCT06149702 . Findings: Sixty participants (30 intervention, 30 control) were recruited and followed up between March 2024 to September 2025. Among those approached, 87% (60/69) consented to participate, 90% (54/60) were retained at six weeks follow up. Overall, the user experience findings indicated strong acceptability and generally positive perceived usability and engagement. No serious adverse events, including injurious falls, were reported during the intervention period. Interpretation: KOKU-LITE was feasible to deliver and acceptable to PLwD in a home-based community setting. Although the study was not powered to assess effectiveness, the findings support progression to a definitive trial, with refinement of outcome selection, intervention-use monitoring and follow-up duration. Funding: National Institute for Health and Care Research (NIHR) and Alzheimers Society (Award number: NIHR200174).