Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a “GRADIOR” computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. Method: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60–90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2–3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann–Whitney was used. Results: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. Conclusions: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent.

Objective: To provide high-quality elderly care, digital health technologies (DHTs) can potentially assist in reaching the full capacity of comprehensive geriatric assessments (CGAs) to improve communication and data transfer on patients’ medical and treatment plan information and health decision-making. This systematic review aimed to describe the evidence on the feasibility and usability, efficacy and effectiveness, and implementation outcomes of DHTs developed to facilitate the administration of CGAs for long-term care settings or community care and to describe their technical features and components. Methods: A search strategy was conducted in three databases, targeting studies evaluating the DHTs facilitating the administration of CGAs used in long-term care settings or community care. Studies in English and Spanish published up to 5 April 2023 were considered. Results: Four DHTs supporting the administration of the CGAs were identified. Limited information was found on the technical features and required hardware. Some of the barriers identified regarding usability can be overcome with novel technologies; however, training of health professionals on the assessments and staff knowledge regarding the purpose of the data collected are not technology related and need to be addressed. Conclusions: Barriers regarding usability were related to experienced difficulties navigating the software, unstable network connectivity, and length of the assessment. Feasibility obstacles were associated with the lack of training to use the DHT, availability and accessibility to hardware (e.g. laptops), and lack of insight into the clinical benefits of collected data. Further research must focus on these areas to improve the implementation and usefulness of these DHTs.

En el proceso de envejecimiento, se produce un declive cognitivo debido a la edad. El deterioro cognitivo es uno de los síntomas más comunes de enfermedades neurodegenerativas como la demencia. A lo largo de décadas se han desarrollado diferentes tipos de intervenciones cognitivas y enfoques con el objetivo principal de mejorar o mantener las capacidades cognitivas de las personas mayores. Tal es el caso de la rehabilitación cognitiva por ordenador, que se ha mostrado como una forma eficaz de estimulación capaz de mejorar el funcionamiento cognitivo en personas mayores. El presente documento describe el programa de rehabilitación cognitiva por ordenador gradior 4.5 (última versión), especificando sus diferentes componentes, metodología de aplicación y sus aspectos más relevantes. La experiencia desarrollada durante los más de 20 años de existencia del programa con miles de pacientes provenientes de diferentes dispositivos y los diferentes estudios de eficacia y usabilidad desarrollados, con el fin de satisfacer las necesidades, capacidades, limitaciones y preferencias de los usuarios, han dado lugar a esta nueva versión mejorada que la convierte en una herramienta flexible, dinámica, sencilla, útil y fácil de usar.

EhcoBUTLER is a tablet platform mainly aimed at the elderly with mild cognitive impairment (MCI) to promote their well-being and health. The main objective of this study was to explore the perceptions and feedback level of the ehcoBUTLER potential users and stakeholders to improve its development. Through this exploration, the secondary objective was to contribute to the development of software/apps that promote their integral health. Focus groups were conducted (13 elderly with MCI, 13 with dementia, 12 caregivers, 11 professionals). The content and feedback level were analyzed. Participants liked the appearance of ehcoBUTLER, would like to use it, and were mainly interested in the emotional, healthy lifestyle, cognitive, and ergonomic tools. It is necessary to have prior training, more intuitive/customizable apps, low-price/free, offline/USB content, and add other activities/features. EhcoBUTLER is well-oriented to meet the needs and preferences of potential users. However, improvements in its usability, accessibility, and sustainability are needed. The participants’ perspectives provided a comprehensive view to improve ehcoBUTLER, so that in the future, it can benefit the elderly to be active agents in their health; support caregivers in their role and to have a respite; and professionals to have a multi-intervention platform. The present findings can contribute to the development of tablet software/apps that promote the integral well-being of this population.

Background: This study provides an analysis on the use of emerging technologies for the prevention of suicide in 8 different European countries. Objective: The objective of this study was to analyze the potentiality of using emerging technologies in the area of suicide prevention based on the opinion of different professionals involved in suicide prevention. Methods: Opinions of 3 groups of stakeholders (ie, relevant professionals in suicide field) were gathered using a specifically designed questionnaire to explore dimensions underlying perceptions of facilitating factors and barriers in relation to the use of emerging technologies for suicide prevention. Results: Goal 1 involved facilitating factors for the use of emerging technologies in suicide prevention. Northern European countries, except for Belgium, attach greater relevance to those that optimize implementation and benefits. On the other hand, Southern European countries attach greater importance to professionally oriented and user-centered facilitating factors. According to different stakeholders, the analysis of these facilitating factors suggest that professionals in the field of social work attach greater relevance to those that optimize implementation and benefits. However, professionals involved in the area of mental health, policy makers, and political decision makers give greater importance to professionally oriented and user-centered facilitating factors. Goal 2 was related to barriers to the usability of emerging technologies for suicide prevention. Both countries and stakeholders attach greater importance to barriers associated with resource constraints than to those centered on personal limitations. There are no differences between countries or between stakeholders. Nevertheless, there is a certain stakeholders-countries interaction that indicates that the opinions on resource constraints expressed by different stakeholders do not follow a uniform pattern in different countries, but they differ depending on the country. Conclusions: Although all countries and stakeholders agree in identifying resource constraints as the main barrier to the use of emerging technologies, factors facilitating their use in suicide prevention differ among countries and among stakeholders.

Background: Mental health problems frequently emerge during adolescence and young adulthood, yet many young people do not seek or receive timely support. Digital mental health interventions, including serious games and gamified tools, may improve accessibility and engagement, but evidence for their feasibility and preliminary efficacy across diverse European settings remains limited. Objective: This protocol describes the evaluation and trial component of the SMILE (Supporting Mental Health in Young People: Integrated Methodology for Clinical Decisions and Evidence-Based Interventions) project, which aims to evaluate the acceptability, feasibility, reach, and preliminary efficacy of a cognitive behavioral therapy (CBT)–informed gamified mobile intervention for adolescents and young adults, and to explore mechanisms of change and the impact of its implementation contexts. Methods: SMILE uses a cluster-randomized, multisite, multiarm adaptive proof-of-concept design across 7 European countries, complemented by semistructured stakeholder interviews. Adolescents and young adults aged 10‐24 years are recruited mainly through schools, universities, and community channels; the target sample is 1438 participants. Clusters are assigned to 1 of 3 sequences comprising a neutral baseline period followed by 2, 4, or 5 game modules, and are randomized to a feedback or no-feedback version of the intervention. The intervention consists of the SMILE Game App (Nurogames and DigitalTwin Technology) and Companion App (RDIUP), which deliver CBT-based gamified content, self-monitoring, experience sampling, and, in one of the study conditions, automated personalized feedback. Primary outcomes are anxiety and depression. Secondary outcomes include well-being, resilience, emotion regulation, self-efficacy, and social anxiety. Feasibility, acceptability, engagement, app usage, in-game metrics, and diary-based digital markers are also assessed. Quantitative data will be analyzed using linear mixed-effects models with adaptive interim analyses. Qualitative stakeholder interviews with young people, their legal guardians, school professionals, and clinicians will be analyzed using inductive thematic analysis within a mixed-methods realist evaluation framework. Results: The proof-of-concept trial was prospectively registered on April 29, 2025 (ISRCTN32523126). Study rollout is taking place from September 2025 to June 2026. As of March 2026, recruitment is ongoing, 2 study sequences have been completed, and the third sequence began at the end of March 2026. Primary results are expected in September 2026. Conclusions: SMILE is designed to generate evidence on the feasibility, acceptability, and preliminary efficacy of a scalable gamified mental health intervention for young people across diverse European contexts. The findings will inform intervention refinement, evaluation of the added value of personalized feedback, and the design of a future definitive randomized controlled trial and broader implementation in educational and clinical settings.