The integration of digital technologies in the care of older adults with Mild Cognitive Impairment (MCI) or Mild Dementia (MD) is transforming how personalised care plans are designed and implemented. However, for these solutions to be truly useful, they must be not only technically functional but also effective, efficient, and, above all, usable by their primary users. The European CAREPATH project has tackled this challenge through a rigorous Technical Validation and Usability (TVU) study involving a pilot group in Albacete, Spain, applying internationally recognised tools to measure user experience.

CAREPATH is an integrated system that combines motion and temperature sensors, self-monitoring devices and the tablet with an application that includes the personalized care plan for each patient. This solution aims to promote patient autonomy, improve quality of life, and enable remote monitoring by healthcare professionals. The validation study in Spain involved installing the system in the homes of four older adults with MCI or MD, who used CAREPATH over a three-month period. Although no clinical interventions were made during this phase, participants were closely monitored through telephone interviews, reinforcement tasks, and evaluation questionnaires.

To assess the system’s efficiency, effectiveness and usability, three standardised questionnaires were used: the System Usability Scale (SUS), the User Experience Questionnaire (UEQ) and the Single Ease Question (SEQ). These instruments allow for the evaluation of different dimensions of user experience, from ease of use to overall satisfaction, and are widely used in the field of user-centred design, especially in digital health contexts.

The SUS is one of the most commonly used questionnaires for evaluating perceived usability of technological systems. It consists of 10 items rated on a five-point Likert scale and provides an overall usability score ranging from 0 to 100. The CAREPATH study observed a positive progression, from 51.87 after one month of use to 63.75 at the end of the study. This reflects an improvement in perceived usability as users became more familiar with the system [Brooke, 1996].

The UEQ, on the other hand, evaluates user experience from a broader perspective, measuring dimensions such as attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty. It uses a 7-point bipolar scale ranging from -3 (very negative) to +3 (very positive). Results from the study also showed significant improvements in key dimensions such as efficiency and dependability, reinforcing the idea that the system became more understandable and reliable over time [Laugwitz et al., 2008].

Lastly, the SEQ is a very simple yet useful tool that asks users how easy it was to complete a specific task, on a scale from 1 to 7. In CAREPATH, participants gave multiple ratings throughout the study, with a median score of 6 and a lowest score of 4, indicating a general perception of good to very good usability [Sauro, 2009].

In addition to these quantitative tools, the research team also conducted 11 telephone interviews with each participant, aiming to identify errors, difficulties, or suggestions for improvement. This qualitative data complements the findings from the questionnaires and offers deeper insight into how users interact with the system in their everyday environments. This mixed-methods approach — combining objective metrics with direct user feedback — is key to developing truly user-centred solutions for older adults [Zapata et al., 2015].

The overall results of the study are encouraging. CAREPATH has proven to be a usable and adaptable system for older people with mild cognitive impairment or mild dementia and multimorbidity, laying the groundwork for larger-scale deployment. The system is currently being evaluated in other countries participating in the project, such as Romania and the United Kingdom, which will allow for a broader and more multicultural perspective on its applicability and acceptance.

In conclusion, assessing usability, efficiency and effectiveness in technological systems for the care of older adults is not merely a technical matter but a crucial factor in ensuring their success. CAREPATH stands as an example of how to integrate advanced technology with rigorous, person-centred evaluation, paving the way towards more personalised and sustainable care.