Older people with mild cognitive impairment engaged by social robot-based intervention: Benefits shown in multicountry long term trials (Preprint)

BACKGROUND Loneliness and social isolation are some of the several risk factors that contribute to dementia. Technology‑based interventions using socially assistive robots (SARs) and mobile apps may help not only to maintain cognitive functioning but also to support social connectedness and psychosocial wellbeing in older adults with mild cognitive impairment (MCI); however, evidence from multicountry trials remains limited. OBJECTIVE The proof‑of‑concept (PoC) evaluated the benefits of the engAGE platform, a hybrid intervention combining a social robot, mobile app, and wearable activity tracker, designed to support both social connectedness and cognitive functioning in older people with MCI across three European countries. METHODS Older adults with MCI were recruited in Italy, Switzerland, and Norway. The 6‑month intervention combined weekly robot‑guided group sessions with daily tablet use and continuous activity tracker wear at home. Outcomes were assessed at baseline and post-test and included subjective memory complaints as primary outcome (MAC‑Q), and global cognition (MoCA), loneliness (UCLA), quality of life (QoL‑AD and EQ‑5D‑5L VAS), and mental wellbeing (WEMWBS) as secondary outcomes. Also, usability and acceptance were assessed through SUS and UTAUT after 3 and 6 months of intervention. Intra-group and inter‑group differences in change were explored for any dimension to determine the effects of the intervention. RESULTS Of 50 enrolled participants, 44 (36 assigned to the experimental group - EG; and 8 to the control group - CG) completed the final assessment and were included in the analyses. The subjective memory complaints reduced significantly from 26.41 (±2.23) to 25.22 (±3.19) in the EG, whereas remained unchanged in the CG (26.75 ±0.71). MoCA scores remained stable overall (EG: 23.51 ±2.16 to 23.44 ±3.21), with no significant differences between groups. Psychosocial outcomes showed a mixed pattern: in the Italian EG, loneliness decreased significantly (UCLA: 45.18 ± 9.61 to 37.94 ± 6.56), whereas in Switzerland significantly worsened (p=.021). Also, the self‑rated health (EQ‑5D‑5L-VAS) improved significantly in the EG (p=.013), but no significant differences were detected between groups. Overall QoL‑AD and WEMWBS scores remained broadly stable. SUS scores in the EG improved significantly (p=.020) from 58.81 (±18.17) to 68.54 (±18.54), reaching the commonly accepted usability threshold. CONCLUSIONS The engAGE hybrid intervention, combining robot‑guided group activities with home‑based tablet use and activity monitoring, was delivered across three different socio‑healthcare contexts and showed preliminary benefits in subjective memory, selected psychosocial measures, and usability. CLINICALTRIAL ClinicalTrials.gov NCT06302686; https://clinicaltrials.gov/study/NCT06302686 INTERNATIONAL REGISTERED REPORT RR2-10.2196/67601