A Multidimensional Digital Health Platform to Support Intrinsic Capacity and Healthy Aging: Usability, Acceptance, and Impact in a Multicenter European Pilot Study (Preprint)

BACKGROUND By 2050, nearly 22% of the world's population will be 60 years of age or older, with Europe experiencing remarkably rapid demographic ageing. This demographic shift coincides with the increasing prevalence of chronic diseases and functional decline among older adults, challenging traditional healthcare delivery models. The World Health Organization's concept of healthy aging emphasizes the preservation of functional capabilities through the optimization of Intrinsic Capacity (IC), the totality of all physical and mental abilities across five domains: locomotion, vitality, sensory, cognition, and psychology. Digital Health Solutions (DHS) offers promising approaches to support aging populations through remote monitoring and integrated care; however, significant barriers remain, including low digital literacy and usability challenges among older adults. OBJECTIVE To evaluate the impact of a multidimensional, AI-driven digital health platform (CAREUP) on the dynamic monitoring and personalized enhancement of Intrinsic Capacity in community-dwelling older adults, integrating real-time physiological, cognitive, and behavioral data streams. METHODS A mixed-methods pilot study was conducted across three European countries (Italy, Romania, and Austria) from September to December 2024, enrolling 66 primary users (older adults aged 65 years or older) and 17 secondary users (caregivers). The CAREUP platform integrates Android applications (Careplan and Positive Health apps), smart devices for health monitoring, and an online dashboard. Primary outcomes included system usability, assessed by the System Usability Scale (SUS); user experience, measured by the User Experience Questionnaire short version (UEQ-S); and acceptance, evaluated through qualitative questionnaires. Secondary outcomes encompassed physical and mental health measures, quality of life indicators, and caregiver workload assessments at three-time points (T0, T1, T2). RESULTS Of 66 enrolled participants, 61 primary users (37 women, 24 men; mean age 73.9 years) completed the study. The overall SUS score was 68, indicating acceptable but improvable usability, with significant variations across countries. The UEQ-S score of 1.45 indicated a good overall user experience, with high Hedonic Quality (1.66) suggesting emotional appeal and Pragmatic Quality (1.23) reflecting above-average usability. Most participants (49/61, 80.3%) evaluated the platform as interesting, helpful, and efficient, with 48/61 (78.7%) willing to recommend it to friends. Secondary outcomes demonstrated stable physical and mental health, as well as maintained independence in daily activities. Technical connectivity issues and device complexity emerged as primary barriers to adoption. CONCLUSIONS The CAREUP platform demonstrated the feasibility of monitoring Intrinsic Capacity in older adults, achieving an acceptable level of usability and a positive user experience despite technical challenges. Country-specific variations in acceptance highlight the importance of cultural adaptation and digital literacy considerations in platform deployment. Future iterations should prioritise technical reliability, interface simplification, and enhanced user support to optimise adoption and sustained engagement among ageing populations. CLINICALTRIAL The study was registered on ClinicalTrials.gov with the ID number NCT05963399.