Digital Assistive Technology Acceptance and Use by Caregivers of Older Adults With Cognitive Impairment: Qualitative...

Population aging is associated with a rising number of people living with cognitive impairment (CI), straining traditional caregiving systems. More than 55 million individuals live with CI worldwide, while care delivery faces severe capacity constraints. China's rapid aging provides a context for examining the acceptance and use of digital assistive technologies (DATs) in CI care. Although DATs offer the potential to address this care gap, systematic evidence on acceptance and use remains limited.

This study examined caregivers' acceptance and use of DATs in CI care, applying the Technology Acceptance Model (TAM) framework to identify key facilitators and barriers shaping acceptance and effective technology integration in caregiving environments.

This qualitative study used semistructured interviews and thematic analysis to examine the use of DATs and identify facilitators and barriers shaping caregivers' acceptance of DATs. Purposive sampling recruited 15 primary caregivers of people with CI across varying decline stages. The study focused on caregivers of people with CI aged 60 years and older. Caregivers were selected as participants because they serve as the primary decision-makers and technology facilitators in CI care.

In CI care, DATs served 5 primary functional domains. Caregivers identified perceived usefulness and ease of use as primary acceptance facilitators. Factors shaping acceptance emerged across 3 dimensions: technological design factors, user psychological factors, and external environmental factors.

The findings suggest that traditional TAM constructs may benefit from contextual adaptation. The acceptance of DATs is not merely an individual assessment of usefulness or ease of use but also a relational and socially mediated process shaped by emotional dependence, family attitudes, technology anxiety, and support systems. Technology may therefore need to evolve dynamically across different stages of cognitive decline, while human caregivers remain irreplaceable in providing emotional support, personalized judgment, and crisis management. Effective DAT integration requires coordinated efforts among relevant stakeholders.