Promoting digital memory aid use in older adults with cognitive concerns: A pilot randomized controlled trial of adaptive web-based training

OBJECTIVE: This pilot study evaluated a web-based adaptive training platform for teaching older adults with cognitive concerns to use the Electronic Memory and Management Aid (EMMA), a digital cognitive support tool. Outcomes were compared between a self-guided, technical support-only condition and a clinician-supported (M + T) condition that included motivational enhancement. METHOD: Primarily White, community-dwelling older adults with self-reported cognitive concerns (N = 62) were randomized to one of two conditions. Over 4 weeks, 49 participants successfully completed six adaptive, web-based lessons. The M + T group received weekly clinician-led motivational sessions; both groups had access to technical support. Primary outcomes assessed at baseline and 3 months posttraining included EMMA app usage, everyday function, and self-reported cognitive self-efficacy and health. Secondary outcomes included perceived cognition, coping self-efficacy, compensation use, and medication management. RESULTS: Both groups showed comparable EMMA engagement and improvements in applied everyday cognition (η² = .14), with no significant group-by-time interaction. Medium effect sizes (η² = .06-.09) were observed for other outcomes but did not reach significance. App usage did not predict improvements in applied everyday cognition; however, participants with lower baseline self-efficacy and greater perceived cognitive difficulties used the app more frequently. Qualitative feedback highlighted EMMA's usability and benefits for daily organization, alongside barriers to sustained use. CONCLUSIONS: A self-guided, adaptive training platform with minimal clinician support may be sufficient to promote engagement with a digital memory aid. Findings support scalable digital interventions and underscore the role of perceived need in technology adoption. (PsycInfo Database Record (c) 2026 APA, all rights reserved).