Development and Effectiveness of an AI Chatbot-Based Mobile Cognitive Screening and Customized Training Application for Preventing Dementia: Older Adults Living in Rural Areas of South Korea

Background Dementia, a prevalent condition among the elderly, has emerged as a significant social issue in South Korea due to the nation’s aging population. Given the absence of a cure for dementia, early detection and proactive prevention measures are crucial. This study seeks to evaluate the efficacy of an artificial intelligence (AI) chatbot-based mobile health (mHealth) application, specifically designed for the early detection and customized cognitive enhancement training for dementia prevention. Methods A total of 123 older adults from rural South Korea were randomly assigned to an intervention group (n = 84) or a control group (n = 39). The intervention group participated in a 6-week cognitive assessment and customized cognitive enhancement training app, and an AI chat-based motivational program, while the control group engaged in traditional offline dementia prevention programs such as art therapy, exercise, and group singing. The study evaluated whether the intervention group showed greater cognitive improvements. The analysis also examined app usage frequency, adherence rates, and differences in cognitive improvement between heavy and light users, as well as between cognitively normal and cognitively impaired participants. Interviews were conducted with participants, and both quantitative and qualitative analyses were employed to evaluate the outcomes. Results The results of the study demonstrated significant improvements in cognitive performance among the intervention group, whereas no statistically significant improvement was observed in the control group. Among the intervention group, both cognitively impaired and normal groups showed improvement in the cognitive function, with a larger effect in the impaired group. Higher app usage was linked to greater cognitive improvement. Engagement with the app increased over time, particularly influenced by daily mission reminders and chat-based gameplay, while awarding prizes did not impact user engagement. Conclusions This study demonstrates the effectiveness of an AI chatbot-based mHealth application, specifically designed for early screening and customized cognitive enhancement training for dementia prevention in older adults. The study presents a novel approach to prevent dementia among older adults.