Embedding digital cognitive support in a routine neurology pathway
How Hospital General de Granollers introduced PuntoCare through its neurology and neuropsychology services, and what 102 patients did with it in their first 60 days.
102
patients analysed over their first 60 days
71%
still active after 30 days
4
sessions per user per week on average
The challenge
For the neurology and neuropsychology teams at Hospital General de Granollers, a public hospital in the Barcelona region, the practical problem behind each diagnosis is visible every day: care is delivered in appointments, but the condition is lived at home, and the needs of people living with cognitive impairment are multidimensional rather than purely cognitive. The hospital's neuropsychology unit already works on exactly that, combining symptomatic medication with psychoeducation on healthy lifestyle changes and non-pharmacological therapy, including Cognitive Stimulation Therapy (CST), the most established non-pharmacological intervention in cognitive care. The challenge is reach and continuity: access to CST remains limited and uneven across regions, only 16% of people with dementia report adequate support from memory clinics, GPs or voluntary organisations, and between one consultation and the next, patients and families are largely on their own to keep those routines alive.
Digital tools could carry that support into the home, but their track record with older adults is poor: limited digital confidence, usability barriers and lack of integration into clinical pathways mean most health apps are abandoned within days. The team wanted to know whether a digital companion, introduced by clinicians as part of routine care, could extend what already works in the unit into patients' everyday lives.
The solution
PuntoCare was embedded directly into the hospital's existing care pathways, with no separate research infrastructure. In outpatient neurology and neuropsychology consultations, clinicians introduced the app as part of their usual psychoeducation on cognitive symptoms, gave patients an informational leaflet, and helped with the download where needed. In the Sant Jordi Daycare Hospital pathway, onboarding was more structured, with a guided first session and informal weekly check-ins.
At home, patients received a daily plan through the app: a mood and sleep check-in, six cognitive stimulation activities spanning memory, attention, language, logic, orientation and visuospatial skills, a set of physical exercise videos matched to their mobility level, and one or two wellbeing activities such as guided relaxation. Difficulty adapts automatically to each user's performance, and a points-based system with a customisable garden provides gentle progress feedback rather than competition.
No minimum dose was prescribed. Patients were simply encouraged to use the app as regularly as they could, alone or with a family member. This mattered for the evaluation: any engagement observed would reflect genuine adoption, not compliance with a study protocol.
The results
Of 109 total downloads, 102 users had at least 60 days of observation and were included in the analysis. Adoption of the app was near universal at the start: 94% completed onboarding and 91% went on to complete at least one activity.
The more demanding test was whether use would last. It did: 71% of users were still active 30 days after starting, and 54% were still active at 60 days, averaging four sessions per week. Over their first 60 days, users completed 1,917 cognitive stimulation activities and 1,499 full daily care plans.
Satisfaction matched the behaviour. Among survey respondents, 91% rated the experience 4 or 5 out of 5. Asked what they valued, users pointed to the clarity of the explanations, the variety of activities, and the exercises "that make you think".
"The daily games are entertaining and they exercise the mind."
Pilot participant, Hospital General de Granollers
Engagement was not uniform, and the evaluation says so openly: a group of highly engaged users sat alongside others who used the app only occasionally. That heterogeneity is itself a finding. It identifies the subgroup of patients who need more support, whether structured onboarding, carer involvement or clinician reinforcement, and it is shaping how PuntoCare is deployed at new sites.
What happened next
When the evaluation period ended, the clinical team asked to keep using PuntoCare with their patients, and the app remains in use at the hospital today. Conversations are underway with the hospital's management about how to make that continuity permanent, and the results are being prepared for submission to a peer-reviewed journal.