60 days of self-directed cognitive care at home
Hospital del Mar's Geriatrics team asked a harder question: what happens when older adults are given PuntoCare and then left entirely to their own devices?
67
patients followed for a full 60 days, of 122 enrolled
7,012
cognitive games completed in 60 days
51.7%
still active at 30 days
80%
rated their general satisfaction positively
The challenge
Most digital health pilots succeed with scaffolding: reminder calls, scheduled follow-ups, a nurse checking in when usage drops. That support improves results, but it hides the answer to the question every health system eventually asks: will patients use this on their own? Any tool that only works with intensive clinical support will struggle to scale, because clinical time is precisely the resource in shortest supply.
The Geriatrics team at Hospital del Mar in Barcelona designed their pilot to answer that question directly, choosing the least favourable conditions they could: older adults, many living with cognitive impairment, using a health app at home with essentially no support from the clinic.
The solution
The deployment was deliberately minimal. During a routine visit, patients received an informational leaflet with instructions. They downloaded PuntoCare onto their own phone or tablet, and from that point on used it freely at home: daily plans combining cognitive stimulation, physical exercise, healthy habits and relaxation, with the app's own optional reminders as the only nudge. No scheduled follow-up calls. No appointments about the app. Nothing that would not exist in a real deployment at scale.
The results
Recruitment at Hospital del Mar is ongoing, so this case study takes a fixed 60-day window on the 2026 cohort: of the patients enrolled since January 2026, 67 have so far reached at least 60 days of follow-up, and it's their first 60 days that are analysed here; more patients will qualify as recruitment continues. Within that cohort, 94% completed onboarding and 86.6% went on to use the program at least once, together completing 7,012 cognitive games and 799 full daily plans in their first 60 days. Nearly all patients (96.55%) completed at least one activity in their first week, and engagement held up well after that: 81% were still active after 7 days, 51.7% after 30 days, and 41.4% were still active a full 60 days after joining, entirely on their own initiative.
Adherence varied across the cohort, which the team now uses to guide outreach: 20.7% of patients engaged consistently throughout the full 60 days, while 67.2% showed lower, more intermittent adherence. First-week activation stayed strong regardless, at 96.55%, with a median of 55.56% of assigned tasks completed in the most recent 7-day window.
Self-reported outcomes echoed the usage data: 53.8% of survey respondents said they felt better in day-to-day life, another 53.8% reported improved physical functioning, and 38.5% felt less anxious, stressed or overwhelmed since starting the program. Overall, 80% rated their general satisfaction with PuntoCare positively.
To understand the experience behind the telemetry, the team ran two focus groups with participants. The picture that emerged was not of patients following a prescription, but of people who had made the app part of their day. Participants described PuntoCare as useful, easy to use, entertaining and with a clear purpose, and singled out the language and association games as favourites.
"It's great to be playing and having fun while you train your brain."
Pilot participant, Hospital del Mar
"I love the anagrams. When I can't solve one, I send it to the family WhatsApp group so they can help me."
Pilot participant, Hospital del Mar
That second comment captured something the team had not planned for: cognitive care becoming a source of family connection rather than a solitary task. The focus groups also surfaced two clear product lessons. Motivation fluctuates, and external reminders help users re-engage after quiet periods; and users want to see their own progress over time, as reinforcement to keep going. Both insights have fed directly into PuntoCare's development roadmap.
What happened next
Recruitment is still ongoing. By the end of July 2026, total enrollment had grown to 122 patients, of whom 112 (91.8%) had completed setup and 104 (85.25%) had used the program at least once.
The Geriatrics team's verdict was to expand. Work is underway to extend PuntoCare to the hospital's Neurology department, and a joint publication of the pilot's results is being planned with the clinical team.