Six months 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?
58
activated users, from 67 downloads
4,684
cognitive exercises completed
3
sessions per user per week on average
6
months of sustained, unsupported use
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
Over six months, 67 people downloaded the app and 58 of them (87%) completed onboarding and became active users. Together they completed 4,684 cognitive stimulation exercises and 605 full daily plans, averaging three sessions per week. Thirty-day retention was 38%, and long-term usage stabilised at around one in five users still active at six months, entirely on their own initiative.
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
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.