Abstract
BACKGROUND: Smartphones have become deeply embedded in daily life, supporting a range of social and practical activities. Individuals with dementia can potentially use smartphones to compensate for cognitive decline and maintain independence. However, while smartphones are widely studied in controlled research settings, little is known about how individuals with dementia spontaneously use them in everyday life. Understanding usage patterns and their potential link to social participation could inform strategies to support smartphone use in their social and practical daily activities. OBJECTIVE: This study aimed to identify factors associated with spontaneous smartphone use, describe usage patterns, and examine whether smartphone use is associated with participation in social activities. METHODS: In 2024, we conducted a cross-sectional survey among community-dwelling individuals with mild to moderate dementia from 17 medical facilities in Tokyo. Structured questionnaires were completed by the participants, their families, and attending physicians. Participation in social activities was assessed using the "Spending Time with Others" subscale of the Social Functioning in Dementia (SF-DEM) scale. Factors associated with smartphone use were analyzed using multinomial logistic regression. Associations with participation in social activities were assessed via hierarchical linear regression. RESULTS: Among 151 participants with a mean age of 82.9 (SD 6.6) years, 43 (29%) participants were regular smartphone users. Smartphone use was negatively associated with older age (odds ratio [OR] 0.41, 95% CI 0.21-0.80) and positively associated with longer education (OR 1.82, 95% CI 1.00-3.30), living alone (OR 3.17, 95% CI 1.08-9.31), and better cognitive function (OR 2.14, 95% CI 1.24-3.69). Common uses included calling, texting, taking photos and videos, and checking the news and weather. Smartphone users reported marginally more frequent participation in social activities than nonusers did (b=1.41, 95% CI -0.01 to 2.83), particularly visiting the homes of friends or family (b=0.43, 95% CI 0.08-0.78) and shopping together (b=0.49, 95% CI 0.15-0.83). CONCLUSIONS: Despite their limited use at the time of this writing, commercial-based smartphones have the potential to support participation in social activities among individuals with dementia. Targeted support may help bridge the gap between this usage and the broader capabilities of these devices, enhancing their role in sustaining meaningful social participation.