The increase in life expectancy in recent decades has catalysed a significant increase in the elderly population worldwide, which in turn has contributed to a marked increase in the prevalence of age-related neurodegenerative diseases, with Alzheimer's disease (AD) being the most prevalent form of dementia (1). AD accounts for 60%–70% of dementia cases worldwide, and is characterised by progressive cognitive decline, behavioural changes, and loss of autonomy (2). It is estimated that 55 million people worldwide currently live with dementia, a figure expected to almost triple to 152 million by 2050, highlighting a critical public health challenge (1). Spain reflects this global trend, with over 900,000 people currently affected by Alzheimer's disease (AD) or related dementias. This figure is expected to double within the next two decades (3). In Catalonia specifically, around 90,000 people currently live with AD or related dementias (4).

Informal care plays a key role in managing the multifaceted needs of people with dementia, especially as the disease progresses. Informal caregivers, often close family members, but also neighbours or friends, provide unpaid daily support ranging from assistance with activities of daily living, symptom management, and emotional support to coordinating medical care (5–7). Evidently, these caregiving responsibilities entail complex and changing physical and cognitive demands, requiring caregivers to possess specific knowledge and skills to perform their roles effectively (8, 44). Different studies have shown that caregivers, particularly those of people with dementia, experience higher levels of psychological burden and distress compared to caregivers of other populations (9). Emotional stress can lead to increased anxiety and depression and a significant reduction in quality of life, demonstrating the significant impact that caring for others can have on an individual's well-being (10, 11). These emotional challenges are often exacerbated by the practical stresses of managing caregiving tasks, which can lead to fatigue and social isolation (12). Furthermore, studies such as that by Stall et al. (13) have demonstrated that caregiver distress exacerbates the health of individuals with dementia, leading to higher rates of institutionalisation and intensifying the behavioural and psychological symptoms of the disease.

In this context, a wide range of formal interventions have been developed to support these informal caregivers, ranging from educational programmes, psychosocial support and respite care to structured training modules (14–16). These programmes have been shown to reduce caregiver stress, improve quality of life for both caregivers and patients, and reduce healthcare costs, while alleviating the burden on health and social services. However, substantial differences remain between the availability of support interventions and their use and acceptability among caregivers (17).

Contributing factors include rigid service delivery models, a lack of services that meet caregivers' needs, difficulties accessing services, and a failure to consider caregivers' individual circumstances and preferences. Research by Morrisby et al. (18) revealed that services focusing on empowering disabled people and their caregivers achieved better outcomes than unresponsive, inflexible services. According to these authors, caregivers often find it difficult to recognise their own needs, which can hinder access to adequate support. Regarding caregivers of people with AD, the main unmet needs include acquiring specific and in-depth knowledge about AD, receiving guidance on available services and support, managing physical and psychological health, and maintaining social support networks, which are vital for emotional resilience (7, 12).

A particularly neglected area is that of caregivers' information needs. Rutkowski et al. (19) identified a mismatch between information products and caregivers' information behaviour—the generation, acquisition, management, use, communication, and search for information. As Sbaffi et al. (20) state, caregivers require more than just the knowledge that information is available 'somewhere', as each situation is different in terms of the stage of the disease, the severity of the condition, and the geographical location of the support network. Therefore, information must be personalised and context-sensitive rather than generic.

Thus, technology-based support interventions have attracted growing interest as promising solutions to these challenges (17). Digital platforms, mobile health applications, and online educational resources can provide caregivers with timely information, peer support, and training in a scalable, flexible, and personalised way, regardless of geographical and time constraints. For instance, mobile health applications have been shown to improve communication and daily care activities for caregivers of individuals with mild cognitive and communicative impairments (21). However, for digital interventions to be truly effective, they must be carefully tailored to the diverse needs, preferences, and digital literacy levels of caregivers.

Digital literacy is defined here as the ability to use digital technologies effectively and is a determining factor in the acceptance and sustained use of technology among caregivers, many of whom are older adults with limited prior exposure to technology (22). Socioeconomic factors, age, education, and confidence influence digital participation, constituting critical barriers to technology access among this population (23). In Catalonia, the digital divide is particularly pronounced among individuals over 65 years of age (23). The same authors define the digital divide as significant disparities between those who can access and benefit from digitalisation and those who cannot be due to economic, technical, or digital literacy constraints.

Many existing digital platforms are significantly limited by a lack of user-centred design and empirical evaluation that considers the end user's experience (7, 12). Participatory design approaches, which actively involve caregivers throughout the design, development, and evaluation processes, have been identified as the best way to ensure the tools are relevant, usable, and adopted (21, 24). This inclusive methodology facilitates the creation of tools that better address the complex realities of caregiving and the adaptive nature of dementia progression. Rigorous mixed-methods research approaches are essential for properly addressing caregivers' needs and ensuring the quality of technological interaction (25–28).

In contemporary digital health innovation, active user involvement is crucial for developing technologies that effectively support family caregivers of people living with dementia. Co-creation is a collaborative process that brings together diverse stakeholders—including users, clinicians, technical experts and organisational actors—to jointly identify problems, generate ideas and shape solutions. This innovation-driven approach emphasises inclusive participation, shared decision-making and iterative prototyping to produce scalable, sustainable and collectively owned outcomes (29–31). Co-creation fosters dialogue across social and professional boundaries, helping to address structural barriers and enhance health equity by integrating lived user experiences and multiple forms of expertise (29, 31, 32).

As research projects advance from conceptualisation toward development and evaluation, Participatory Design (PD) often becomes the preferred methodology to deepen user engagement. Unlike broader co-creation frameworks, PD centres on the experiential knowledge of end-users, such as family caregivers, involving them continuously through cycles of ideation, prototyping and testing. This dialogic, context-sensitive approach addresses users' real-life needs, cultural considerations and ethical demands, enhancing the usability and acceptability of digital health interventions (30, 31). PD not only ensures that users' voices decisively shape the iterative refinement of solutions but also supports mutual learning between developers and participants, resulting in more adaptable and sustainable technologies (29, 31).

The evolution of digital platforms for family caregivers of people with Alzheimer's disease reveals a continuously transforming field, profoundly shaped by technological innovation and a growing recognition of caregivers' emotional, informational, and organizational needs. Early digital solutions in the 2000s focused primarily on information provision through basic web pages and community forums, marking the initial democratization of specialized knowledge and fostering virtual support communities for geographically or socially isolated caregivers. Over time, digital caregiving tools have advanced to integrate sophisticated technologies—such as artificial intelligence, geolocation, and home automation—which now underpin interactive, personalized systems aimed at improving both care management and caregiver well-being. Current digital platforms for caregivers act as hybrid spaces for technological and social intervention. Their main functions include digital intermediation (linking families with professionals and services), integrated care management (planning, communication, and monitoring), and community-based training and support, thereby empowering caregivers and facilitating informed decision-making. In recent years, the detected need is to move from unidirectional information dissemination to the participatory co-creation of user-centred environments, integrating caregivers' perspectives to address practical, emotional, and relational challenges associated with Alzheimer's care with more impact.

In this context, the project “Creation of a comprehensive digital platform in the field of Alzheimer's disease in Catalonia” aims to develop and implement a free, comprehensive, user-centred and scalable digital platform designed specifically to support informal carers of people with AD in Spain and Catalonia. The AreaAlzheimer platform seeks to address unmet informational and training needs and other critical challenges faced by carers through technological empowerment., with the goal of improving well-being, care quality and social inclusion. It embodies a holistic approach to dementia-care support, integrating training, knowledge dissemination, community building and research functions to offer flexible and personalised assistance that responds to users' real-life situations, while also helping to reduce digital inequalities and foster a broad community of caregivers.

The aim of this article is to present the AreaAlzheimer digital platform and the empirical work underpinning its development. More specifically, this study has three research objectives: (1) to identify and analyse the social, informational and technological needs, expectations and practices of family caregivers of people with AD in Catalonia; (2) to translate these findings into the co-design and development of the AreaAlzheimer platform, defining its content, structure and core functionalities across its information, training, community and research components; and (3) to implement and pilot the prototype with family caregivers, assessing its usability, accessibility, perceived usefulness and intention to use.

AreaAlzheimer is part of a project entitled Creation of a Comprehensive Digital Platform in the Field of Alzheimer's Disease in Catalonia, funded by resources granted by the Department of Social Rights within the framework of the Recovery, Transformation and Resilience Plan, which in turn is financed by the European Union through the Next Generation program.

AreaAlzheimer is a bilingual Spanish and Catalan open-access platform aiming to support informal caregivers of people with Alzheimer's disease.

The information section categorises Alzheimer's resources and topics based on their most preferred content. Content is tagged to connect it with user preferences. This way, all users have access to a personalized content section (Figure 1).

Digital community channels the exchange of knowledge and experiences among people who share a connection with Alzheimer's disease. This section focuses on peer-to-peer connection (Figure 2).

Training and support programs offered by the Pasqual Maragall Foundation are held by professionals, providing access to a virtual classroom environment where they are carried out (Figure 3).

Investigation section contributes to generating specialized knowledge in the field of Alzheimer's disease care and makes this information available to users of the platform (Figure 4).

Through the home page, users can navigate to the different sections, while having access to other cross-cutting tools such as event calendar (Figure 5) and webinars (Figure 6) when published.

The AreaAlzheimer project offers a case study on the implementation and challenges of technology-based interventions for informal caregivers of people with Alzheimer's disease in Catalonia. Building on the quantitative and qualitative results, the discussion connects these findings to existing literature and outlines implications for future digital tools for caregiver support.

One of the first elements to note is the explicit alignment between the project's sample demographics and the widely documented caregiver profile in Spain and similar contexts: most caregivers are women (67.44%), mostly adult children and spouses, with a mean age of 60 years. This coincides with Spanish National Institute of Statistics (INE) demographic data and international findings that caring responsibilities, especially for dementia, disproportionately fall on middle-aged and older women—an aspect repeatedly flagged in the literature as both a social inequality and a determinant of the types of digital solutions needed (12, 39). The relatively high level of cohabitation among study participants (65.89% living with care recipients) further underscores the intensive nature of caregiving in the sample, reflecting the intense emotional and practical pressures that digital platforms must address.

Technological profiles reveal a heterogeneous picture. Most respondents report intermediate or advanced digital literacy according to the adapted DigComp framework, yet a significant minority—particularly caregivers over 65—fall within basic or non-autonomous usage levels. This echoes work highlighting that the digital divide is driven not only by access, but also by confidence, habitual use and specific skills (23, 28). That around one third of caregivers do not use mobile phones for caregiving tasks, mainly due to lack of knowledge or perceived usefulness, suggests that technological solutions must be accompanied by explicit strategies to foster digital inclusion.

The user-centred, iterative structure of AreaAlzheimer is consistent with recommendations from systematic reviews (7, 12, 26). Four main priority needs—updated and practical information, support in care tasks, emotional guidance and relationship management, and access to a support network—mirror the multidimensional challenges described in previous research and reinforce the importance of interventions that integrate practical, emotional and social components (8, 26, 40). Caregivers in this study clearly prioritised immediately usable content (symptom management, routines, legal and administrative information) over more academic or abstract information, supporting calls for highly tailored, context-sensitive digital resources (8, 25).

Existing digital platforms for dementia caregiving frequently target needs like those identified in AreaAlzheimer, including information provision, support for care tasks and emotional counselling. However, many tools have been criticised for generic, one-size-fits-all content, limited personalisation and modest engagement with interactive features (7, 28). In line with these observations, AreaAlzheimer confirms that caregivers prioritise practical, context-specific information on symptom management, service navigation and daily care organisation over abstract or purely biomedical content, and value opportunities for peer connection and structured programmes (8, 17, 27). At the same time, the platform extends previous work by integrating four components—information, community, training and research—within a single environment, addressing informational, emotional and social needs in a more holistic way than many existing tools (21, 27).

AreaAlzheimer therefore addresses a key innovation gap in the field by moving beyond single-focus, generic digital tools towards a participatory, context-specific platform that combines information, community, training and research functions within a single environment. Unlike many stand-alone resources, it is co-designed with caregivers, explicitly incorporates their needs, expectations and digital literacy profiles, and is anchored in the Catalan social and healthcare system with a view to future integration into routine services. In addition, by including a dedicated research component, AreaAlzheimer functions not only as a support tool but also as an infrastructure for generating knowledge about caregivers’ needs and vulnerabilities, thereby informing more effective and equitable dementia-care policies.

From a usability perspective, AreaAlzheimer's performance is comparable to, or slightly higher than, that reported by other web-based interventions. Global usability scores above commonly accepted thresholds (SUS = 74.3/100) and positive perceptions of visual design and ease of navigation align with recent feasibility and implementation studies (26, 27, 38). Difficulties in more complex tasks—such as modifying profiles or using forums—mirror recurrent challenges in other platforms, where advanced features are often underused or perceived as unintuitive (41, 42). These parallels suggest that adding functionalities alone is insufficient; interfaces must be simplified, aligned with users' mental models and explicitly adapted for those with low digital confidence (23, 28).

The findings also reinforce concerns about the digital divide in dementia caregiving. Despite widespread access to smartphones and computers, many caregivers face barriers related to limited skills, lack of confidence, distrust in technology or privacy concerns, particularly among older adults (23, 28, 41). Similar patterns have been described in evaluations of web-based and mobile interventions, where older or less digitally literate users are less likely to register, participate or sustain long-term use (12, 25). AreaAlzheimer fits within this landscape, highlighting that digital innovation must be accompanied by inclusive design strategies—simplified interfaces, clear tutorials and alternative access routes—to ensure equitable benefits and avoid exacerbating existing inequalities.

An additional key finding concerns the relationship between perceived usefulness and behavioural intention to use. In the pilot, usefulness received the lowest score of the three user-experience dimensions, while intention to use was very high. This suggests that, although current content and functionalities are still limited, caregivers perceive strong potential value and are willing to engage as the platform evolves. The gap between moderate perceived usefulness and high intention to use echoes broader evidence in digital health, where early adoption often depends on perceived potential and trust in the sponsoring institution (7, 27, 40). In this sense, AreaAlzheimer illustrates how a participatory, co-designed development process can foster engagement intentions while generating a user-driven roadmap for optimisation and scaling.

Overall, these dynamics highlight the importance of continuous participatory research and agile development in digital dementia care. Caregivers' demands for personalised, phase-adapted content, downloadable tools and interactive, community-based features should remain central to future iterations (21, 43). Beyond this specific platform, the results support broader recommendations that digital interventions for dementia caregiving should combine robust empirical needs assessment, user-centred and inclusive design, and iterative, mixed-method evaluation to maximise feasibility, equity and scalability.

AreaAlzheimer was developed through a rigorous user-centred, participatory mixed-methods process, illustrating how co-design with family caregivers can guide the development of digital tools that genuinely address their priorities. The platform demonstrated good usability and accessibility, and caregivers expressed a strong intention to use it, particularly to obtain practical and stage-adapted information, participate in structured support programs, and connect with peers for emotional and social support. At the same time, moderate usefulness ratings, task-specific difficulties, and marked differences in digital competence—especially among older caregivers—highlight the need to refine navigation, simplify complex actions, expand personalised content, and systematically address digital inclusion. These findings reinforce the value of robust needs assessment, user-centred design, and ongoing iterative development grounded in caregivers lived experience. Overall, AreaAlzheimer provides a solid foundation for scalable, inclusive digital support with the potential to improve caregivers' day-to-day care, emotional well-being, and outcomes for families facing Alzheimer's disease, while pointing to clear priorities for further optimisation and wider implementation.