Maria Schneider, 78, had never used a smartphone before joining a study in Oldenburg, Germany. But when researchers handed her a tablet to track what she ate during her rehabilitation stay, she didn't need much help.
"She just went for it," said Julia Berndt, the study's lead researcher at the Carl von Ossietzky University of Oldenburg. "She figured it out on her own."
Schneider is one of 44 patients aged 70 and older who took part in a pilot study testing whether older rehab patients could independently use a nutrition-tracking app. The answer, it turns out, is yes.
When designed with older users in mind — bigger buttons, simple food pictures instead of text, and portion sizes measured by hand like "a handful of fruit" — 68 percent of patients completed the task without any help. They gave the app a usability score of 76 out of 100, rated as "good" and edging toward "excellent."
The study focused on geriatric rehabilitation patients, many of whom were dealing with weakness, poor eyesight, or memory problems. Despite these challenges, most handled the technology just fine.
"Assumptions about low-tech literacy are often just that — assumptions," said a researcher from the OFFIS-Institute for Information Technology, which co-designed the app with the university.
The research addresses a real problem: malnutrition is shockingly common in rehabilitation settings. Up to 20 percent of older rehab patients aren't getting enough to eat, and another 54 percent are at risk. Proper nutrition helps patients build muscle, regain strength, and get back to living independently at home. But tracking what patients eat takes up valuable time that nutritionists could spend actually helping them.
The e-food record — as the app is called — aims to fix that. Patients used a 10.1-inch tablet over three days to log meals and drinks. The interface used simple symbols and intuitive portion guides. When the research team compared the app data to what a nutritionist recorded during a traditional 24-hour recall interview, the results were close — though patients did report slightly lower food and fluid intake on the app, which researchers say could be fixed with gentle reminders to log drinks like water or coffee.
The findings suggest that digital health tools don't have to leave older adults behind. With thoughtful design tailored to their needs, even clinically burdened patients can participate in their own care.
Next, the team plans larger studies to test the app in more settings — including acute hospital wards, short-term care facilities, and patients recovering from strokes or other neurological conditions. The goal is to eventually let nutritionists spend less time on paperwork and more time giving patients personal attention.
For Maria Schneider, though, the result was simpler. She tracked her meals, asked a few questions, and proved something important: older adults deserve a seat at the digital health table.