Effectiveness, Adoption Determinants, and Implementation Challenges of ICT-Based Cognitive Support for Older Adults with MCI and Dementia: A PRISMA-Compliant Systematic Review and Meta-Analysis (2015–2025)
Abstract
1. Introduction
- What types of ICT technologies are most used in cognitive support interventions?
- How do ICT-based cognitive and memory support tools affect the mental health, daily activities, and independence of older adults?
- What are the long-term sustainability and implementation challenges of these interventions in real-world settings?
- What are the key enablers and barriers that influence the usability and adoption of technology-based cognitive support tools among older adults?
2. Materials and Methods
2.1. Summary of Inclusion and Exclusion Criteria
2.2. Study Selection Process
2.3. Data Extraction
2.4. Selected Study
2.5. Quality Assessment (Risk of Bias)
3. Analytical Process
3.1. Word Cloud Visualization of Key Terms
3.2. Key Findings
4. Results
4.1. ICT Intervention Types in Dementia Care
4.1.1. ICT Platforms
4.1.2. Tablet-Based Devices
4.1.3. Assistive Technologies
4.1.4. Wearable Devices
4.1.5. Smartphone Devices
4.1.6. Telephone
4.1.7. Robotics and AI Assistive Devices
4.1.8. mHealth and eHealth Interventions
4.1.9. Computer
4.1.10. Other Devices
4.2. ICT Adoption Enablers and Barriers
4.2.1. ICT Platforms
4.2.2. Tablet
4.2.3. Assistive Technologies
4.2.4. Wearables
4.2.5. Smartphones
4.2.6. Telephone
4.2.7. Robotics and AI
4.2.8. mHealth and eHealth
4.2.9. Computer
4.2.10. Other ICT
4.3. Effectiveness of ICT-Based Interventions Regarding Cognitive Outcomes
4.4. Heterogeneity and Publication Bias Assessment
4.5. Interpretation of Heterogeneity (I2)
4.6. Sensitivity Analyses
5. Discussion
5.1. Ethical Considerations and Implications
5.2. Policy Direction
6. Future Research
- Large-scale, long-term follow-up studies are necessary to compare the long-term cognitive, affective, and functional impact of digital interventions [66]. Multi-stakeholder funding models integrate research grants with investments in the healthcare system.
- Future trials must examine the impact of early prolonged digital activity on the postponement of cognitive decline onset and progression of dementia [57].
- Evaluations of the cost-effectiveness, feasibility, and real-world utility of customized digital interventions, remote cognitive testing, and serious games are necessary to optimize intervention designs [43,60]. Therefore, it is necessary to integrate the collection of real-world evidence through routine healthcare data.
- Emerging technologies, such as voice-controlled assistants, socially assistive robots, and cognitive prediction tools based on AI, must be extensively validated for usability, ethical integration, and clinical utility [67].
- Future research should prioritize pragmatic trial designs with embedded sustainability assessments and stakeholder engagement throughout the implementation process.
7. Strengths and Limitations
8. Recommendation
- Step 1. Assess Needs and Involve Caregivers
- Step 2. Tailored Interventions
- Step 3. Educating Older Adults and Training Caregivers
- Step 4. Incorporate ICT into Daily Practice
- Step 5. Personalize ICT Applications
- Step 6. Enhance Policy and Broadband Access
- Step 7. Sustain Use and Support Adaptation
9. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
MCI | Mild Cognitive Impairment. |
ICT | Information and Communication Technology. |
AT | Assistive Technology. |
ADL | Activities of Daily Living. |
ADAS | Alzheimer’s Disease Assessment Scale. |
Appendix A. JBI Quality Assessment
Study Type | Author | Q1 | Q2 | Q3 | Q4 | Q5 | Q6 | Q7 | Q8 | Q9 | Q10 | Q11 | Q12 | Q13 | Total | JBI Quality Rating | Total Overall Appraisal |
Randomized Control Trial | [51] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | 13 | High | include |
[62] | Y | Y | Y | N | N | Y | Y | Y | Y | Y | Y | Y | Y | 11 | High | include | |
[64] | Y | N | Y | N | N | N | Y | Y | Y | Y | Y | Y | Y | 9 | Moderate | include | |
Systematic Review | [60] | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | Y | 10 | High | include | ||
[66] | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | Y | 10 | High | include | |||
[70] | Y | Y | Y | Y | Y | Y | Y | Y | N | Y | Y | 10 | High | include | |||
[71] | Y | Y | Y | Y | Y | N | N | Y | N | Y | Y | 8 | Moderate | include | |||
Cohort Study | [44] | Y | Y | Y | Y | Y | U | Y | N | N | N | Y | 7 | Moderate | include | ||
[53] | Y | Y | Y | Y | Y | Y | Y | Y | U | U | Y | 9 | High | ||||
[56] | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | 11 | High | include | |||
[65] | Y | Y | Y | N | Y | Y | Y | Y | Y | Y | Y | 10 | High | include | |||
Qualitative Study | [43] | Y | Y | Y | Y | Y | N | N | Y | Y | Y | 8 | |||||
[59] | Y | Y | Y | Y | Y | N | N | Y | Y | Y | 8 | High | include | ||||
[69] | Y | Y | Y | Y | Y | N | N | Y | Y | Y | 8 | High | include | ||||
Mixed-Method Study | [47] | Y | Y | Y | Y | N | N | Y | Y | Y | Y | 8 | High | include | |||
Y | Y | N | Y | Y | Y | N | Y | 6 | |||||||||
Quasi-Experimental Study | [55] | Y | Y | Y | Y | Y | Y | Y | Y | Y | 9 | High | include | ||||
[58] | Y | Y | Y | N | Y | Y | Y | Y | Y | 8 | High | include | |||||
[61] | Y | Y | Y | N | Y | Y | Y | Y | Y | 8 | High | include | |||||
[63] | Y | Y | Y | N | N | Y | Y | Y | Y | 7 | High | include | |||||
Analytical Cross-Sectional Survey | [42] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | |||||
[45] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
[46] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
[48] | Y | Y | Y | Y | N | N | Y | Y | 6 | Moderate | include | ||||||
[49] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
[50] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
[52] | Y | Y | Y | Y | N | N | Y | Y | 6 | Moderate | include | ||||||
[57] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
[68] | Y | Y | Y | N | N | Y | Y | Y | 6 | High | include | ||||||
[72] | Y | Y | Y | Y | Y | Y | Y | Y | 8 | High | include | ||||||
Narrative Review | [54] | Y | Y | Y | Y | Y | Y | 6 | High | include | |||||||
[67] | Y | Y | Y | Y | Y | Y | 6 | High | include |
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Criteria | Inclusion | Exclusion |
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Comparator |
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Outcome |
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Study Design |
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Search Term | Databases | Results |
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(“ICT” OR “Digital Health” OR “mHealth” OR “eHealth” OR “Telehealth” OR “Telemedicine” OR “Wearable Technology” OR “Mobile Health Applications” OR “Device Ownership” OR “Technology Adoption” OR “Digital Literacy”) AND (“Dementia” OR “Cognitive Impairment” OR “Cognitive Decline” OR “Alzheimer’s Disease” OR “Neurodegenerative Disorders” OR “Memory Loss”) AND (“Older Adults” OR “Aging Population” OR “Elderly” OR “Seniors” OR “Medicare Beneficiaries”)) |
| 67 64 799 1121 901 123 475 |
Study | Study Year | Study Design | Country | Study Setting | Technology Type | Groups in the Study | Device Used | Type of Intervention and Study Type | Objective | Main Findings | Cognitive Effects |
---|---|---|---|---|---|---|---|---|---|---|---|
Martinez et al. [42] | 2025 | Cross-sectional study | USA | Home-based | ICT devices (Smartphones, tablets, computers, the internet, social media, or other applications) | Older Asian Americans in affordable housing | ICT Platforms/Devices | Training cognitive function with a computer game | To investigate the relationships between perceived usefulness (PU), perceived ease of use (PEOU), ICT use, and loneliness among low-income, older Asian Americans. | 1. ICT acceptance and use reduce loneliness 2. Ease of use influences ICT adoption 3. Digital literacy training is essential. 4. Policy support is needed for access to technology | Subjective cognitive decline |
Kwek et al. [43] | 2025 | Qualitative study | Singapore | Lab-based playtesting and interview sessions | Tablet-based CURATE.DTx system | Community-dwelling older adults | Tablet-based | Digital therapeutic cognitive training | To evaluate the acceptability and user experience of CURATE.DTx, a multitasking-based DTx platform for cognitive training | 1. Digital therapy is acceptable. 2. Users need more training 3. Customization improves engagement 4. Future improvements should target accessibility | Improved attention, engagement, and executive functioning |
Yan et al. [44] | 2024 | Cohort study | Canada | Remote preoperative assessments | Telemedicine-based cognitive assessment tools (Telephone Montreal Cognitive Assessment) | Patients were assessed using four cognitive screening tools | Telephone | Remote cognitive screening tools are used through telemedicine | To determine the prevalence of suspected cognitive impairment using multiple screening tools | 1. Screening tools detect cognitive impairment 2. Different tools yield varying prevalence rates 3. Remote assessments improve risk stratification. 4. Further validation needed | Detected impairment; varied by screening tool |
Peng et al. [45] | 2024 | Cross-sectional study | USA | Data analysis from the National Health and Aging Trends Study (NHATS) | ICT devices, everyday technology, digital health technology | Homebound, semi-homebound, and non-homebound groups | ICT platforms/devices | Assessment of digital technology usage | To examine 1. The prevalence of digital technology use among community-dwelling older adults with or without homebound status 2. The association between digital technology use and homebound status. | 1. Homebound seniors tend to have lower rates of technology adoption 2. Physical and cognitive limitations impact digital engagement 3. Accessibility remains a key barrier for homebound individuals. | Digital exclusion accelerates cognitive decline |
Nakahara and Yokoi [46] | 2024 | Cross-sectional study | Japan | Community gathering places in Osaka Prefecture, Japan | ICT devices (including the internet, communication tools, etc.) | Older adults participating in social activities | ICT platforms/devices | ICT-facilitated social participation | To quantify how ICT use, participation frequency, and social networks influence cognitive function and loneliness among socially active people | 1. ICT use strengthens social interaction, improving the quantity and quality of social participation among older adults 2. Frequent use of ICT improves cognitive function 3. ICT-driven engagement reduces feelings of loneliness | Improved cognitive function indirectly |
McMurray et al. [47] | 2024 | Mixed-methods study | Canada | Primary care settings (FHTs) | Tablet-based digital screening tool (BrainFx SCREEN) | Older adults diagnosed with dementia | Tablet-based | Tablet-based cognitive impairment screening | To assess the validity, reliability, and applicability of the BrainFx SCREEN tool for MCI screening in a primary care context | 1. Tablet-based screening shows promise 2. Accessibility improvements needed. 3. Large-scale testing is required 4. Integration with healthcare workflows is beneficial | Moderate sensitivity; limited reliability |
Hackett et al. [48] | 2024 | Cross-sectional study | USA | Home-based and real-world mobility tracking | Smartphone with the mindLAMP app for passive GPS tracking | Community-dwelling older adults | Smartphones | Smartphone-based digital phenotyping | To assess the feasibility, acceptability, and validity of using smartphone-based GPS tracking to infer cognition, function, and mood | 1. Mobility patterns link to cognition 2. GPS-based tracking shows cognitive decline patterns 3. Future studies should refine model accuracy | Greater mobility is linked to cognition |
Martinez et al. [49] | 2024 | Cross-sectional study | USA | Survey-based data collection | ICTs (general technology use, internet, computers, mobile devices) | Low-income Asian American older adults | ICT platforms/devices | Technology acceptance modeling | To examine the role of self-rated health and subjective cognitive decline in ICT use | 1. ICT use is linked to self-rated health perceptions 2. Digital skills training improves adoption 3. Socioeconomic factors influence engagement 4. Tailored policies can improve participation | Subjective decline moderated ICT use. |
Choi et al. [50] | 2024 | Cross-sectional study | USA | Survey-based data collection | ICT and ICT-based communication and internet access (focused on cellphones, email, texting, and the internet) | Homebound and semi-homebound older adults | ICT platforms/devices | Assessment of the digital divide | To explore the digital divide between homebound and semi-homebound older adults using ICT device ownership and usage data | 1. Homebound older adults face severe digital inequities. 2. Socioeconomic factors have a significant impact on access to ICT 3. Policy interventions can help bridge the gap 4. More targeted interventions are needed | Dementia is linked to reduced ICT use |
Chae and Lee [51] | 2024 | Randomized controlled trial | South Korea | Participant’s home | Tablet-based training (Smart Brain program) | Community-dwelling older adults | Tablet-based | Digital Therapeutic Cognitive Training | To examine the effects of Smart Brain, an ICT-based cognitive training program, on multi-domain function in older adults with dementia | 1. Cognitive function improved significantly in the intervention group. 2. Depression levels decreased among Smart Brain users. 3. Physical and nutritional health showed positive changes. 4. Participants reported high adherence and satisfaction. | Improved cognition, mood, physical, and nutritional status |
Cay et al. [52] | 2024 | Cross-sectional study | USA | Lab-based reading task with speech recording | Wearable microphone to derive digital biomarkers (machine learning) | Cognitively impaired vs. cognitively intact groups | Wearable device | Speech-based digital biomarker analysis | To evaluate the effectiveness of speech-based digital biomarkers in detecting cognitive impairment severity | 1. Speech biomarkers offer a viable screening method 2. Strong correlation with cognitive test results 3. May serve as an early diagnostic tool | Accurately detected and predicted cognitive impairment |
Anaraky et al. [53] | 2024 | Cohort study | USA | Observational study using survey data | Internet, computers, tablets, texting, and emails | Community-dwelling older adults | ICT platforms/devices | Monitoring technology use for cognitive change | To determine whether technology use patterns could serve as an indicator of cognitive change in older adults | 1. Tech usage changes can indicate early dementia 2. Monitoring online activity is useful 3. Declining engagement predicts cognitive issues | Technology discontinuation is linked to decline |
Addae et al. [54] | 2024 | Narrative review | Various countries | Not specified (focuses on technological interventions) | IoT devices, wearable technologies, and machine learning algorithms | Older adults with dementia. | Wearable and IoT | Monitoring dementia | To explore smart and innovative solutions for early detection, prediction, monitoring, and management of dementia for the advancement of IOT | 1. Wearable tech improves dementia management 2. AI-driven models help with early detection 3. Future research should integrate solutions | Supports early detection and monitoring |
Kim et al. [55] | 2024 | Quasi-experimental study | South Korea | Older adults living alone | ICT-based smart care services for physical and cognitive functions | Older adults living alone in the community | ICT platforms/devices | ICT-based smart care services | To examine how ICT-based innovative care services affect physical and cognitive functions in older adults living alone | 1. ICT-based innovative care services are effective at enhancing the physical function of the lower limb 2. Improvements observed in working memory and attention 3. Mixed results in global cognition (decreased K-MMSE score) | Improved working memory function |
Heponiemi et al. [56] | 2023 | Cohort study | Finland | Community-dwelling adults | Internet use (not device-specific; focused on performance tests and self-reported digital use) | Community-dwelling adults | Telephone | Digital access competence prediction | To examine how impairments in visual, physical, and cognitive functioning predict internet use and digital competence | 1. Older adults with physical and cognitive limitations are more likely to experience digital exclusion 2. Vision and physical functioning affect digital skill levels 3. Memory performance is a key indicator of digital competence | Smart technologies support mitigating cognitive decline. |
Benge et al. [57] | 2023 | Cross-sectional study | USA | Observational research setting | Smartphones, social media, texting, and video calls | People having internet access | Smartphones and social media | Technology use and subjective cognition | To evaluate whether the frequency of digital device use is associated with greater or lesser subjective cognitive concerns (SCCs) in older adults. Cross-sectional study using hierarchical multiple | 1. Increased device use is associated with fewer symptoms of cognitive control (SCC), especially in terms of executive function 2. General device usage matters more than use of social media or texting 3. Digital engagement may protect cognitive function with age | More use is linked to fewer concerns |
Park et al. [58] | 2022 | Quasi-experimental study | USA | Sensor-based in-home interactive exercise system (tele-exergame) | Home-based remote intervention | Sensor-based tele-exergame system with a telemedicine interface | Computer | Telemedicine-based exergame training | To assess the feasibility, acceptability, and effectiveness of a sensor-based in-home tele-Exergame system for cognitive and motor function improvement in older adults with MCI/dementia | 1. Tele-exergames are feasible. 2. Engagement was high 3. The long-term impact requires further study 4. Technology accessibility needs improvement | Cognition improved with the tele-exergame |
König et al. [59] | 2022 | Qualitative study | Various countries | Home-based intervention | MEMENTO, a system of two e-ink tablets and a smartwatch | EG assistive intervention with MEMENTO | Assistive Technology | Assistive digital device system | To evaluate the usability, acceptance, and impact of the MEMENTO assistive system for dementia patients and their caregivers | 1. Assistive devices help with daily functions 2. Setup complexity is a challenge 3. Caregivers provide essential support 4. Personalization enhances use | No measurable cognitive improvement observed |
Holthe et al. [60] | 2022 | Systematic review | Norway | Community-dwelling older adults with MCI and dementia | Digital assistive technology | Older community adults with MCI and dementia | Assistive technology | Wearable and assistive technologies to support older adults with MCI and dementia. | To assess advancements in technology use for older adults with mild cognitive impairment | 1. Wearables enhance independence by providing reminders for individuals with dementia 2. Apps help with managing daily activities 3. Adoption is rising, but still limited | Supportive role in daily cognition |
Eun et al. [61] | 2022 | Quasi-experimental study | South Korea | Older adults with varying cognitive impairments | AI-driven serious game | Older adults with varying cognitive impairments | Wearables (or motion-sensing gaming devices) | AI-personalized therapeutic exercise serious game | To assess the effectiveness of an AI-based personalized serious game in enhancing cognitive and physical abilities | 1. AI-based serious games were found to be acceptable, interesting, and motivating for elderly participants. Post-intervention assessments revealed improvements in cognitive function, a reduction in depression levels, and an enhanced quality of life. | Improved cognition and motivation |
Coley et al. [62] | 2022 | Randomized controlled trial | Various countries | Online (web-based) | eHealth (web-based platform) | High-, moderate-, and low-engagement groups | ICT platforms/devices | Web-based eHealth intervention with personalized coaching and health tracking features | 1. Identifying factors influencing older adults’ engagement with an eHealth intervention 2. Examining its impact on cardiovascular and dementia risk factors | 1. Participants who engaged more showed better improvements in cardiovascular and dementia risk factors, including blood pressure, body mass index (BMI), and cholesterol levels 2. Greater interaction (logins, goal setting, coach messages) led to significantly better health | Higher engagement is linked to improvement |
Manca et al. [63] | 2021 | Quasi-experimental study | Italy | Controlled laboratory or training setting | Humanoid robots in supporting serious games | Local Train the Brain program. | Robotics/AI-assistive technology | Humanoid robot-based serious games | This study aims to explore the effect of utilizing humanoid robots in supporting serious games for older adults with mild cognitive impairment (MCI) | 1. Robot users showed higher levels of engagement and emotional connection 2. Tablet users achieved higher accuracy in correct responses 3. Both groups improved over time, but the robot’s empathic cues appeared to boost motivation | Improved engagement and cognitive training |
Kim et al. [64] | 2021 | Randomized controlled trial | South Korea | Community-dwelling or institutionalized | ICT-based Training platform | Community-dwelling or institutionalized | ICT-based system | ICT-based cognitive-physical training | ICT-based training devices, including a virtual reality (VR) bicycle integrated with cognitive training modules such as arithmetic operations, fruit-picking tasks, and puzzle-solving activities | 1. Personalized serious games are effective for elderly care 2. Integration of AI enhances therapeutic impact 3. High usability and acceptance among older users 4. Supports dual-target interventions (physical and cognitive) | Improved ADAS–Cog cognitive score (better cognitive performance) |
Kelleher et al. [65] | 2021 | Cohort study | USA | MapHabit mHealth app, which assists with cognitive impairments | Tablet-based MapHabit app | MapHabit mHealth app in improving ADL recall | mHealth/eHealth | Assistive technology app featuring personalized visual mapping templates for supporting activities of daily living | To assess the feasibility and preliminary impact of a mHealth assistive technology app in supporting individuals with cognitive impairment in performing ADLs | 1. Older adults with cognitive impairments were willing to use the MapHabit mHealth app to assist with activities of daily living (ADLs) 2. After using the app, participants perceived positive effects on functional abilities, social engagement, mood, and memory | Improved memory and ADL performance |
Jung et al. [66] | 2021 | Systematic review | South Korea | Home-based or familiar environments | ICT devices (PCs, desk-tops, laptops, handheld devices, and wireless or other devices) | Patients undergoing cognitive assessment | ICT platforms/devices | ICT-based cognitive interventions | To analyze the effectiveness of ICT interventions for older adults with MCI using a systematic review and meta-analysis | 1. ICT-based interventions have been shown to significantly improve cognitive function in older adults with MCI 2. The findings support their feasibility, with a call for more rigorous and long-term studies | Significant improvement in cognition |
Diaz-Orueta et al. [67] | 2020 | Narrative review | European Union | Not applicable (discussion and review) | Various ICT devices (e.g., robotics, serious games, AR, VR, Smart home systems) | Older adults | Assistive technology | Shaping tech for older adults ethically | To explore the ethical implications, privacy concerns, and autonomy considerations associated with the development and implementation of ICT | 1. Ethical considerations are lacking in tech design 2. Older adults prioritize autonomy 3. Privacy and data security concerns | Focus on ethical cognitive support |
Contreras-Somoza et al. [68] | 2020 | Cross-sectional study | Eight European countries | Older adults with MCI, informal caregivers, formal caregivers, and administrative staff | EhcoBUTLER ICT platform (tablet-based) | Older adults with MCI, informal caregivers, and formal caregivers | Tablet-based | Feasibility of ICT-based cognitive tools | To assess the acceptability of the EchoBUTLER ICT platform among older adults with MCI and stakeholders involved in their care | 1. The EchoBUTLER platform is generally acceptable to older adults with MCI and their caregivers 2. End users find social functionalities particularly valuable | Potential support for cognitive training |
Blok et al. [69] | 2020 | Qualitative study | Netherlands | Home and daily life settings | Various ICT devices in everyday use (smartphones, computers, tablets) | Older people with cognitive impairments | ICT platforms/devices | ICT use experience analysis | 1. To address how older adults with cognitive impairments use ICT daily 2. To identify the perceived barriers and benefits of ICT usage by older adults | 1. ICT use helps enhance social and emotional well-being, facilitating engagement in daily activities 2. Social networks influence ICT use by assisting, initiating, restricting, or enabling the use of shared devices | Supports social and emotional engagement |
Holthe et al. [70] | 2018 | Systematic review | Various countries | Home-based and research settings | Various (assistive devices, smart home tech, entertainment, and social tech) | Community-dwelling with MCI and dementia | Wide range/not device-specific | Assistive technology for everyday support | To review technologies explored for older people with MCI/D, usability and acceptability, and involvement of family carers | 1. Usability issues impact adoption among older adults 2. User participation enhances the design of technology 3. Standardized assessments are needed for evaluation 4. Accessibility remains a critical concern | Support for aging in place |
Pinto-Bruno et al. [71] | 2017 | Systematic review | Various countries | Mixed (community and institutionalized) | ICT-based application in daily living | 10 different interventions identified | Smartphone | Digital phenotyping to monitor cognition, mood, and life-space | To assess the validity and efficacy of ICT-based interventions in promoting social health and active aging among people with dementia | 1. ICT interventions enhance social participation 2. The lack of standard measures limits the effectiveness of the impact assessment 3. Personalized interventions yield better results | Greater mobility is associated with improved cognitive function |
Malinowsky et al. [72] | 2017 | Cross-sectional study | Sweden | Interview-based assessment | Various ET devices for everyday use (unspecified) | Older adults with SCI and MCI | Everyday technologies such as Wearables, computer, phone | Comparing technology use with varying cognitive status. | To investigate and compare self-perceived ability in ET use and the number of ETs used among older adults with SCI, MCI, and controls | 1. MCI patients tend to engage less with technology 2. Self-reported usage predicts decline 3. Support programs needed for accessibility | Supports memory and daily functioning |
Technology | Adoption Enablers (with References) | Adoption Barriers (with References) |
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ICT Platform |
| |
Tablet | ||
Assistive Technology | ||
Wearable |
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Smartphone | ||
Telephone | ||
Robotics/AI Assistive | ||
mHealth/eHealth | ||
Computer | ||
Other Devices |
|
Publication Bias | Coefficient | SE | 95% CI | Z | p | ||
Lower Limit | Upper Limit | ||||||
Egger’s regression test | intercept | 1.83 | 0.30 | 1.16 | 2.51 | 6.14 | <0.001 |
slope | −0.25 | 0.12 | −0.49 | −0.01 | −2.06 | 0.04 | |
Hedge’s | 95% CI | ||||||
Lower Limit | Upper Limit | ||||||
Trim and fill | original | 0.46 | 0.35 | 0.57 | - | - | |
corrected | 0.39 | 0.28 | 0.49 | - | - |
Sensitivity Analysis | Pooled Effect Size (Cohen’s d) | I2 (%) | Impact on Overall Result |
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All studies included | 0.49 | 46.0% | -- |
Excluding high-risk bias studies | 0.50 | 55.4% | Minimal, robust findings |
Dimension | Focus on the Current Study | Typical Approaches in Prior Studies |
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Study Scope |
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Primary Focus |
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Key Focuses |
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Research Gaps |
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Study Contributions |
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Data Confidentiality |
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User Experience and Accessibility |
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Integration withCare Systems |
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Future Directions |
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Strengths | Limitations |
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The review followed PRISMA guidelines to ensure a transparent and reproducible methodology. | Many studies used self-reported cognitive data, which may miss subtle impairments and introduce personal bias [47,57]. |
Covered a broad range of ICT interventions (e.g., tablets, smartphones, mHealth, AI, wearables), showing real-world applicability. | Few studies included long-term follow-up, making it difficult to assess the lasting impact of ICT interventions [43,60]. |
Focused on diverse user groups, including those with MCI and dementia, to capture varying stages of cognitive decline [42,43,46]. | Digital literacy challenges were not thoroughly addressed, particularly among low-income or minority groups [42,46]. |
Highlighted the need for user-centered and ethically grounded digital solutions, especially in AI-based dementia care technologies. | Ethical issues such as data privacy, transparency, and accountability) In AI-based care, these issues were rarely discussed [58,68]. |
Emphasized the central role of caregivers in enabling and sustaining ICT use among individuals with cognitive impairment [25,26]. | Limited research exists on caregiver support and technological readiness, despite these factors being vital for successful adoption [25,26,59]. |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Alam, A.; Rabbani, M.G.; Prybutok, V.R. Effectiveness, Adoption Determinants, and Implementation Challenges of ICT-Based Cognitive Support for Older Adults with MCI and Dementia: A PRISMA-Compliant Systematic Review and Meta-Analysis (2015–2025). Healthcare 2025, 13, 1421. https://doi.org/10.3390/healthcare13121421
Alam A, Rabbani MG, Prybutok VR. Effectiveness, Adoption Determinants, and Implementation Challenges of ICT-Based Cognitive Support for Older Adults with MCI and Dementia: A PRISMA-Compliant Systematic Review and Meta-Analysis (2015–2025). Healthcare. 2025; 13(12):1421. https://doi.org/10.3390/healthcare13121421
Chicago/Turabian StyleAlam, Ashrafe, Md Golam Rabbani, and Victor R. Prybutok. 2025. "Effectiveness, Adoption Determinants, and Implementation Challenges of ICT-Based Cognitive Support for Older Adults with MCI and Dementia: A PRISMA-Compliant Systematic Review and Meta-Analysis (2015–2025)" Healthcare 13, no. 12: 1421. https://doi.org/10.3390/healthcare13121421
APA StyleAlam, A., Rabbani, M. G., & Prybutok, V. R. (2025). Effectiveness, Adoption Determinants, and Implementation Challenges of ICT-Based Cognitive Support for Older Adults with MCI and Dementia: A PRISMA-Compliant Systematic Review and Meta-Analysis (2015–2025). Healthcare, 13(12), 1421. https://doi.org/10.3390/healthcare13121421