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Review

Human-Centred Design (HCD) in Enhancing Dementia Care Through Assistive Technologies: A Scoping Review

by
Fanke Peng
*,
Kate Little
and
Lin Liu
City West Campus K4-9, University of South Australia, Creative, North Terrace, Adelaide, SA 5000, Australia
*
Author to whom correspondence should be addressed.
Digital 2025, 5(4), 51; https://doi.org/10.3390/digital5040051
Submission received: 4 August 2025 / Revised: 21 September 2025 / Accepted: 28 September 2025 / Published: 2 October 2025
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Abstract

Background: Dementia is a progressive neurodegenerative condition that impairs cognitive functions such as memory, language comprehension, and problem-solving. Assistive technologies can provide vital support at various stages of dementia, significantly improving the quality of life by aiding daily activities and care. However, for these technologies to be effective and widely adopted, a human-centred design (HCD) approach is of consequence for both their development and evaluation. Objectives: This scoping review aims to explore how HCD principles have been applied in the design of assistive technologies for people with dementia and to identify the extent and nature of their involvement in the design process. Eligibility Criteria: Studies published between 2017 and 2025 were included if they applied HCD methods in the design of assistive technologies for individuals at any stage of dementia. Priority was given to studies that directly involved people with dementia in the design or evaluation process. Sources of Evidence: A systematic search was conducted across five databases: Web of Science, JSTOR, Scopus, and ProQuest. Charting Methods: Articles were screened in two stages: title/abstract screening (n = 350) and full-text review (n = 89). Data from eligible studies (n = 49) were extracted and thematically analysed to identify design approaches, types of technologies, and user involvement. Results: The 49 included studies covered a variety of assistive technologies, such as robotic systems, augmented and virtual reality tools, mobile applications, and Internet of Things (IoT) devices. A wide range of HCD approaches were employed, with varying degrees of user involvement. Conclusions: HCD plays a critical role in enhancing the development and effectiveness of assistive technologies for dementia care. The review underscores the importance of involving people with dementia and their carers in the design process to ensure that solutions are practical, meaningful, and capable of improving quality of life. However, several key gaps remain. There is no standardised HCD framework for healthcare, stakeholder involvement is often inconsistent, and evidence on real-world impact is limited. Addressing these gaps is crucial to advancing the field and delivering scalable, sustainable innovations.

1. Introduction

Dementia is a neurodegenerative disorder prevalent among the elderly [1], characterised by a progressive decline in cognitive function. While memory loss is the most recognised symptom, the impact of dementia extends far beyond this. It affects vital cognitive functions such as language comprehension, problem-solving, and other essential functions that we often take for granted in our daily lives [2]. As the global population continues to age, the incidence of dementia is rising [1]. This increase underscores the need for a deeper understanding of the disorder’s complexities and highlights the urgent demand for innovative and effective solutions. However, the challenges posed by dementia are multifaceted. At its core, dementia is not just a clinical or neurological challenge; it is a deeply human one [3]. Beyond the evident cognitive impairments, dementia casts a profound emotional and psychological shadow [4]. Individuals diagnosed with dementia often struggle with a range of emotions, from anxiety and depression to an overwhelming sense of isolation. Their journey is not a solitary one; it reverberates through their families and caregivers, impacting the very fabric of relationships and shared memories. Moreover, as individuals strive to hold onto their sense of self, independence, and identity, the challenges intensify, underscoring the need for holistic interventions. human-centred design (HCD) offers a promising approach to addressing these complex and multifaceted challenges by guiding the development of assistive technologies that complement traditional medical interventions. HCD is a design methodology that prioritises the nuanced needs and experiences of the end-user. It represents a paradigm shift from conventional design methodologies, moving away from a one-size-fits-all approach. HCD emphasises the creation of tailored solutions that are deeply embedded in the context and experiences of the users [5]. This user-centric approach is particularly relevant in the realm of dementia care, where individual experiences can vary significantly based on the stage of the disease, co-morbidities, socio-cultural background, and personal history [4,6].
HCD has been increasingly advocated in dementia-related technology development. HCD is a framework that places end-users, including people with dementia, their caregivers, and other stakeholders, at the heart of the design process to ensure that solutions are relevant, usable, and meaningful [7]. This includes participatory and iterative methods such as co-design, focus groups, and usability testing and evaluation. Involving people with dementia and their carers in design processes is especially important due to the complexity of their needs and the risk of developing technologies that are technically functional but practically irrelevant or inaccessible [6].
Despite growing interest in this approach, the application of HCD in the context of assistive technologies for dementia care remains fragmented. Studies vary in their definitions of HCD, levels of user involvement, and reporting of outcomes. A consolidated understanding of how HCD is currently implemented in this field is needed to guide future innovation and support evidence-informed design practices.
A scoping review is particularly appropriate for addressing this gap. Unlike systematic reviews, which are often designed to assess the effectiveness of interventions, scoping reviews are used to map key concepts, clarify definitions, and identify gaps in knowledge across broad and diverse bodies of literature [8]. Given the heterogeneity in HCD practices and the evolving nature of assistive technologies for dementia, this approach allows for an inclusive and exploratory examination of existing evidence.
Several prior reviews have examined assistive technologies within healthcare and dementia contexts; however, they differ in scope and focus from the current study. The most closely aligned review by Suijkerbuijk et al. [9] focused on the involvement of people with dementia in developing assistive technologies but did not specifically explore HCD frameworks. Additionally, this review is somewhat outdated, having been published in 2019 with search coverage only up to 2017. Other systematic and scoping reviews [10,11,12,13,14,15] have predominantly concentrated on technological types, adoption barriers, or specific technology modalities, without explicitly addressing HCD processes. Reviews by [16,17] focus on engagement outcomes and arts-based activities, respectively, rather than on HCD. In contrast, our scoping review explicitly centres on HCD approaches in the design and development of assistive technologies for people with dementia. We also introduce a high-level logic model for applying HCD and provide comprehensive stakeholder mapping, both of which have not been covered in previous literature. This focused approach addresses a critical gap and advances design practices tailored to dementia care.

2. Objectives

The aim of this scoping review is to explore how HCD has been applied in the development of assistive technologies for people with dementia.
This review addresses the following research questions:
  • What types of assistive technologies have been developed using HCD approaches for people with dementia?
  • To what extent, and in what ways (how) are people with dementia and other stakeholders involved in the design process?
  • What are the reported HCD approaches and frameworks in this context?
By answering these research questions, this review aims to highlight the pragmatic potential of HCD in improving the quality of life for those affected by dementia. It advocates for a future where technological innovation and empathetic care work together to uphold dignity, autonomy, and a renewed sense of purpose in dementia care. With the anticipated rise in global dementia prevalence, the insights from this review are intended to inform effective care strategies and the development of human-centred assistive technologies, contributing to a shift towards more proactive care in dementia’s evolving narrative.

3. Methods

3.1. Scoping Review Framework

Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR), a scoping review was conducted to explore the application of HCD approaches in the development of assistive technologies for people with dementia [18]. This method was chosen due to its suitability for mapping key concepts, types of evidence, and research gaps within a broad and emerging field. The approach outlined by Arksey and O’Malley [19] was followed, allowing for a systematic search and synthesis of existing literature to better understand how HCD is being implemented and evaluated in this context.

3.2. Eligibility Criteria

The inclusion and exclusion criteria for this scoping review were guided by the commonly used Population–Concept–Context (PCC) framework (Table 1), as recommended by the Joanna Briggs Institute [20]:
  • Population: People living with dementia, encompassing all stages and types of the condition. In addition to studies that involved people with dementia, this review also included studies if they also incorporated the perspectives and experiences of carers and family members, recognising their central role in the design, use, and implementation of assistive technologies.
  • Concept: HCD approaches, including user-centred design, participatory design, co-design, and other methodologies that engage people with dementia and/or their carers in the development or evaluation of assistive technologies.
  • Context: Any dementia care setting, including individuals living independently in the community as well as those in institutional environments such as residential aged care facilities. This broad inclusion was intended to capture a comprehensive understanding across diverse care environments and stages of dementia.
Table 1. Summary of inclusion and exclusion criteria based on the PCC framework.
Table 1. Summary of inclusion and exclusion criteria based on the PCC framework.
PCC FrameworkInclusion CriteriaExclusion Criteria
PopulationPeople with dementia, and/or their caregiversFocus on populations other than people with dementia or their caregivers
ConceptHuman-centred design approaches, including user-centred design, participatory design, co-design, and other methodologies that engage people with dementia and/or their carersFocus solely on patient-centred care without any human-centred design components.
ContextAny care settingn/a
Studies were eligible for inclusion if they were published after 2016. This timeframe was selected to ensure that the most recent and relevant research was captured, particularly as the application of HCD in assistive technologies for dementia has grown in recent years. Studies published in languages other than English were excluded to maintain consistency and ensure that the review team could accurately interpret and evaluate the literature. All types of publications were eligible for inclusion, including peer-reviewed journal articles, full-text research articles, conference proceedings papers, reviews, and editorials.

3.3. Literature Search

A comprehensive search strategy was employed to identify relevant literature addressing HCD approaches to assistive technologies for people with dementia. The search was conducted across five selected databases: Web of Science, JSTOR, Scopus, and ProQuest (see Appendix C: Search Strategy). These databases were chosen for their interdisciplinary coverage and relevance to health, technology, and design research.
Search terms included combinations of the following keywords: “human centred design,” “assistive technology,” “dementia,” “co-design,” “co-creation,” and “Alzheimer’s.” (see Appendix A: Definitions).

3.4. Study Selection

A search was conducted in May 2025. The search strategy and eligibility criteria were applied. Citations from the search were screened according to these criteria. All identified records were imported into reference management software, Covidence [21], and duplicates were removed. Two reviewers independently screened titles and abstracts against the inclusion criteria. Full-text screening was conducted in the same manner, with discrepancies resolved through discussion.

3.5. Data Extraction and Synthesis

Data from the included studies were systematically extracted and charted to capture key information including study design, participant demographics, care settings, data collection methods, analytical approaches, and main findings. As this review aimed to map existing evidence and identify gaps rather than evaluate study quality, no formal assessment of methodological rigour was conducted. The included papers reflected a range of HCD approaches, research methods, and digital technologies. Given this diversity, findings were synthesised narratively and are presented in three main categories: (i) characteristics of the included studies, (ii) types of assistive technology interventions, and (iii) the extent and nature of involvement of people with dementia and their carers in the design process.

4. Results

In total, 350 records were identified across all databases. After deduplication, 288 unique records were screened.
Following the initial title and abstract screening, 89 full-text articles were obtained for independent assessment. Ultimately, 49 publications met all the eligibility criteria and were included in the review. The study selection process is summarised in the PRISMA 2020 flow diagram (Figure 1). The characteristics of the included studies are summarised in Table 2 (further details in Table A1, Appendix B).
This scoping review explored how human-centred design (HCD) principles have been applied in the development of assistive technologies for people living with dementia between 2017 and 2025, with the majority of 39 (80%) studies published within the last five years. Only English-language papers met the inclusion criteria and were included in the review. Of the total 49 publications that were included, 14 studies used a qualitative design, 18 studies used a mixed-methods design, and one study used a quantitative design. The studies were undertaken in the United Kingdom (n = 9), United States of America (n = 10), Australia (n = 5), Canada (n = 4), Belgium (n = 3), Germany (n = 3), Denmark (n = 2), The Netherlands (n = 2), Spain (n = 2), Austria (n = 1), Croatia (n = 1), Italy (n = 1), Norway (n = 1), Peru (n = 1), and Portugal (n = 1). Three studies were conducted across multiple locations: Germany, Italy, Portugal, Romania, Spain [2]; Austria, Cyprus, Poland [22]; and USA, Mexico [23].

5. Discussion

The 49 included studies demonstrate a growing awareness of the importance of HCD in the technology design process, with varying degrees of stakeholder engagement, methodological approaches, and types of technologies developed or evaluated.

5.1. Diversity of Technologies and Areas of Innovation

The reviewed studies reveal a broad and rapidly evolving landscape of assistive technologies designed to support people living with dementia and those involved in their care. This diversity underscores both the adaptability of HCD principles across technological domains and the increasing complexity of dementia care needs across different stages and contexts (Figure 2). Figure 2 presents the key types of assistive technologies identified in the selected studies, aligned with the key stages of the human-centred design (HCD) process, adapted from the Double Diamond model by the British Design Council [24]. The process spans multiple phases. It is an iterative process integrated with both divergent thinking and convergent thinking [25].
  • Explore + Reframe: Gain a deep understanding of the perspectives of people with dementia and their carers. Identify broad principles, guiding ideas, and key constraints that inform the HCD process.
  • Create + Catalyse: Generate and prototype ideas, leading to the development of products (e.g., digital tools), services, and systems (e.g., platforms). Develop a proof of concept, then validate and refine it in collaboration with key stakeholders, including people with dementia and their carers.
mHealth applications featured prominently, including tools for cognitive monitoring [26], nutritional management [27], reminiscence therapy [28], and tailored caregiver support [29]. These apps often prioritise portability and personalisation.
Smart home technologies also emerged as a substantial area of innovation. These systems integrate wearables, environmental sensors, and remote monitoring to promote independent living, enhance safety, and alleviate caregiver burden [30,31,32]. Technologies built on Internet of Things (IoT) infrastructures [33] and passive sensing platforms [34] reflect a shift towards unobtrusive, ambient solutions designed to fit seamlessly into users’ daily lives.
More experimental tools are also being explored. Socially assistive robots [12,23] and augmented reality applications [35], for example, highlight efforts to push the boundaries of dementia technology design. While these innovations hold promise for engagement and cognitive stimulation, they are often developed without robust stakeholder involvement, especially during early conceptual stages, raising concerns about accessibility, inclusion, and sustainability.
Several studies developed or evaluated AI-powered chatbots [36,37], informational platforms [38], or digital tools for advanced care planning [13,39]. These highlight a broader trend towards technologies that facilitate not just physical or cognitive support, but also emotional, legal, and communication needs. Ecosystem-level platforms that combine multiple services and address multimorbidity [2,40] further demonstrate a shift from stand-alone tools towards integrated care solutions/systems.
Personalisation and context-awareness were consistent themes across the spectrum of innovations, with many technologies designed to accommodate users’ individual routines, environments, and social contexts [35,41]. The involvement of interdisciplinary teams, including designers, healthcare professionals, caregivers, and people with dementia, was also cited as a success factor, enabling solutions that are more relevant and adaptable to real-world use [42].

5.2. Patterns in Stakeholder Involvement and Design Frameworks

A key theme emerging from the review is the variation in the depth and timing of stakeholder involvement (Figure 3), closely tied to the frameworks and processes applied in design (Table 3).
Several studies explicitly employed well-recognised HCD or co-design frameworks, demonstrating structured, iterative engagement cycles. For example, ref. [35] applied a three-phase HCD approach based on Buchanan’s model (discovery, development, and evaluation) [62], highlighting iterative refinement grounded in user feedback.
Ref. [30] proposed a PERCEPT framework, centring on persona-based participatory technology design, moving through exploration, design, and evaluation phases to deeply integrate user perspectives.
Other studies adapted established international standards, such as ISO 9241-210:2019, to guide their work [31,41], emphasising user understanding, defining requirements, design, and evaluation. These structured approaches support systematic and iterative development cycles that aim to embed user needs throughout.
Several co-design approaches drew on [63,64,65] or participatory models [42,51,52]. These studies exemplify detailed, multi-step processes: from empathising with users and defining needs, through ideation and prototyping, to multiple rounds of testing and refinement. [50] incorporated clinical trials into their co-design cycle, demonstrating a comprehensive iterative design and evaluation process.
Conversely, some studies, such as [43], applied user-centred design principles primarily through heuristic evaluation without iterative user involvement, indicating limited stakeholder engagement and suggesting a less participatory approach. Similarly, several reviews and conceptual papers [10,16,60] focused more on synthesising existing knowledge than detailing iterative design cycles.
Community-based participatory research [56] and literature reviews paired with focus group interviews [58] further highlight the variety of methods used to engage users and caregivers, ranging from collaborative data collection to thematic reflection on user needs and barriers.
Importantly, only around one-third of the studies explicitly detailed iterative cycles involving user participation aligned with formal HCD or co-design frameworks. This suggests a persistent gap between conceptual endorsement of HCD principles and their full implementation in assistive technology development for dementia care. Many studies described user input primarily in early or late phases, with fewer engaging users continuously throughout development.

5.3. Methodological Approaches and Identified Gaps

While many studies articulate or adapt formal HCD frameworks, the consistency and transparency of their application vary significantly. The lack of methodological consistency and clarity limits comparability across interventions and impedes cumulative knowledge-building.
Moreover, although the value of involving people with dementia was widely acknowledged, few studies evaluated the long-term effectiveness or sustainability of these technologies in real-world contexts. There was limited exploration of how users’ needs evolve over time, how technologies adapt to such changes, or what factors influence technology retention and continued use.

5.4. Emerging Themes and Trends

Several cross-cutting themes emerged from the reviewed studies. Contextual adaptation and personalisation were emphasised across technology types, reflecting a broader recognition that one-size-fits-all solutions are often inappropriate for dementia care. Design processes increasingly incorporated feedback from multiple user groups (people with dementia, caregivers, clinicians, and policy-makers), though the extent of their influence on the final designs varied.
Interdisciplinary collaboration was frequently cited as central to successful outcomes, with teams bringing together expertise in clinical care, software engineering, design, and lived experience [23,42]. Despite this, engagement often remained concentrated in the later stages of design, such as pilot testing or user validation, rather than shaping early concepts and priorities. In studies involving cutting-edge technologies such as AR, robotics, or AI, this issue was even more pronounced, suggesting a persistent tension between innovation and inclusive practice.

6. Limitations in the Literature

Despite growing interest in HCD and user engagement, several limitations remain evident in the literature. Terminological ambiguity continues to challenge the field: terms such as “human-centred,” “user-centred,” and “participatory” are often used interchangeably or without a clear methodological definition. This lack of clarity hinders efforts to compare findings or assess the rigour of stakeholder involvement across studies.
Ethical concerns about engaging people with dementia, particularly around consent and cognitive capacity, were frequently cited, leading many researchers to rely on proxy input from carers or clinicians. While pragmatic, this approach may limit the authenticity and relevance of the final design. Another major limitation is the lack of longitudinal insights. Most studies reported short-term or cross-sectional outcomes, leaving significant gaps in understanding how assistive technologies function over time, adapt to user needs, or integrate into care routines in sustainable ways. Potential biases also remain, as many studies relied on small convenience samples and self-reported data, limiting generalisability and introducing risks of researcher and reporting bias.

7. Implications for Future Research and Practice

This review highlights several key directions for advancing research and practice in the development of assistive technologies for dementia care. First, engaging people with dementia and their carers earlier and more consistently throughout the design lifecycle is essential to ensure that resulting technologies are meaningful, usable, and empowering. Participation should not be limited to end-stage testing but embedded in the foundational stages of problem definition and idea generation.
The field must navigate the tension between innovation and accessibility. While emerging technologies such as AI, robotics, and XR are reshaping what is possible, their development must remain grounded in the lived realities and cognitive capacities of users. Future work should strive to ensure that advances in technology do not come at the expense of usability, inclusion, or ethical engagement.
Inclusion must be broadened. Underrepresented populations (rural communities, Indigenous groups, and ethnically diverse users) remain marginal in this literature. Expanding efforts to reach these groups is critical for equitable design and implementation.
Real-world implementation and evaluation also require greater attention. Longitudinal, ecological, and mixed-methods studies could provide more robust insights into how technologies are adopted, adapted, and retained over time, particularly in dynamic home and care environments.
Importantly, greater methodological consistency is needed. While many studies invoke HCD or participatory ideals, few clearly describe how these are operationalised. Transparent use of frameworks such as ISO 9241-210 or the Double Diamond, along with explicit reporting of stakeholder roles, iteration cycles, and decision-making processes, would improve rigour and comparability across studies. For example, clearly identifying whether people with dementia were involved in ideation, prototyping, or validation, and how their input shaped design decisions, would allow future researchers to build on these methods more effectively. Journals and reviewers may also have a role in encouraging structured reporting of design processes, similar to the function of CONSORT in clinical trials.
Collectively, these recommendations point to a need for more thoughtful, transparent, and inclusive design practices. Addressing these gaps will support the development of assistive technologies that are not only innovative but also genuinely responsive to the lived experiences of people with dementia.

Author Contributions

Conceptualization, F.P. and L.L.; methodology, F.P. and K.L.; validation, F.P. and K.L.; formal analysis, F.P. and K.L.; investigation, F.P. and L.L.; data curation, F.P. and K.L.; writing—original draft preparation, F.P. and K.L.; writing—review and editing, F.P., K.L. and L.L.; visualization, F.P.; supervision, F.P. and L.L. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The original contributions presented in this study are included in the article/Appendix. Further inquiries can be directed to the corresponding author(s).

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A. Definitions

Dementia: People with dementia are individuals who have been diagnosed with a group of cognitive disorders characterised by a decline in cognitive functioning, including memory, thinking, and reasoning. Dementia is often associated with changes in behaviour and the ability to perform everyday activities [66,67].
Human-centred design: Understanding end-users’ demands, behaviours, and preferences is a top priority for human-centred design (HCD), an iterative design methodology. It involves acquiring an understanding of users’ needs, identifying their issues, producing solutions, prototyping them, and testing them [68].
Co-design: Co-design involves the design of products or services through collaboration with end-users. This method helps identify the problems that end-users are facing and for which they need solutions [69,70]. When developing solutions for complex, user-centred challenges, such as those related to dementia, co-design proves to be helpful.
Assistive technology: Assistive technology refers to the use of tools, software, or devices that can be used to improve the quality of life of people who have disabilities. Assistive technology can play a crucial role in helping people suffering from dementia to carry out their daily activities [71].

Appendix B. Overview of Assistive Technologies, Stakeholder Involvement and HCD Methods and Methodologies

Table A1. Overview of Assistive Technologies, stakeholder involvement and HCD methods and methodologies from all 49 selected studies in the review.
Table A1. Overview of Assistive Technologies, stakeholder involvement and HCD methods and methodologies from all 49 selected studies in the review.
Study RefMethodologyStakeholdersTechnologies
[2]
Multiple (Germany, Italy, Portugal, Romania, Spain)
Journal
Research Article		Qualitative; semi-structured interviews with diverse stakeholders. The study serves as both an evaluative and planning tool for future user-centred design.Strongly emphasised, with engagement across multiple sectors and roles.ICT-based healthcare platforms, specifically aimed at supporting care for dementia and Parkinson’s disease.
[35]
Australia
Journal
Literature review 		Review, with a focus on personal stories and user feedback.Emphasised, with a focus on adapting technology to meet the needs of individuals with dementia.Augmented Reality, Microsoft HoloLens, smart mirrors, etc., are used as assistive technologies for dementia care.
[30]
UK
Conference Proceedings (Full Paper)		Co-design, with a focus on the PERCEPT approach to engage vulnerable user groups in the design process.Emphasised through the co-creation of personas with users, ensuring that the design is grounded in the needs of the end-users.The focus is on a smart home toolset for individuals with early-stage dementia or Parkinson’s.
[10]
Norway
Journal
Systematic Review		A systematic review of qualitative, quantitative, and mixed-method studies, which provides insights into adoption barriers and facilitators.High emphasis on involving relevant stakeholders, including people with dementia and caregivers.The study focuses on the implementation and adoption of assistive technology and telecare, including wearables, assistive robots, React app, sensors, remote monitoring technology, etc.
[16]
UK
Journal
Scoping Review		Scoping review, with a focus on digital technologies supporting the well-being of people with dementia.High emphasis on involving people with dementia, family carers, and care professionals in the design and evaluation of technologies.Focus on measuring engagement and well-being outcomes of assistive technology use.
[43]
USA
Journal
Research Article		Quantitative; UX-oriented (heuristic evaluation and card sorting), not participatory or co-creative.The study reflects an awareness of cultural user needs but lacks direct involvement from users or carers.Mobile health (mHealth) apps for Alzheimer’s, sourced from public app stores.
[59]
UK
Journal
Conceptual Paper		A broad range of qualitative, quantitative, and participatory approaches across the articles is discussed.Involvement of users, families, clinicians, and lived experience contributors is a consistent theme.From basic aids to advanced smart systems and digital tools, including Augmentative and Alternative Communication (AAC) devices, smart home tech, textured insoles, and brain-computer interfaces.
[50]
Spain
Journal
Evaluation		Qualitative; user-centred, iterative, and evaluative through ecological testing and planned clinical trials.Strongly emphasised: users, caregivers, professionals, and healthcare systems are considered.TV-based support system (smart TV), video conferencing, remote monitoring, and cognitive support tools.
[23]
USA, Mexico
Journal
Research Article		Mixed methods; framework-based, with application to a case study; follows an iterative and participatory design process informed by HCD/HCAI.Emphasised as a core element of the framework. Stakeholder needs and perspectives are integrated into design and evaluation.Socially Assistive Robots (SARs), with application in Cognitive Stimulation Therapy.
[28]
Spain
Journal
Research Article		Mixed methods, including usability testing, task-based evaluation, and qualitative analysis.Occupational therapists were involved as co-designers and evaluators. People with dementia were not directly engaged.Reminiscence therapy planning app for therapists.
[27]
Portugal
Journal
Research Article		Mixed methods; design-based research, user-centred design, and quantitative user experience evaluation.Therapists, caregivers, and nutritionists were involved in requirements gathering; caregivers participated in usability testing and feedback.Mobile app for food plan management and nutritional monitoring.
[29]
USA
Journal
Research Article		Mixed methods; combining qualitative feedback from caregivers with quantitative usability testing to evaluate the platform’s effectiveness. Use of Design Thinking and iterative testing with caregivers as primary users. Involvement of diverse racial and ethnic groups.Active and participatory, with dementia caregivers providing continuous feedback throughout the design and evaluation phases, ensuring the platform meets their specific needs.A platform to provide personalised resources for dementia caregivers, with a focus on financial and legal assistance. It uses a Personalisation Algorithm to tailor information based on user needs.
[39]
Belgium
Journal
Research Article		Mixed methods (interviews, surveys, usage data), pre-post-test design with continuous follow-up.Both people with dementia and family caregivers are involved, particularly in evaluating the tool in real-life conditions.Web-based advance care planning tool.
[33]
Austria
Journal
Conceptual Paper		Framework proposal: user-centred via UX/design thinking, digitally enabled.User perspective is central; professional stakeholders are engaged through the framework.Building Information Modelling (BIM) and Internet of Things (IoT), applied to therapeutic environments for dementia care.
[36]
UK (York)
Conference Proceedings (Full Paper)		Mixed methods; multi-phase user-centred methodology including design requirement gathering, system development, and user testing through interviews and surveys.Dementia caregivers were involved from the discovery and definition stage through to evaluation.Chatbot for dementia caregiver support (structured vs. generative AI models)
[37]
Peru
Journal
Research Article		Mixed methods; multi-phase, including qualitative user input and contextual field observations.Stakeholders informed the design, tested the chatbot, and shaped context-specific insights and recommendations.AI-powered chatbot (‘Ana’) for dementia caregiving, tested in both predefined and generative formats; use of WhatsApp as a delivery platform.
[26]
UK
Journal
Research Article		Qualitative; Agile, iterative development with formalised co-design structures; user testing and feedback clearly inform final product design.Strongly emphasised, with meaningful and iterative input from both people living with dementia and their care partners.Smartphone app (mHealth), designed to track cognitive performance in people with dementia.
[41]
UK
Conference Proceedings (Full Paper)		Qualitative, user-requirement driven.Clear involvement of patients and informal caregivers through interviews, with distinct needs identified and respected.Health/home monitoring platforms, with a focus on self-management and care customisation.
[40]
USA
Conference Proceedings (Full Paper)		Qualitative; iterative, user-informed design, with co-created mock-ups indicating a practical application of HCD.Involves patients, caregivers, and healthcare professionals across multiple clinical sites.Mobile application (Patient Empowerment Platform) designed for dementia-related multimorbidity care.
[32]
Germany
Journal
Research Article		Mixed methods, including structured observation, self-report questionnaires, and qualitative content analysis.Participants with dementia were directly involved in evaluation and their input was used to assess and prioritise features.Smartwatch-based assistive technology, used for prompting daily activities and cognitive tasks.
[12]
Australia
Journal
Systematic review		Systematic review: summarising design attributes relevant to the field.Stakeholders are emphasised as necessary in the design process, though actual involvement is discussed at a conceptual level based on secondary evidence.Socially Assistive Robots (SARs) are used in dementia care.
[72]
USA
Journal
Research Article		Qualitative, using semi-structured interviews and affinity diagramming to develop personas, reflecting the user-centred nature of the design process.Strong stakeholder involvement, with direct input from rural caregivers, community partners, and a study advisory board.While the study does not focus on a specific technology, the personas created in the study are meant to guide the design of interventions and technologies that address the unique needs of rural caregivers.
[31]
UK
Journal
Research Article		Case report, with a focus on implementation strategy using HCD principles.Inclusion of healthcare managers and informal care partners.Supportive smart home technology in a hospital alternative level of care setting.
[14]
USA
Journal
Scoping review 		Scoping review, with thematic analysis, mapping support functions to human needs.Not directly enacted in this study.Mobile technologies (various functions, including tracking, memory aids, and social engagement).
[52]
Italy
Journal
Research Article		Mixed methods; participatory design case study, combining reflective practice with practical co-creation.People with dementia participating as expert co-creators.eHealth and mHealth apps co-designed with people living with dementia.
[57]
Germany
Journal
Research Article		Qualitative; interviews with thematic analysis, using fictional vignettes to explore contextualised user perspectives.Includes direct engagement with people with dementia and caregivers to explore perceptions and ethical concerns.GPS tracking, dressing aids, and emotion recognition tools.
[17]
UK
Journal
Scoping Review		Scoping review: reflects on state of the field and suggests methodological improvements rooted in HCD principles.Limited in existing studies but strongly advocated for in future work.Technology for arts-based activities; supporting music, storytelling, and visual arts for older adults with MCI or dementia.
[60]
The Netherlands
Journal
Evaluation		Conceptual paper describing the theory and implementation of HCD in healthcare; although not specific to dementia, it offers valuable insights for framing, assessing, and guiding HCD-based research and development in dementia-related technology.Emphasised as a core HCD element.Not applicable—this paper is not about a specific device or intervention.
[22]
Multiple (Austria, Cyprus, Poland)
Journal
Research Article		Mixed methods; market research to identify user preferences, followed by prototype development and iterative user feedback collection.The system design is informed by both users with dementia and caregivers, with feedback mechanisms in place.eSticky reminder system using ePaper displays, base station, and web platform.
[34]
USA
Journal
Conceptual Paper		The paper integrates experiences from several studies, both experimental and observational, focusing on the usability and acceptability of passive sensing technology.End-users (older adults, including those with dementia) and research staff are both considered, with strategies mentioned to address the challenges faced by these groups.Remote passive sensing technology, used to monitor older adults’ activities and functions for behavioural interventions in home settings
[51]
Denmark
Conference Paper
Evaluation		Qualitative: workshops with stakeholders as part of a design process.The study involves significant stakeholder feedback from multiple sources (caregivers, healthcare professionals, and local government).Focuses on electronic tagging and tracking technologies.
[47]
Belgium
Journal
Research Article		Mixed methods; iterative usability testing (think-aloud, SUS, interviews), guided by formal development frameworks.People with dementia, caregivers, dyads, and PPI contributors were involved across multiple stages of design and evaluation.Web-based advance care planning tool.
[48]
Belgium
Journal
Research Article		Mixed methods (quantitative usability metrics and qualitative feedback), supporting the depth and rigour of user engagement. The study employs a structured and iterative development process with meaningful involvement from end-users and stakeholders.Strongly emphasised, with direct involvement from people with dementia, caregivers, and a stakeholder advisory group.A user-centred, interactive website for advanced care planning in dementia care.
[15]
Australia
Journal
Scoping Review		Scoping Review: examining the outcomes of robotics and multimedia technologies in residential care settings.The study includes evidence on the needs of residents with dementia but does not specifically engage them. Focuses on robotics and multimedia computer programs for engagement and interaction.
[42]
Australia
Journal
Research Article		Qualitative; two-phase co-design approach with expert-informed input, resulting in a prototype application.Direct and meaningful; includes caregivers and professionals across relevant disciplines.Android-based mHealth application for caregivers of people with dementia.
[45]
USA
Journal
Research Article		Mixed methods; early-stage user-centred design using surveys and a mock-up apartment for pilot testing.Family caregivers are directly involved.Mobile interface for cognitive assistive technology (CAT) to support IADLs.
[54]
USA
Journal
Conceptual/Protocol Paper		Mixed methods; following recognised NIH intervention development stages, combined with participatory design.People with dementia, caregivers, care providers, designers, and researchers are involved.Innovative bio-experiential platform aimed at enhancing emotional health and engagement for dementia dyads.
[13]
USA
Journal
Systematic Review		Systematic review, synthesising findings from existing literature to assess the effectiveness and gaps in current remote monitoring technologies.Strong focus on patients, caregivers, and healthcare professionals, with a call for improved evaluation of these technologies in relation to their usability and privacy concerns.Remote monitoring technologies, including wearables, environmental sensors, and smart home systems, are designed to support patients with Alzheimer’s and ease caregiver burden.
[55]
Canada
Journal
Research Article		Qualitative; participatory, iterative, consistent with HCD and co-design principles.Direct involvement of people with MCI/EOD and their care partners in shaping design.Focus on workplace technologies for people with mild cognitive impairment/early onset of dementia.
[46]
Canada
Journal
Research Article		Mixed methods; secondary quantitative analysis of real-world interactions, persona development, and design recommendations in conceptual and design-preparatory phases. It uses an evidence-based approach to develop realistic user personas, which are then used to generate context-sensitive design recommendations.Indirect stakeholder involvement, via video-based behavioural analysis, but robust in capturing real user needs. The focus is on informing the design of assistive technologies for cognition, not a specific product, but the recommendations are tailored for tech supporting executive function in people with dementia.
[11]
UK
Journal
Systematic Review		Systematic review, with an emphasis on carer experience and ethical concerns.Carers are the focus of the review, but not active participants in the design processes of the technologies covered.Broad spectrum of assistive devices for home-based dementia care (e.g., medication dispensers, wearables, trackers, robotic aids, smart home management systems, etc.).
[56]
Canada
Journal
Research Article		Qualitative, participatory needs assessment with strong cultural sensitivity and community engagement.Includes people with dementia, carers, healthcare professionals, and community leaders.Focus is on identifying needs and barriers to technology use in Indigenous dementia care contexts.
[9]
The Netherlands
Journal
Systematic Review		Systematic review with interdisciplinary reach (healthcare, HCI, design), assessing phases of involvement and engagement strategies.Centred on direct participation of people with dementia, including as co-designers in some studies.Broad range of supportive technologies.
[61] 2020
USA
Journal
Literature review		Narrative mini-review.Stakeholders’ needs and barriers are acknowledged, but not through participatory methods.Intelligent Assistive Technologies (IAT), including wearable, handheld devices, mobility aids, voice-activated assistants, robotics, and sensors.
[58]
Croatia
Journal
Research Paper		Mixed methods; literature review and qualitative data from focus groups.Older adults were consulted through focus groups.Digital platforms and assistive technologies for health and social care. Telehealth, remote monitoring, and assistive devices.
[49]
Germany
Journal
Research Article		Qualitative, using focus groups and content analysis to gather and analyse feedback from key stakeholders. An emphasis on iterative feedback and ethical considerations.Strong involvement of people with dementia, therapists, caregivers, and researchers, ensuring that the technology is developed in alignment with their needs and ethical concerns.Mobile service robots are applied within a psychosocial group therapy setting, designed to assist therapists and participants with dementia.
[44]
Canada
Journal
Research Article		Mixed methods, with qualitative analyses and user experience questionnaires to assess the usability of the technology and guide further modifications.Strong stakeholder involvement, with users actively participating in both laboratory and real-world settings to inform the design process and address usability issues.COOK (Cognitive Orthosis for coOKing), an assistive technology designed to support older adults, especially those with cognitive impairments, in cooking tasks.
[53]
Denmark
Conference Proceedings (Full Paper)		Qualitative; participatory workshops using participatory design and design thinking frameworks; iterative.High involvement of end-users and multi-disciplinary teams throughout the design process.Focus on natural language processing technology applied in dementia care contexts.
[38]
Australia
Journal
Research Article		Mixed methods, including usability testing, interviews, observations, and standardised usability scoring. It reflects core HCD principles such as iteration, user feedback, adaptation to cognitive needs, and the consideration of overlapping but distinct user journeys. People with dementia and carers were both involved in testing and provided feedback that directly shaped design changes.Dementia-focused informational website (Forward with Dementia).

Appendix C. Search Strategy

Host platform and databases searched:
(1)
JSTOR sources
(2)
SCOPUS sources
(3)
WEB OF SCIENCE sources
(4)
ProQuest sources
The keywords used in the research for human-centred design for dementia care:
human-centred design, dementia or Alzheimer’s, assistive technology or technology
Web of science:
  • #1- TS = (“human centred design” OR “human centred design” OR “user-centred design” OR “user-centred design” OR “design thinking”)
  • #2- TS = (“dementia” OR “Alzheimer’s” OR “Alzheimer disease”)
  • #3- TS = (“assistive technology” OR “technology” OR “adaptive technology” OR “Assistive Devices” OR “technology, assistive”)
#1 AND #2 AND #3
Complete Strategy:
TS = (“human centred design” OR “human centred design” OR “user-centred design” OR “user-centered design” OR “design thinking”) AND TS = (“dementia” OR “Alzheimer’s” OR “Alzheimer disease”) AND TS = (“assistive technology” OR “technology” OR “adaptive technology” OR “Assistive Devices” OR “technology, assistive”)
Scopus:
(“human centred design”[Title/Abstract] OR “human centred design”[Title/Abstract] OR “user-centred design”[Title/Abstract] OR “user centred design”[Title/Abstract] OR “design thinking”[Title/Abstract])AND (“dementia”[Title/Abstract] OR “Alzheimer’s”[Title/Abstract] OR “Alzheimer disease”[Title/Abstract] OR “Alzheimers”[Mesh] OR “Dementia”[Mesh]) AND (“assistive technology”[Title/Abstract] OR “technology”[Title/Abstract] OR “adaptive technology”[Title/Abstract] OR “Assistive Devices”[Mesh] OR “technology, assistive”[Mesh]
ProQuest:
SU.EXACT (“Human Centred Design”) OR SU.EXACT (“Human Centred Design”) OR SU.EXACT (“User-Centred Design”) OR SU.EXACT (“User Centred Design”) OR SU.EXACT (“Design Thinking”) AND SU.EXACT (“Dementia”) OR SU.EXACT (“Alzheimer’s”) OR SU.EXACT (“Alzheimer Disease”) AND SU.EXACT (“Assistive Technology”) OR SU.EXACT (“Adaptive Technology”) OR SU.EXACT (“Assistive Devices”) OR SU.EXACT (“Technology, Assistive”) OR technology
JSTOR:
(“human centred design” OR “human centred design” OR “user centred design” OR “user centred design” OR “design thinking”) AND (“dementia” OR “Alzheimer’s” OR “Alzheimer disease”) AND (“assistive technology” OR “technology” OR “adaptive technology” OR “Assistive Devices” OR “technology, assistive”)

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Figure 1. PRISMA flowchart for the scoping review process.
Figure 1. PRISMA flowchart for the scoping review process.
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Figure 2. Key types of assistive technologies developed using human-centred design (HCD) approaches for people with dementia.
Figure 2. Key types of assistive technologies developed using human-centred design (HCD) approaches for people with dementia.
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Figure 3. Stakeholder map for human-centred design (HCD) in dementia care.
Figure 3. Stakeholder map for human-centred design (HCD) in dementia care.
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Table 2. Summary of the selected studies.
Table 2. Summary of the selected studies.
Number of Studies (N = 49)
Publication date
After 202039
2017–202010
Before 20170
Region
Europe28
North America15
Oceania5
South America1
Study design
Qualitative14
Mixed methods18
Quantitative1
Other (e.g., review, case report, framework proposal)16
Assistive technology type
mHealth/eHealth18
Smart Home Systems5
Internet of Things (IOT)3
Robotics3
Chatbot/Natural Language Processing3
Mixed16
TV-based1
Table 3. Summary of the HCD framework, phases, and cycles adopted by the studies included in the review.
Table 3. Summary of the HCD framework, phases, and cycles adopted by the studies included in the review.
FrameworkPhases/CyclesReferences
PERCEPT framework Explore, Design, Evaluate[30]
Human-Centred Design
/User-Centred Design approach		Discovery, Development, Evaluation[35]
App identification and categorisation, sampling, expert heuristic evaluation (Nielsen’s Usability Heuristics), guideline development (no iterative or user-involved cycles)[43]
Exploration; Ideation; Generation; Evaluation (iterative cycles)[44]
Studying users; Designing for the problem; Testing IADL system components; Evaluating the IADL/CAT system[45]
Structured observation, self-report questionnaires, qualitative content analysis[32]
Requirement gathering, prototyping, feedback, iteration, and final design approval[40]
Persona development/Not applicable[22,46]
Content specification (user needs assessment, evidence synthesis, translation into preliminary content); Creative design (storyboard, prototype development, iterative usability testing with continuous stakeholder engagement)[47,48]
Focus group discussion, app improvement suggestions, technical implementation, and deployment[49]
Phase 1: identify requirements and design prototype; Phase 2: evaluation by occupational therapists[28,39]
Stakeholder engagement; Intervention design and development; Evaluation (interviews, satisfaction survey)[36,37]
ISO 9241–210:2019 Discover, Design (Prototyping and Evaluation)[27]
ISO 9241–210:2019 Understand, Define, Design, Evaluate (ongoing iteration)[31,41]
Co-DesignUser Requirements, Prototype 1, Internal Test, Prototype 2, Feasibility Study, Prototype 3, Clinical Trial, System Improvement.[50]
Research, Ideation, Prototyping, Evaluation[51]
Needs assessment, Development[42]
Empathise, Define, Ideate, Prototype, Test[52]
Planning, Design, Development, Testing (combined with Agile methodology)[26]
Design Thinking with Participatory DesignPhase I: Platform development and pilot test; Phase II: iterative platform development and evaluation[29]
Empathise, Define, Ideate, Prototype, Test (Stanford d.school model)[33,53]
Understanding user needs, goals, strengths; Prototype development and refinement; Observing user interactions (aligned with NIH Stage Model)[54]
Semi-structured interviews, participatory sessions, and data analysis[55]
Community-Based Participatory Research (CBPR)Planning, data collection (focus groups/interviews), analysis, theme development, reflection[56]
Qualitative study Not applicable (using vignettes or interviews)[2,57,58]
Usability and ergonomics focusedNot applicable[34,38]
No design framework, no phases/cycles [9,10,11,12,13,14,15,16,17,59,60,61].
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Peng, F.; Little, K.; Liu, L. Human-Centred Design (HCD) in Enhancing Dementia Care Through Assistive Technologies: A Scoping Review. Digital 2025, 5, 51. https://doi.org/10.3390/digital5040051

AMA Style

Peng F, Little K, Liu L. Human-Centred Design (HCD) in Enhancing Dementia Care Through Assistive Technologies: A Scoping Review. Digital. 2025; 5(4):51. https://doi.org/10.3390/digital5040051

Chicago/Turabian Style

Peng, Fanke, Kate Little, and Lin Liu. 2025. "Human-Centred Design (HCD) in Enhancing Dementia Care Through Assistive Technologies: A Scoping Review" Digital 5, no. 4: 51. https://doi.org/10.3390/digital5040051

APA Style

Peng, F., Little, K., & Liu, L. (2025). Human-Centred Design (HCD) in Enhancing Dementia Care Through Assistive Technologies: A Scoping Review. Digital, 5(4), 51. https://doi.org/10.3390/digital5040051

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