Table 6.

Summary of reviewed studies.

Study (year and country)	Study Type	Study Aim and Methodology	Participants1	mHealth app with Features	Study Outcomes	Study Category
Nirjjon et al. [45], 2014, USA.	Usability Study	Aim: To provide convenient, automated and easy to administer dementia screening test that can be taken at home. Methodology   (i) Development of application. (ii) Use local database for displaying words on the screen. (iii) Pre-processing, feature extraction, training and classification for clock drawing test. (iv) k-NN algorithm for classification of recognized digits.	7 healthy adults (3 females, 4 males) age ~ 25-35	MOBI-COG App with remembering words, clock drawing test and recalling words.	Questionnaire of the usability study, 99.53% accuracy in clock drawing test.	Screening
Kong [40], 2015, USA.	Exploratory Study	Aim: To explore the implementation of apps on the iPad to conduct cognitive exercises. Methodology   (i) Keyword based app selection from iTunes. (ii) Questionnaire to determine the familiarity of the participant with technology. (iii) Finalize the apps based on a questionnaire.	10 PwD (6 males, 4 females) age ~ 64-84 MoCA: 15.74 (diagnosed with early-stage dementia)	Free Apps (iTunes) with visual-spatial, memory and problem-solving.	Participants' rating of exercise, Clinicians response for further implementation of apps.	Cognitive training and daily living
Zorluoglu et al. [47], 2015, Turkey.	Novel Study	Aim: To evaluate the cognitive skills by involving different tests for cognitive functions assessment. Methodology   (i) Experimental study to conduct 33 tests in 14 different cognitive skills. (ii) Display the radar chart to show progress.	23 participants with CG+PwD Control Group   9 healthy people age ~ 63-95 Females = 78.78%, Males= 22.22% Avg. MoCA score: 24.55 ± 3.08 PwD Group   14 dementia people age ~ 73-89 Females = 78.57%, Males= 22.43% Avg. MoCA score: 13.57 ± 5.61	Mobile Cognitive Screening (MCS) App with trail making, clock drawing, attention, visual, shape similarity, shape matching, arithmetic, proverb, naming, numbers, colourful shapes, market, date, and story recall test.	Correlation between MCS and MoCA scores was r2=0.57; this correlation was meaningful (p <0.01).	Screening
Sindi et al. [46], 2015, Finland.	CAIDE Study	Aim: To predict the risk of dementia through CAIDE (cardiovascular risk factor, ageing and incidence of dementia) Risk Score app. Methodology   (i) Development of app based on CAIDE dementia risk score by involving information on age, educational level, hypertension, hypercholesterolemia, obesity, and physical inactivity.	Four independent population-based random samples Participants MMSE score ≤ 24	CAIDE Risk Score App with graphical display of risk scores, risk of developing dementia estimation, guidance and suggestions to users, the recommendation of a health practitioner.	Receiver operating characteristics (ROC) curve demonstrated the dementia risk score predicted effectively. 95% confidence interval (0.71-0.83).	Screening
Thorpe et al. [41], 2016, Denmark.	UCD case	Aim: A UCD (User-centred design) to investigate the adoption of pervasive assistive technology among mild dementia people. Methodology   (i) Selection of key support features. (ii) User testing of selected applications.	5 Dyads with PwD of MCI PwD: 3 males, 2 females age~ 61-73	11 Free Android Apps with scheduling, navigation, communication, emergency help, monitoring and orientation.	System Usability Scores (SUS) in usability testing and field testing.	Cognitive training and daily living + Navigation + Health and Safety Monitoring
Vahia et al. [42], 2016, USA.	Open-Label Study	Aim: To investigate the feasibility, usability and safety of tablet apps in managing agitation among dementia patients. Methodology   (i) Personalization of tablet applications (rate selected apps as per complexity). (ii) Find the correlational analysis between tablet use and demographic characteristics of the group.	36 participants (n) with Mild to Severe dementia (females: 61.1%, males: 38.9%) Mildly impaired MoCA score: 18 to 25; n=23 Moderately Impaired MoCA score: 10 to 17; n=7 Severely Impaired MoCA score <10; n=16 Age~ avg 79.9	70 Free iTunes Apps with communication, games, music and musical instruments, video, entertainment and recording, web browser and news, and picture/photograph-viewing apps.	Well Utilization of app. Agitation reduction in the mildly impaired group as compared to severe impaired = p =0.02.	Cognitive training and daily living
Boyd et al. [50], 2017, Ireland.	Usability Study	Aim: To develop and evaluate the usability of EnCare diagnostics (ECD) and Brain Fit Plan (BFP) app. Methodology   (i) Select Android apps. (ii) Design trails-based study. (iii) Usability assessment of apps.	Includes 02 trials: Trial 1: 11 healthy people (age > 60) Females: 9, Males: 2 4 older adults with physical impairment Trail 2: 8 older adults Females: 4, Males: 4 MMSE score: 21-26 Diagnosed with early-stage dementia	ECD App with screening of dementia. BFP App with logical thinking based on existing apps (chess, jigsaw etc.).	75% dropout at Trail 1 for BFP testing due to in familiarity with technology and lack of carer support. High acceptability in ECD. No usability issue in ECD.	Screening (ECD)   Cognitive training and daily living   (BFP)
Dethlefs et al. [43], 2017, England.	Pilot Study	Aim: To provide elderly people and PwD computer-based cognitive simulation via spoken natural language. Methodology   (i) Wizard-of-Oz interface. (ii) To process input speech of participant and respond accordingly.	23 participants with Healthy and PwD Healthy People: 13   Avg. age~ 84.33 PwD: 10   Avg. age~ 78.20	Wizard-of-Oz System with sorting, naming, recall, quiz and proverb.	Enjoyment and wanted to use it again.	Cognitive training and daily living   (Memory & Communication)
Bayen et al. [51], 2017, USA.	Pilot Study	Aim: To analyse how continuous video monitoring and review of falls of PwD can support a better quality of care. Methodology   (i) Measure the count of falls occurring in the video covered area. (ii) Evaluate the use of video recording and replay possibilities for care practice.	Overall 38 PwD with 10 participants allowing written and oral consent for video recording in their private rooms.	SafetyYou App with video view feature from past 72 hours, live video view on a smartphone from each installed camera.	Drop in fall rate. Positive impact on quality of care.	Health and Safety Monitoring   (Fall Detection)
Mulvenna et al. [54], 2017, England.	Feasibility Study	Aim: To investigate the effects of individual-specific reminiscence activity provided by using the app. Methodology   (i) An agile development approach for prototype (ii) Local database for the storage of multimedia content.	28 Dyads	InspireD App to enable PwD and their carer gather together, store selected generic and personalized memorabilia.	Engagement. Use for personal multimedia content.	Leisure and Socialization (Reminiscence Therapy)
Megges et al. [56], 2017, Germany.	Pilot Study	Aim: To evaluate the user experience regarding prototype locating system in home dementia care to better understand the needs and preferences of PwD and their carers. Methodology   (i) Use of locating system for 4 weeks. (ii) Measure usability, product functions and features. (iii) Measure caregiver burden perceived self-efficacy, the frequency of use, and willingness to purchase the prototype.	18 Dyads PwD Count   3 MCI, 6 Mild disease severity, 9 moderate disease severity Avg. age ~ 71.94 Carers Count   10 husbands, 6 wives, 2 daughters	Prototype Locating System with a call, alarm, location tracking and service hotline. Sub-Features: Zone mapping Zone Sharing	Usability rating declined, product functions rated positively. No difference in caregiver burden and perceived self-efficacy. Moderate frequency of use, and high willingness to purchase.	Navigation
Tyack et al. [44], 2017, England.	Quantitative and Qualitative Study	Aim: To explore whether art-based intervention can be delivered via a touchscreen tablet device displaying art images. Methodology   (i) The quantitative data followed a quasi-experimental repeated measures design. (ii) Compare before and after use of the tablet on well-being. (iii) The qualitative data collected during interviews was analysed using thematic analysis.	12 Dyads PwD   Males: 8, Females: 4 Avg. age ~ 75 Diagnosed dementia with 4 years Carer   Males: 2, Females: 10 Avg. age ~ 66	Art Viewing App for presenting choices of art genre to view from museums and area artists.	Improvement in well-being and enthusiasm.	Cognitive training and daily living   (Stimulating, Remembering, Attention)
Docking et al. [52], 2017, England.	Qualitative Study	Aim: To improve the pain assessment of PwD and management in this vulnerable population. Methodology   (i) conducting usability testing of an app to assess pain in adults with dementia treated by paramedics. (ii) evaluate the appropriateness of the algorithm used in an app. (iii) identifying areas for further development and response to recommendations.	24 paramedic students from two England Ambulance services. Females: 11, Males:13 7 Delphi Panel Experts Females:1, Males: 6	Pain Assessment App with the Abbey Pain Scale based questionnaire.	Positive usability testing. Paramedics Students and Delphi panel of experts state it as a useful tool in a pre-hospital setting.	Health and Safety Monitoring   (Emergency Help, Pain assessment)
Huang et al. [48], 2017, Taiwan.	Experimental Study	Aim: To develop a psychometrically valid touchscreen tablet-based cognitive test battery to identify early cognitive impairment due to dementia in older adults. Methodology   (i) To conduct 8 tests with 13 subscores for the measurement of different cognition skills.	120 participants (n) CDR=0; n=41; age ~64-88 CDR=0.5 with MCI; n=43; age ~59-91 CDR=1; n=36; age ~56-91	Attention, Visual Memory, Visuospatial, Reaction Time, Fine Motor Control. (App name not mentioned)	Mann–Whitney U tests were significant for CDR = 0 versus 0.5, and CDR = 0 versus 1. Confirmation of the four-factor model by Confirmatory factor analysis (CFA).	Screening
Welsh et al. [55], 2018, England.	Experimental Study	Aim: To encourage conversation between younger people and their old relatives living with dementia. Methodology   (i) Extend the previous work by developing an application that incorporates the following four design requirements: (1) Setting up a profile. (2) Inspiration (media to use for talk). (3) Collecting media. (4) Preparing a conversation.	Deployment with 02 families of PwD. Deployment in care home involves 3 volunteers to maintain a conversation with 10 residents, age ~ 80-95 with moderate to severe dementia. 9 older people with personal/professional dementia experience for expert critique.	Ticket To Talk App to create a profile for an older person, prompt carers to collect media (audios, videos, and images etc.), helps carers to organize media, use media as prompts and conversation starters	Promoting and managing reminiscence, Starting and maintaining conversation, Redistributing Agency.	Leisure and Socialization (Reminiscence Therapy, Relaxation)
Shibata et al. [49], 2018, Japan.	Experimental Study	Aim: To report that MCI patients have a significantly larger vocabulary than healthy elderly people. Methodology   (i) Use automatic speech recognition for measuring language abilities. (ii) Analyze narrative speech and find four language abilities scores.	18 participants PwD: 8 with MCI CG: 9	VocabChecker App to calculate the number of tokens, number of types, token type ratio, potential vocabulary size.	p-values in t-test show that token type ratio of PwD is higher than CG (p <0.05, highly significant)	Screening (language abilities based)
Atee et al. [53], 2018, Italy.	Novel Study	Aim: To describe a novel system called PainChek™ focusing on its conceptual foundation, clinical and technical contents, clinical use, and practical tips for use in clinical settings. Methodology   (i) Following things to consider while developing an application: (a) Subjective nature of pain. (b) Complexity, and dynamicity of pain as a construct. (c) An objective description of key pain behaviours. (d) The temporality of pain and related behaviours. (ii) Simple scoring mechanism.	12 Dyads PwD Males: 8, Females: 4 Avg. age ~ 75 Diagnosed dementia with 4 years Carer Males: 2, Females: 10 Avg. age ~ 66	PainChek™ App to test pain scale (42 items across 6 domains), to display pain assessment log, Pain chart and local patient database, to provide medications and therapies and comments section.	Sound psychometric properties. Excellent concurrent validity, interrater reliability, internal consistency, and excellent test re-test reliability.	Health and Safety Monitoring   (Emergency Help, Pain assessment)

¹ PwD: People with Dementia; CG: Control Group; MoCA: Montreal Cognitive Assessment; Dyad: PwD and carers; MMSE: Mini-Mental State Examination; MCI: Mild Cognitive Impairment.