Table 5.
Interventions for PWD.
| References | Focus | Methods | Interventions | Results | Conclusions |
|---|---|---|---|---|---|
| Brando et al. (2017)* | Analysis of the advantages and disadvantages associated with the implementation of technology into works with PWD and caregivers. | Literature Review. 30 studies, 27 on PWD. | Cognitive rehabilitation using technologies (videogames, VR setting, smartphone, computer and tablet). Cognitive assessment using digital tests. | Cognitive rehabilitation leads to a large generalization of the benefits. Significative outcomes on cognitive and depressive symptoms using videogames. Greater results on self-efficacy, perceived improvement, involvement and cognitive symptoms using VR rehabilitation than traditional activities. Positive effects on QoL using everyday technologies. Using digital tests for the assessment allow to standardize the administration process and the presentation of stimuli. | Cognitive rehabilitation using technologies has advantages over traditional rehabilitation. Further RCT studies are required to compare the advantages associated with different devices. |
| Brims and Oliver (2019) | Analysis of the effectiveness of ATs in improving the safety of PWD. | Systematic Review and Meta-analysis. Three RCTs. | Interventions using devices (sensors and tech-armbands) to increase safety in domestic setting. | The probability of a fall occurring was 50% lower in the intervention group [risk ratio 0.50 95% CI (0.32, 0.78); Z = 3.03; p = 0.002]. Significant fewer risky behavior in 1/3 studies (p < 0.001). No significant differences emerged between groups in care home admission, QoL and depressive symptoms. | Current evidence supports the use of safety AT by PwD. Further research is required to infer causality. |
| Daly Lynn et al. (2019) | Analysis of the ATs used for PWD in residential care settings. | Systematic Review, 61 studies. | Interventions based on technologies. Telecare (23), light therapy (4), pet robots (12), simulated presence therapy (9), leisure activities (8) and ADL (5). | Telecare technologies – improvement in safety and increased PWD's autonomy. Light therapy – Improvement in circadian rhythms. Pet robots – decreased BPSD and depressive symptoms; increased social interactions. Daily living activities – positive effects on cognition, communication and physical activity. ADL – increased autonomy in personal hygiene, decreased stress using digital prompts. | Positive outcomes support the potential of ATs in dementia context. More standardized studies are required to explore the effectiveness of each device. |
| Dove and Astell (2017) | Analysis of the available motion-based technologies in dementia context. | Literature Review. Thirty-one studies, section of 25/31 on PWD. | Interventions combining cognitive stimulation, physical activity and leisure activities using videogames based on motion sensors. | Motion-based technologies have benefits on general cognition, mobility, balance, fall risks, self-esteem, well-being and social health. | Motion-based technologies are feasible to stimulate PWD. A positive acceptability emerged. |
| El-Saifi et al. (2018) | Analysis of interventions aimed at improving medication adherence in PWD. | Systematic Review, 20 studies, one relevant. | Intervention of tele-monitoring during day/night time. | Significative compliance in the intervention group (81%), compared to the control group (66%), p < 0.05. Also, unmonitored patients' compliance fell of 12%. | Tele-monitoring was the only intervention able to increase PWD's compliance. Further standardized studies are required. |
| Fleming and Sum (2014) | Analysis of the effectiveness of ATs in dementia care. | Systematic Review, 41 studies. | Interventions based on ATs to sustain: daily living, safety, therapies and telecare. | ATs for daily life were positively evaluated, but their usage decreased over time. - Safety ATs had potential benefits, but technical issues also emerged. – Positive outcomes on BPSD and circadian rhythms came out using technology-based therapy. -Telecare led to positive outcomes concerning cognitive training and medication adherence. | Mixed results emerged using ATs in dementia care. Further standardized studies are required to assess the effectiveness of technologies for PWD |
| García-Casal et al. (2017) | Analysis of the effectiveness of computer-based cognitive interventions targeting PWD. | Systematic Review and Meta-analysis. | Computer-based interventions of cognitive training, cognitive rehabilitation, cognitive stimulation and cognitive recreation. | Moderate effects on cognition, assessed with MMSE and HDS-R (SMD −0.69; 95% CI = −1.02 a to 0.37; P < 0.0001; I∧2 = 29%); greater effects on cognition of computer-based interventions compared to traditional interventions (SMD 0.48; 95% CI = 0.09–0.87; P = 0.02; I∧2 = 2%). Small effects in depression, assessed with GDS and CES-D (SMD 0.47; 95% CI = 0.16 a 0.78; P = 0.003; I∧2 = 0%). Moderate effects on anxiety, assessed with STAI (SMD 0.55; 95% CI = 0.07 a 1.04; P < 0.03; I∧2 = 42%). No significant effects on IADL (p > 0.05). | Computer-based cognitive interventions have moderate effects on cognition and anxiety; small effects on depression. Computer-based interventions have greater effects over the traditional ones. Longer-term follow up are required to examine effects' retention. |
| Klimova and Maresova (2017) | Analysis of the effectiveness of computer-based cognitive training for PWD and MCI. | Mini Review, section of four RCTs on PWD. | Computer-based cognitive training interventions. | 1/4 study showed improvement in episodic memory and abstract reasoning. 1/4 study was effective in delaying the progression of the cognitive impairment. 2/4 studies revealed no effects. | Mixed results emerged. Further standardized studies are required to examine the effectiveness of computer-based cognitive training on PWD. |
| Lazar et al. (2014) | Analysis of the use of ICTs for facilitating reminiscence therapy. | Systematic Review, 44 studies. | Reminiscence therapy using technologies (videogames, multimedia and digital interfaces). | Technologies accommodate for motor and sensor impairments, using devices as earphones, image projectors or touchscreens. ICTs allow to compensate for memory deficits. Also, ICTs facilitate the administration process using clouds or telecare. | Technologies enrich reminiscence therapy for PWD. Further studies should focus on the effectiveness at different stages of dementia. |
| Liapis and Harding (2017) | Analysis of the effectiveness of computer-based therapies for PWD. | Systematic Review, section of five relevant studies, one RCT. | Technology-based therapy interventions and leisure activities for PWD. | Interventions have been evaluated as feasible and enjoyable by PWD. No quantitative improvement in cognition emerged using MMSE. People with mild and moderate dementia preferred videogames; people with severe dementia preferred listening to music or watching videos. | Potential benefits emerged, but more standardized studies are required to examine the effectiveness of technology-based therapies for PWD. |
| Lorenz et al. (2019)* | Mapping technologies for PWD and caregivers, classified by function, target user and disease progression. | Rapid Review, interviews and blog analysis. Forty-seven studies. | Online psycho-social support, cognitive training, psycho-education and remote monitoring of the PWD. | Most technologies target people with moderate and severe dementia living in their homes are focused on safety. Most technologies for PWD living in care homes are focused on care delivery and therapies. Memory aids and daily living technologies mostly target people with mild dementia living in their homes. | Little evidence back up the practical application of the identified technologies. Further researches should examine the impact of a wide range of technologies on the daily living. |
| Maia et al. (2018) | Analysis of interventions for PWD using ATs to sustain BADL. | Systematic Review, four studies. | Technology-based interventions to sustain BADL (safety, memory aid, monitoring, etc.). | Monitoring sensors has been evaluated as useful by PWD and caregivers; prompt systems facilitated medication adherence and finance management; navigation systems improved PWD's autonomy in movements. 1/4 study reported technical issues. | ATs are feasible to sustain PWD's BADL. |
| Neubauer et al. (2018) | Analysis of the types of technologies used to manage wandering behavior in PWD. | Scoping Review, 12 studies. | Interventions targeting PWD using sensors, alarms and locators to manage wandering. | 26 types of technologies identified (GPS, sensors, alarms, Bluetooth, etc.). 67.7% of the devices were wearable. 7/12 studies reported positive results in managing wandering behaviors. The general acceptability was high. | Technologies can reduce risks associated with wandering behaviors and improve the autonomy in movements of PWD. Further studies are required to increase levels of evidence. |
| Pinto-Bruno et al. (2017) | Analysis of the validity and the efficacy of ICT-based interventions to promote social health and an active aging. | Systematic Review, six studies. | ICT-based interventions of reminiscence therapy, leisure activities, cognitive and physical training. | Qualitative – technologies foster social participation in PWD. Quantitative – People in the intervention group made more choices [t(10) = 3.6717, p < 0.05] and sang more [t(10) = 2.191, p < 0.05] than the control group. People in the control group spent more time asking questions [t(10) = 3.13, p < 0.01] and initiated less conversations (z = 2.03, p < 0.05) than the intervention group. | Initial positive evidence emerged using ICT interventions. Specific outcomes measure to assess social health and social participation are needed for future studies. |
| Tyack and Camic (2017) | Analysis of the impact on well-being of touchscreen-based interventions for PWD. | Systematic Review, 16 studies. | Intervention using touchscreen devices to sustain reminiscence therapies, leisure activities, safety, communication and prompting systems. | Mixed results. Positive evidence on mood, involvement, perceived well-being and perceived satisfaction. A significant positive correlation emerged in one study between age and impact on mood (rs = 0,46, p < 0.05), with greater effects on older people. Benefits of social interaction with relatives and on the sense of mastery (technological skills and satisfaction increasing). | Touchscreen-based interventions can improve the psychological well-being of PWD. More rigorous future studies are needed. |
| Yousaf et al. (2019) | Analysis of the evidence on the use of mHealth application for PWD. | Overview, 17 studies. | Interventions using mHealth Apps to sustain cognitive training, daily living, screening, safety, navigation and leisure activities. | Cognitive domain – available Apps target memory, communication, logical thinking, attention, language abilities and schedule. Screening domain – Apps target dementia detection and cognitive screening. Health/safety monitoring domain – Apps for fall detection and emergency help. Leisure domain – Apps for reminiscence therapy and socialization therapy. Navigation domain – Apps for tracking and location service. | Mobile health Apps are interactive, easy to use and independence promoting. These seems feasible AT intervention for PWD and caregivers. |