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

Background: The increasing prevalence of dementia and mild cognitive impairment (MCI) among the elderly population is a global health issue. Information and Communication Technology (ICT)-based interventions hold promises for maintaining cognition, but their viability is affected by several challenges. Objectives: This study aimed to significantly assess the effectiveness of ICT-based cognitive and memory aid technology for individuals with MCI or dementia, identify adoption drivers, and develop an implementation model to inform practice. Methods: A PRISMA-based systematic literature review, with the protocol registered in PROSPERO (CRD420251051515), was conducted using seven electronic databases published between January 2015 and January 2025 following the PECOS framework. Random effects models were used for meta-analysis, and risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists. Results: A total of ten forms of ICT interventions that had proved effective to support older adults with MCI and dementia. Barriers to adoption included digital literacy differences, usability issues, privacy concerns, and the lack of caregiver support. Facilitators were individualized design, caregiver involvement, and culturally appropriate implementation. ICT-based interventions showed moderate improvements in cognitive outcomes (pooled Cohen's d = 0.49, 95% CI: 0.14-1.03). A sensitivity analysis excluding high-risk studies yielded a comparable effect size (Cohen's d = 0.50), indicating robust findings. However, trim-and-fill analysis suggested a slightly reduced corrected effect (Cohen's d = 0.39, 95% CI: 0.28-0.49), reflecting potential small-study bias. Heterogeneity was moderate (I² = 46%) and increased to 55% after excluding high-risk studies. Subgroup analysis showed that tablet-based interventions tended to produce higher effect sizes. Conclusions: ICT-based interventions considerably enhance cognition status, autonomy, and social interaction in older adults with MCI and dementia. To ensure long-term scalability, future initiatives must prioritize user-centered design, caregiver education, equitable access to technology, accessible infrastructure and supportive policy frameworks.

Keywords: ICT; assistive technology; cognitive support; dementia; digital health; digital literacy; healthcare technology; mild cognitive impairment; technology adoption.

Figure 1

Systematic literature review (SLR) process for article selection.

Figure 2

PRISMA flow diagram.

Figure 3

Word cloud visualization of key terms.

Figure 4

Yearly distribution of publications.

Figure 5

Distribution of study designs.

Figure 6

Geographical distribution.

Figure 7

Distribution of device types used in ICT-based interventions for older adults with cognitive impairment.

Figure 8

AI-integrated cognitive assessment and training systems.

Figure 9

Forest plot showing random effects [46,50,51,52,55,57,58,59,62,64,72].

Figure 10

Forest plot of effect sizes (Cohen’s d) by intervention type [46,50,51,52,55,57,58,59,62,64,72].

Figure 11

Funnel plot of meta-analysis [46,50,51,52,55,57,58,59,62,64,72].

Figure 12

Overview of principal findings: ICT-based dementia interventions among older adults.

Figure 13

Framework for Integrating ICT into Dementia Care.