Restricted accessResearch articleFirst published online 2026
The Effects of a Robot-Assisted Intervention Program on Cognitive Function and Psychosocial Outcomes in Community-Dwelling Older Adults: A Quasi-Experimental Study
With global population aging, dementia prevention has become a major public health priority. This study evaluated the effects of an 8-week robot-assisted intervention on cognitive and psychosocial outcomes among community-dwelling older adults. A total of 80 participants aged 65 years and older were recruited from two community centers and assigned to either a robot-assisted intervention group (n = 40) or a usual care comparison group (n = 40). The intervention involved structured group sessions using a humanoid robot: Kebbi (NUWA Robotics). Cognitive function, social engagement, depressive symptoms, and loneliness were assessed. Data were analyzed using paired t-tests and generalized estimating equations. Results showed significant group × time interaction effects across all outcomes (p < .001). These findings indicate that robot-assisted intervention programs are effective in improving cognitive and psychosocial functioning and support their integration into comprehensive dementia prevention strategies.
AlbertM. S.DeKoskyS. T.DicksonD.DuboisB.FeldmanH. H.FoxN. C.GamstA.HoltzmanD. M.JagustW. J.PetersenR. C.SnyderP. J.CarrilloM. C.ThiesB.PhelpsC. H. (2011). The diagnosis of mild cognitive impairment due to alzheimer’s disease: Recommendations from the national institute on aging–alzheimer’s association workgroups on diagnostic guidelines for alzheimer’s disease. Alzheimer’s & Dementia, 7(3), 270–279. https://doi.org/10.1016/j.jalz.2011.03.008
2.
BärnighausenT.TugwellP.RøttingenJ.-A.ShemiltI.RockersP.GeldsetzerP.BrownA.GrimshawJ.DanielsK.BorJ.TannerJ.RashidianA.BarretoM.VollmerS.AtunR. (2017). Quasi-experimental study designs series—paper 4: Uses and value. Journal of Clinical Epidemiology, 89, 21–29. https://doi.org/10.1016/j.jclinepi.2017.03.012
3.
BassukS. S.GlassT. A.BerkmanL. F. (1999). Social disengagement and incident cognitive decline in community-dwelling elderly persons. Annals of Internal Medicine, 131(3), 165–173. https://doi.org/10.7326/0003-4819-131-3-199908030-00002
4.
BelpaemeT.KennedyJ.RamachandranA.ScassellatiB.TanakaF. (2018). Social robots for education: A review. Science Robotics, 3(21), eaat5954. https://doi.org/10.1126/scirobotics.aat5954
5.
BlavetteL.RigaudA.-S.AnzaloneS. M.KerguerisC.IsabetB.DacunhaS.PinoM. (2022). A robot-mediated activity using the nao robot to promote COVID-19 precautionary measures among older adults in geriatric facilities. International Journal of Environmental Research and Public Health, 19(9), 5222. https://doi.org/10.3390/ijerph19095222
6.
BroadbentE.StaffordR.MacDonaldB. (2009). Acceptance of healthcare robots for the older population: Review and future directions. International Journal of Social Robotics, 1(4), 319–330. https://doi.org/10.1007/s12369-009-0030-6
ChalfontG.MilliganC.SimpsonJ. (2020). A mixed methods systematic review of multimodal non-pharmacological interventions to improve cognition for people with dementia. Dementia, 19(4), 1086–1130. https://doi.org/10.1177/1471301218795289
9.
ChenL.SuW.FengY.WuM.SheJ.HirotaK. (2020). Two-layer fuzzy multiple random forest for speech emotion recognition in human-robot interaction. Information Sciences, 509, 150–163. https://doi.org/10.1016/j.ins.2019.09.005
10.
ChenN. J.ChangC. H.HuangC. M.LinF. H.LuL. T.LiuK. Y.GuoJ. L.HouY. C. (2025). Assessing the effectiveness of interactive robot-assisted virtual health coaching for health literacy and disease knowledge of patients with chronic kidney disease: Quasiexperimental study. Journal of Medical Internet Research, 27, Article e68072. https://doi.org/10.2196/68072
11.
ChenS. C.JonesC.MoyleW. (2018). Social robots for depression in older adults: A systematic review. Journal of Nursing Scholarship, 50(6), 612–622. https://doi.org/10.1111/jnu.12423
12.
ChristlJ.GrumbachP.JockwitzC.WegeN.CaspersS.MeisenzahlE. (2025). Prevalence of depressive symptoms in people aged 50 years and older: A retrospective cross-sectional study. Journal of Affective Disorders, 373, 353–363. https://doi.org/10.1016/j.jad.2024.12.099
13.
Cohen-MansfieldJ.PerachR. (2015). Interventions for alleviating loneliness among older persons: A critical review. American Journal of Health Promotion, 29(3), e109–e125. https://doi.org/10.4278/ajhp.130418-LIT-182
14.
DesaiP.NgT. K.KruegerK. R.WilsonR. S.EvansD. A.RajanK. B. (2025). Social engagement, depressive symptoms, and loneliness, and longitudinal cognitive decline in a population-based cohort of older adults. The American Journal of Geriatric Psychiatry: Open Science, Education, and Practice, 6, 39–48. https://doi.org/10.1016/j.osep.2025.02.004
15.
DrorI.SchmidtP.O’connorL. (2011). A cognitive perspective on technology enhanced learning in medical training: Great opportunities, pitfalls and challenges. Medical Teacher, 33(4), 291–296. https://doi.org/10.3109/0142159X.2011.550970
16.
ForbesM.LotfalianyM.MohebbiM.ReynoldsC. F.WoodsR. L.OrchardS.RyanJ.AgustiniB.O'NeilA.BerkM. (2024). Depressive symptoms and cognitive decline in older adults. International Psychogeriatrics, 36(11), 1039–1050. https://doi.org/10.1017/S1041610224000541
17.
ForsmanA. K.SchierenbeckI.WahlbeckK. (2011). Psychosocial interventions for the prevention of depression in older adults: Systematic review and meta-analysis. Journal of Aging and Health, 23(3), 387–416. https://doi.org/10.1177/0898264310378041
HarrisA. D.McGregorJ. C.PerencevichE. N.FurunoJ. P.ZhuJ.PetersonD. E.FinkelsteinJ. (2006). The use and interpretation of quasi-experimental studies in medical informatics. Journal of the American Medical Informatics Association, 13(1), 16–23. https://doi.org/10.1197/jamia.M1749
20.
JangY. J.KimM.-J.MoonY. K.LimS.-W.KimD. K. (2025). Changes in dementia risk along with onset age of depression: A longitudinal cohort study of elderly depressed patients. BMC Psychiatry, 25(1), 247. https://doi.org/10.1186/s12888-025-06683-w
21.
KangH. (2021). Sample size determination and power analysis using the G* power software. Journal of Educational Evaluation for Health Professions, 18, 17. https://doi.org/10.3352/jeehp.2021.18.17
22.
KimG. H.JeonS.ImK.KwonH.LeeB. H.KimG. Y.ChoH.SeoS. W.NohY.ParkS. E.HwangJ. W.YoonC. W.YeB. S.ChinJ. H.KimJ. H.NaD. L. (2015). Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly. PloS One, 10(4), Article e0123251. https://doi.org/10.1371/journal.pone.0123251
23.
KruegerK. R.WilsonR. S.KamenetskyJ. M.BarnesL. L.BieniasJ. L.BennettD. A. (2009). Social engagement and cognitive function in old age. Experimental Aging Research, 35(1), 45–60. https://doi.org/10.1080/03610730802545028
24.
KuiperJ. S.ZuidersmaM.Oude VoshaarR. C.ZuidemaS. U.Van Den HeuvelE. R.StolkR. P.SmidtN. (2015). Social relationships and risk of dementia: A systematic review and meta-analysis of longitudinal cohort studies. Ageing Research Reviews, 22, 39–57. https://doi.org/10.1016/j.arr.2015.04.006
25.
LancasterG. A.ThabaneL. (2019). Guidelines for reporting non-randomised pilot and feasibility studies. Pilot and Feasibility Studies, 5(1), 114. https://doi.org/10.1186/s40814-019-0499-1
26.
LiX.FengH.ChenQ. (2025). Social participation patterns and associations with subsequent cognitive function in older adults with cognitive impairment: A latent class analysis. Frontiers in Medicine, 12, Article 1493359. https://doi.org/10.3389/fmed.2025.1493359
27.
LinL. C.LiaoJ. Y.HuangC. M.LinF. H.LuL. T.ChienH. C.GuoJ. L. (2025). Effectiveness of robot-assisted board games on cognitive function and mental health for older adults with mild cognitive impairment: A cluster randomized trial. Games for Health Journal, 14(4), 321–331. https://doi.org/10.1089/g4h.2024.0207
28.
LorY. C. M.TsouM. T.TsaiL. W.TsaiS. Y. (2023). The factors associated with cognitive function among community-dwelling older adults in Taiwan. BMC Geriatrics, 23(1), 116. https://doi.org/10.1186/s12877-023-03806-4
29.
LuchettiM.AschwandenD.SeskerA. A.ZhuX.O'SúilleabháinP. S.StephanY.TerraccianoA.SutinA. R. (2024). A meta-analysis of loneliness and risk of dementia using longitudinal data from over 600,000 individuals. Nature Mental Health, 2(11), 1350–1361. https://doi.org/10.1038/s44220-024-00328-9
30.
MarsdenE.TorgersonC. J. (2012). Single group, pre-and post-test research designs: Some methodological concerns. Oxford Review of Education, 38(5), 583–616. https://doi.org/10.1080/03054985.2012.731208
31.
MartiC. N.ChoiN. G. (2022). Measuring social engagement among low-income, depressed homebound older adults: Validation of the social engagement and activities questionnaire. Clinical Gerontologist, 45(3), 548–561. https://doi.org/10.1080/07317115.2020.1753275
32.
Ministry of Health and Welfare. (2025). Latest national community dementia prevalence survey results announced by the. Ministry of Health and Welfare. https://www.mohw.gov.tw/cp-16-78102-1.html
33.
ParkE.-A.JungA.-R.LeeK.-A. (2021). The humanoid robot sil-bot in a cognitive training program for community-dwelling elderly people with mild cognitive impairment during the COVID-19 pandemic: A randomized controlled trial. International Journal of Environmental Research and Public Health, 18(15), 8198. https://doi.org/10.3390/ijerph18158198
34.
ParkS. H.KwakM. J. (2021). Performance of the geriatric depression Scale-15 with older adults aged over 65 years: An updated review 2000–2019. Clinical Gerontologist, 44(2), 83–96. https://doi.org/10.1080/07317115.2020.1839992
35.
PenninkilampiR.CaseyA. N.SinghM. F.BrodatyH. (2018). The association between social engagement, loneliness, and risk of dementia: A systematic review and meta-analysis. Journal of Alzheimer’s Disease, 66(4), 1619–1633. https://doi.org/10.3233/JAD-180439
PfeifferE. (1975). A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23(10), 433–441. https://doi.org/10.1111/j.1532-5415.1975.tb00927.x
38.
PuL.MoyleW.JonesC.TodorovicM. (2019). The effectiveness of social robots for older adults: A systematic review and meta-analysis of randomized controlled studies. The Gerontologist, 59(1), e37–e51. https://doi.org/10.1093/geront/gny046
39.
RaiH. K.KernaghanD.SchoonmadeL.EganK. J.PotA. M. (2022). Digital technologies to prevent social isolation and loneliness in dementia: A systematic review. Journal of Alzheimer’s Disease, 90(2), 513–528. https://doi.org/10.3233/JAD-220020
40.
RussellD. W. (1996). UCLA loneliness scale (version 3): Reliability, validity, and factor structure. Journal of Personality Assessment, 66(1), 20–40. https://doi.org/10.1207/s15327752jpa6601_2
41.
SaitoT.CableN.AidaJ.ShiraiK.SaitoM.KondoK. (2019). Validation study on a Japanese version of the three‐item UCLA loneliness scale among community‐dwelling older adults. Geriatrics & Gerontology International, 19(10), 1068–1069. https://doi.org/10.1111/ggi.13758
42.
TannerA.UrechA.SchulzeH.ManserT. (2023). Older adults’ engagement and mood during robot-assisted group activities in nursing homes: Development and observational pilot study. JMIR Rehabilitation and Assistive Technologies, 10, Article e48031. https://doi.org/10.2196/48031
43.
WangH. X.KarpA.WinbladB.FratiglioniL. (2002). Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: A longitudinal study from the kungsholmen project. American Journal of Epidemiology, 155(12), 1081–1087. https://doi.org/10.1093/aje/155.12.1081
World Health Organization. (2025). Dementia: Fact sheet 2025: WHO.
46.
XiangX.LaiP. H. L.BaoL.SunY.ChenJ.DunkleR. E.MaustD. (2021). Dual trajectories of social isolation and dementia in older adults: A population-based longitudinal study. Journal of Aging and Health, 33(1–2), 63–74. https://doi.org/10.1177/0898264320975238
47.
YuanF.KlavonE.LiuZ.LopezR. P.ZhaoX. (2021). A systematic review of robotic rehabilitation for cognitive training. Frontiers in Robotics and AI, 8, Article 605715. https://doi.org/10.3389/frobt.2021.605715
