Effectiveness of telemedicine interventions on health outcomes in older adults with dementia: A systematic review of randomized controlled trials

Abstract

Introduction

Dementia prevalence is rising, imposing significant burdens on patients and caregivers. Telemedicine, encompassing devices, software, and videos, shows potential to address these challenges, but evidence on its effectiveness across dementia severities and intervention types remains unclear. This study aimed to systematically evaluate the effects of different telemedicine types on health outcomes in older adults with dementia using randomized controlled trials (RCTs).

Methods

Six databases were searched through February 2026 for RCTs involving adults ≥60 years with dementia. Twelve studies (21500 participants) were included, assessing telemedicine interventions (video, device, software) versus usual care. Outcomes included cognitive function, activities of daily living (ADLs), depression, and caregiver burden. Risk of bias was evaluated via Cochrane RoB 2.0, and meta-analyses used RevMan 5.4.

Findings

Telemedicine significantly improved ADLs (Z = 2.63, P < 0.05, I²=1%) but showed no effects on cognitive function, depression, caregiver burden, or transfer rates. High heterogeneity was noted in cognitive (I²=81.6%) and depression (I²=87%) analyses. Subgroup differences between video and device interventions were nonsignificant.

Conclusions

Telemedicine modestly enhances ADLs in dementia but lacks broad efficacy across other outcomes. Variations in intervention content, population severity, and technological accessibility may influence results. Future research should stratify by dementia severity, tailor interventions to cognitive levels, and integrate caregiver-focused approaches to optimize telemedicine impact.