Abstract

Background: Despite growing interest in digital interventions to mitigate cognitive decline in older adults, their effectiveness remains uncertain due to heterogeneous study designs and the lack of core components for successful intervention design. This review systematically evaluated the efficacy of digital interventions through randomized controlled trials (RCTs) to identify key success factors and address gaps in effective design.

Methods: The search was conducted on CINAHL, Embase, PubMed, PsycINFO, and grey literature from 1 January 2010, to 1 June 2024, to identify RCTs that examined the effects of digital interventions on global cognitive function in individuals with MCI. The study was registered prospectively with PROSPERO under CRD42024528458.

Results: Out of 3414 studies, 21 RCTs were analyzed. Digital interventions improved global cognitive function in MCI patients (SMD (95 % CI) = 0.52(0.36-0.68)). Narrative synthesis showed that eight critical factors contributed to the success of these interventions: (1) User-friendly technology; (2) Multiple cognitive domains coverage; (3) Simulation of real-life scenarios; (4) Integration with physical exercise; (5) Real-time feedback and rewards; (6) Professional guidance and supervision; (7) Human participation; and (8) Social interaction. Additionally, methodological considerations for future RCTs on digital MCI interventions were: (1) Collecting data on support engagement and adherence throughout the intervention; (2) Using a hybrid outcome measurement approach with qualitative interviews and quantitative questionnaires; (3) Supplementing assessments with objective neurobiological evaluations; (4) More comparable and standardized control group; (5) Conducting follow-ups for at least one-year post-intervention; (6) Ensuring personalization and adaptability; (7) Incorporating social and professional support networks.

Conclusion: The insights from this systematic review and meta-analysis empower future digital MCI interventional researchers, health professionals, clinicians, and patients to design, develop, and implement successful interventions for older users.