App-Based Interventions for People with Alzheimer's Disease or Dementia and Their Caregivers: A Systematic Review

Background/Purpose

Today, over 46 million people live with dementia worldwide and it is estimated to increase to 131.5 million by 2050 (Prince, Wimo, Guerchet, Ali, Wu, & Prina, 2015). Hundreds of smartphone applications are available to download for the use of supporting people with Alzheimer’s disease (AD) or dementia and their caregivers. Mobile phone applications may provide a unique and effective means of administering interventions related to Alzheimer’s disease or dementia. However, there is no review study about apps-based interventions for people with AD/dementia and their caregivers. The purpose of this systematic review was to: 1) systematically search and describe the literature on mobile apps used in interventions on AD/dementia, 2) describe the features and focus of those apps, and 3) evaluate the potential of apps to be implemented in AD/dementia interventions.

Methods

An extensive literature search from January 1^st 2007 to April 11^th 2016 was conducted through fourteen databases including JMIR, Academic Search Premier, CINAHL, PubMed Medline, Computers and Applied Sciences Complete, Web of Science, PsycINFO, etc., using search terms (mobile apps OR mobile applications) AND (Alzheimer's OR dementia). Guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) (Moher, Liberati, Telzlaff, Altman, & the PRISMA Group, 2009), studies were eligible for the following inclusion criteria: using a mobile app in the program, evaluation study of a program, AD/dementia related, and in English. App functions, app platform, target user groups, country, study design, and sample size were coded for each study of the final sample.

Results

The initial search yielded 416 references. Screening at abstract and title level resulted in 36 studies for full text review. A final sample of 11 studies were eligible for the final analysis. Of all the 11 studies, over half were primarily feasibility and pilot studies of mobile apps. Studies had relative small sample size, ranging from 4 to 243, with 8 studies having than 50 participants. Studies were mostly conducted in European countries (n=6), with Android being the preferred platform (n=8). Functions of the mobile apps mainly focused on occupational therapy to support people with AD/dementia, and cognitive assessment to encourage general public to have early screening of cognitive impairment. Mobile phone apps were generally user friendly and satisfied by study participants. Limitations of mobile apps included relative small screen for older adults, privacy and security concerns, and reliability issues of cognitive tests on mobile platform.

Conclusions and Implications

Findings of the review provide early evidence that mobile phone apps may be a feasible and acceptable means of administering health interventions, but more rigorous evaluation research with large sample size are needed to determine efficacy and establish evidence for best practice. Further studies need to focus on the reliability and validity of cognitive assessment tool conducted using mobile apps.