Digital Technologies to Prevent Social Isolation and Loneliness in Dementia: A Systematic Review

Abstract

Background: Dementia poses significant and sustained challenges to global society. Diagnosis can lead to increased feelings of loneliness and social isolation. People with dementia living alone are particularly at risk. Considering the growing number of technologies proposed to aid people with dementia address social isolation and loneliness, we reviewed the existing literature.Objective: To collate and summarize current evidence for digital technologies to prevent social isolation and loneliness for people with dementia.Methods: Following the PRISMA guidelines, we systematically searched five databases to identify studies of digital technologies designed to support or prevent social isolation or loneliness for people with dementia. Pre-specified outcomes included social isolation, loneliness, and quality of life. We used deductive thematic analysis to synthesize the major themes emerging from the studies.Results: Ten studies met our inclusion criteria where all studies reported improvements in quality of life and seven reported benefits regarding social inclusion or a reduction in loneliness. Technologies were varied across purpose, delivery format, theoretical models, and levels of personalization. Two studies clearly described the involvement of people with dementia in the study design and five technologies were available outside the research context. Conclusion:There is limited-but increasing-evidence that technologies hold potential to improve quality of life and reduce isolation/loneliness for people with dementia. Results presented are largely based in small-scale research studies. Involvement of people with dementia was limited and few research concepts are reaching implementation. Closer collaboration with people with dementia to provide affordable, inclusive, and person-centered solutions is urgently required.

Impact of digital assistive technologies on the quality of life for people with dementia: A scoping review

“…From 50 of the included studies, the following were used to promote autonomy: patient monitoring [25], [38], [39], [46], [50], [51], [61], [93]–[95], [100], [101], [103], [105]–[108], [111], [120]–[123], [125], [132], [137], [141], care support [53], [95] and digital therapeutics [21], [22], [25], [30], [32], [33], [38], [39], [49]–[51], [53], [56], [60], [61], [64], [70], [80]–[82], [86], [91], [93]–[95], [100], [104], [105], [107], [109]–[111], [114], [123], [125], [131], [138], [141]. Resilience was also mentioned as a significant factor contributing to enhanced autonomy [41], [62], [129], [130].…”

“…The topic of engagement and social interaction was highlighted in 64 studies. They differentiated between cases where DATs increased social interaction [20], [28], [29], [34], [35], [38], [41], [45], [54], [59], [64], [70], [72], [80], [82], [83], [85], [100], [102], [112], [113], [123], [129], [131], [133], [134] and fostered higher engagement (i.e., in therapy settings) [23], [26], [29], [34], [36]–[38], [40]–[42], [45], [53]–[55], [57], [60], [62], [63], [66]–[68], [70], [73], [76]–[79], [84], [85], [87], [88], [90], [91], [96], [100], [109], [112], [114], [116], [118], [122], [127], [130], [131], [133], [135], [136], [138], [139], [141].…”

“…In 18 studies, the Quality of Life in Alzheimer’s Disease Scale (QOL-AD) was utilized [25], [28], [30], [41], [43], [44], [52], [62], [65], [67], [70], [73], [85], [90], [91], [125], [130], [136], and in 11 studies the Quality of Life in Late-Stage Dementia scale (QUALID) [27], [35], [41], [43], [61], [73], [85], [91], [104], [126], [136]. Additionally, the self-reported Dementia Quality of Life measure (DEMQoL) was employed in 4 studies [73], [92], [104], [112], the Dementia Quality of Life Instrument (DQoL) in 3 studies [41], [61], [93], the EQ-5D-5L in 3 studies [99], [104], [110]. Other measuring instruments were used only once in each case: Quality of Life (GQL8) [124], Quality of Life for People with Dementia (QUALIDEM ) [41], Quality of Life Alzheimer’s disease (QoL) scale [98], SF-36 quality of life instrument [103], Cantril QoL ladder [63], Carer-Qol-7D [112], EUROHIS-QoL-8 and EuroQoL 5 Dimension Questionnaire [91].…”

“…Additionally, the self-reported Dementia Quality of Life measure (DEMQoL) was employed in 4 studies [73], [92], [104], [112], the Dementia Quality of Life Instrument (DQoL) in 3 studies [41], [61], [93], the EQ-5D-5L in 3 studies [99], [104], [110]. Other measuring instruments were used only once in each case: Quality of Life (GQL8) [124], Quality of Life for People with Dementia (QUALIDEM ) [41], Quality of Life Alzheimer’s disease (QoL) scale [98], SF-36 quality of life instrument [103], Cantril QoL ladder [63], Carer-Qol-7D [112], EUROHIS-QoL-8 and EuroQoL 5 Dimension Questionnaire [91].…”

Social connections as determinants of cognitive health and as targets for social interventions in persons with or at risk of Alzheimer’s disease and related disorders: a scoping review

“…In Indigenous communities, Walker et al (2020) found that noting culture as a source of strength (OR = 0.514) was associated with lower risk of ADRD, though these results were not significant statistically. (Neal et al, 2021;Rai et al, 2022), while one included older people without ADRD (Heins et al, 2021). The eight articles are subdivided into (A) five on technology-based social interventions (Heins et al, 2021;Hirt et al, 2021;Neal et al, 2021;Pinto-Bruno et al, 2017;Rai et al, 2022), (B) two on other social interventions (Marks and McVilly, 2020;Scott et al, 2022), and (C) one on mixed technology-based and other social interventions (Han et al, 2016) ○ In one study, VR headset with handheld controllers resulted in increased participation in social activities.…”