Efficacy of digital cognitive stimulation therapy for people with dementia: a systematic review and meta-analysis

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Abstract
Background: There is growing interest in using digital health technologies to deliver Cognitive Stimulation Therapy (CST) for people with dementia, given the potential to improve access and outcomes. However, evidence for the effectiveness of delivering CST using digital technologies (“digital CST”) remain limited, making it difficult to determine best practices. This study systematically reviews and evaluates the efficacy of digital CST on cognitive and psychosocial outcomes in people with dementia. Methods: We conducted a comprehensive literature search in CINAHL, Cochrane Library, Embase, MEDLINE, PubMed, and Web of Science. We included randomized controlled trials and quasi-experimental studies that examined the effects of digital CST in people with dementia. We assessed methodological quality using the Cochrane Risk of Bias tool (RoB 2) and ROBINS-I. We applied a DerSimonian and Laird random-effects model to estimate pooled standardized mean differences (SMDs). Results: Eighteen studies comprising 756 participants met inclusion criteria. Digital CST significantly improved cognitive function (k = 559; SMD = 0.33; 95% CI: 0.04–0.62; p = 0.03; I 2 = 61.39%) and semantic fluency (k = 181; SMD = 0.43; 95% CI: 0.13–0.73; p < 0.001; I 2 = 0.00%). It also significantly reduced depressive symptoms (k = 273; SMD = –0.66; 95% CI: –1.12 to –0.20; p = 0.01; I 2 = 68.94%). The greatest cognitive improvements were observed when interventions were delivered biweekly in 45-minute sessions over fewer than eight weeks. Conclusions: This systematic review and meta-analysis demonstrates that digital CST is effective in enhancing cognitive performance and supporting aspects of psychosocial functioning in people with dementia. Improvements were observed particularly in global cognition, semantic fluency, and depressive symptoms, indicating that digital CST offers a beneficial non-pharmacological option within dementia care. Further research is warranted to explore its applicability across different dementia stages and to determine the sustainability of these effects over time. Prospero registration: CRD420250653224.
Funding Information
  • National Institute on Aging of the National Institutes of Health (R21AG085439)
  • MSIT (Ministry of Science, ICT), Korea, under the Global Scholars Invitation Program (RS-2024-00459638)

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