Hu Yule, Li Yan, Li Jiaying, Liu Justina Yat Wa, Gustin Sylvia M, Li Mengqi, Leung Angela Yee Man
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
J Am Med Dir Assoc. 2025 Apr;26(4):105491. doi: 10.1016/j.jamda.2025.105491. Epub 2025 Feb 25.
Telehealth is an encouraging solution for the remote delivery of cognitive interventions. This review aimed to identify the characteristics and effectiveness of telehealth interventions on cognitive functions and related quality of life in adults with neurological disorders.
Systematic review and meta-analysis.
Community and residential, adults with neurological disorders.
Six English and 2 Chinese databases were searched from inception to August 2024. Randomized controlled trials that evaluated telehealth interventions for cognitive function in adults with neurological disorders were eligible. The meta-analysis was conducted using R (Version 4.1.3). The Revised Cochrane risk of bias tool for randomized trials (RoB 2) tool was used for risk of bias assessment.
Sixteen studies with 952 participants were included, 14 of which were eligible for the meta-analysis. Asynchronous telehealth via apps/websites with regular online supervision was the most commonly used format. The pooled results suggested that telehealth interventions could significantly improve global cognitive function [standardized mean difference (SMD) = 0.95; 95% confidence interval (CI): 0.06∼1.83; P = .035], memory (SMD, 0.79; 95% CI: 0.36∼1.23; P = .0004), and quality of life (SMD, 0.57; 95% CI, 0.14∼1.00; P = .01) compared with controls. However, there was no statistically significant effect on attention (SMD, 0.12; 95% CI, -0.11∼0.35, P = .31), executive function (SMD, 0.06; 95% CI, -0.30∼0.42, P = .73), or language (SMD, 0.44; 95% CI, -0.01∼0.89, P = .054).
Telehealth interventions are safe, feasible and acceptable for adults with neurological disorders, and could potentially reduce health care cost. They have beneficial effects on global cognitive function, memory, and quality of life. More exercise-based telehealth interventions with adequate statistical power and rigorous designs are needed to evaluate the long-term benefits and financial impact.
远程医疗是一种令人鼓舞的认知干预远程交付解决方案。本综述旨在确定远程医疗干预对患有神经系统疾病的成年人认知功能及相关生活质量的特征和有效性。
系统评价和荟萃分析。
社区和居住环境中患有神经系统疾病的成年人。
检索了6个英文数据库和2个中文数据库，检索时间从建库至2024年8月。评估针对患有神经系统疾病的成年人认知功能的远程医疗干预的随机对照试验符合纳入标准。使用R（版本4.1.3）进行荟萃分析。采用随机试验的修订版Cochrane偏倚风险工具（RoB 2）进行偏倚风险评估。
纳入了16项研究，共952名参与者，其中14项符合荟萃分析的条件。通过应用程序/网站进行的异步远程医疗并定期进行在线监督是最常用的形式。汇总结果表明，与对照组相比，远程医疗干预可显著改善整体认知功能[标准化均数差（SMD）=0.95；95%置信区间（CI）：0.06∼1.83；P =0.035]、记忆力（SMD，0.79；95%CI：0.36∼1.23；P =0.0004）和生活质量（SMD，0.57；95%CI，0.14∼1.00；P =0.01）。然而，对注意力（SMD，0.12；95%CI，-0.11∼0.35，P =0.31）、执行功能（SMD，0.06；95%CI，-0.30∼0.42，P =0.73）或语言能力（SMD，0.44；95%CI，-0.01∼0.89，P =0.054）没有统计学上的显著影响。
远程医疗干预对患有神经系统疾病的成年人是安全、可行且可接受的，并且可能降低医疗成本。它们对整体认知功能、记忆力和生活质量有有益影响。需要更多基于运动的具有足够统计效力和严谨设计的远程医疗干预措施来评估其长期益处和经济影响。
