Neal David, Craven Michael P, Cross Jane, Evans Shirley, Fox Christopher, Oksnebjerg Laila, Alexandre Isabel, Aryankhesal Aidin, Astell Arlene, Begde Ahmet, Ditton Annabel, Engelsma Thomas, Gregersen Rikke, Heins Pascale, Hogervorst Eef, Kafadar Aysegul Humeyra, Poos Jackie, Robinson Louise, Sezgin Duygu, Smaling Hanneke Ja, Szczesniak Dorota, Tan Josephine Rose Orejana, de Vugt Marjolein, Meiland Franka Jm
Department of Medical Informatics, Amsterdam UMC, Amsterdam, The Netherlands.
NIHR MindTech HealthTech Research Centre & Centre for Dementia, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham UK.
Digit Health. 2025 Aug 3;11:20552076251362353. doi: 10.1177/20552076251362353. eCollection 2025 Jan-Dec.
The use of digital assistive technologies by and for people living with dementia is promising for supporting social health and advocated as a partial solution to growing prevalence worldwide. A state-of-the-art position paper published in 2017 identified challenges regarding digital assistive technologies, around five themes: development, usability, (cost-)effectiveness, implementation and ethics. This systematic review summarizes progress on the challenges found in 2017, and persisting or emerging challenges.
A systematic review of systematic reviews was conducted, focused on studies published after 2016. The inclusion criteria required that the target group included, at least in part, people with dementia living in the community and that the technologies aimed to support social health. For the five themes, literature searches were conducted in Medline, CINAHL, PsycINFO, and Embase databases.
A total of 112 reviews were included, covering various applications such as smart homes, care robots, exergaming and everyday technologies. No applications of artificial intelligence were included. The challenges included personalization of applications (development); limited use of standardized methods (usability); insufficient quantity and quality of randomized controlled trials (cost-effectiveness); overly high expectations of assistive technologies (implementation); and the need for more equitable access to technologies (ethics).
Much research has been conducted since the 2017 state of the art position paper. While some challenges identified at that time remain relevant, others have been addressed, and new challenges have emerged. Future research should prioritize emerging artificial intelligence applications; the development of integrated assistive technologies; evaluation using robust methods and meaningful outcomes; and the promotion of more accessible and inclusive technologies.
痴呆症患者使用数字辅助技术以及为他们开发此类技术，对于促进社会健康很有前景，并被倡导作为应对全球患病率不断上升的部分解决方案。2017年发表的一篇前沿立场文件确定了数字辅助技术在五个主题方面的挑战：开发、可用性、（成本）效益、实施和伦理。本系统评价总结了2017年发现的挑战方面的进展，以及持续存在或新出现的挑战。
对系统评价进行了系统评价，重点关注2016年之后发表的研究。纳入标准要求目标群体至少部分包括居住在社区的痴呆症患者，且技术旨在支持社会健康。针对这五个主题，在医学期刊数据库（Medline）、护理学与健康领域数据库（CINAHL）、心理学文摘数据库（PsycINFO）和荷兰医学文摘数据库（Embase）中进行了文献检索。
共纳入112篇综述，涵盖智能家居、护理机器人、运动游戏和日常技术等各种应用。未纳入人工智能的应用。挑战包括应用的个性化（开发）；标准化方法使用有限（可用性）；随机对照试验的数量和质量不足（成本效益）；对辅助技术期望过高（实施）；以及需要更公平地获取技术（伦理）。
自2017年前沿立场文件发布以来，已经开展了大量研究。虽然当时确定的一些挑战仍然相关，但其他一些挑战已经得到解决，并且出现了新的挑战。未来的研究应优先考虑新兴的人工智能应用；集成辅助技术的开发；使用可靠方法和有意义结果进行评估；以及推广更易获取和更具包容性的技术。
