Abstract
BACKGROUND: The field of Alzheimer disease (AD) has been moving toward earlier detection, personalized assessment of dementia risk, and dementia prevention. In the near future, a gap is expected between the growing demand for Alzheimer-related health care and a shrinking workforce. Responsibility is increasingly assigned to individuals to take an active role in their own brain health management and dementia prevention. Digital tools are thought to offer support regarding these processes.
OBJECTIVE: The aim of this scoping review is to create an overview of digital tools published in scientific literature in the context of AD and dementia aimed at people without an AD or dementia diagnosis as primary end users interacting with these digital tools. Additionally, we aim to gain insight into study sample diversity, the stage of maturity and evaluation of these tools, and recommended future directions.
METHODS: PubMed, IEEE Xplore, Ovid, and Web of Science were searched in January 2023, using terms related to AD and dementia, (pre-)disease stages, digital tools, and various purposes of digital tools. Two independent reviewers screened the titles and abstracts of 2811 records and subsequently 408 full-text articles, based on inclusion and exclusion criteria. Articles on tools targeting those with an AD or dementia diagnosis were excluded. Data extraction included information on the sample characteristics, the digital tool, stage of maturity and evaluation, and future (research) directions.
RESULTS: We included 39 articles, which were aimed at primary prevention (14/39, 36%), secondary prevention (11/39, 28%), daily life support (8/39, 21%), self-administered screening (4/39, 10%), or decision-making (2/39, 5%). Variation in the study sample emerged regarding cognitive abilities (healthy: 11/39, 28%; mild cognitive impairment: 12/39, 31%; [subjective] cognitive impairment: 9/39, 23%; "no dementia": 1/39, 3%; and variation of cognitive abilities: 6/39, 15%). Less variation was found regarding sex (>50% female: 27/39, 69%), education (>50% high education: 13/39, 33%), and age (>50% >60 y: 23/39, 59%). Few articles reported on ethnicity (12/39, 31%) and digital literacy (11/39, 28%). Most tools were in an early evaluation and maturity stage (31/39, 80%), comprising preprototyping (1/35, 3%), prototyping (15/35, 43%), pilot testing (19/35, 54%), efficacy testing (18/40, 45%), usability testing (12/40, 30%), and feasibility testing (10/40, 25%). Future (research) directions comprised the need for further tool development, attention to diversity, and study advancements, such as large-scale longitudinal studies.
CONCLUSIONS: Almost 80% of tools as reported on in academic literature are in early development comprising early stages of maturity and evaluation. Studies and evidence gathered for digital tools developed in the context of AD or dementia aimed at people without an AD or dementia diagnosis are thus preliminary and further development, research, and policy are required before these tools can be implemented for assessing, supporting, and preventing cognitive decline.
| Original language | English |
|---|---|
| Article number | e64862 |
| Journal | Journal of Medical Internet Research |
| Volume | 27 |
| DOIs | |
| Publication status | Published - 25 Aug 2025 |
Bibliographical note
Publisher Copyright:© Tanja J de Rijke, Thomas Engelsma, Chi Him Ng, Kyra KM Kaijser, Henk Herman Nap, Ellen MA Smets, Leonie NC Visser.
Funding
The authors would like to thank Elisabeth Kurpershoek for her advice during search string development. During the preparation of this manuscript, the authors used DeepL Write and Perplexity to assist with grammar checking and for language improvement purposes. The authors reviewed and edited all artificial intelligence–generated grammar and language suggestions and take full responsibility for the final version of the manuscript. The research of Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. Alzheimer Center Amsterdam is supported by Stichting Alzheimer Nederland and Stichting VUmc fonds. The chair of Wiesje van der Flier is supported by the Pasman stichting. EMAS and LNCV are recipients of ABOARD, which is a public-private partnership receiving funding from ZonMW (number 73305095007) and Health~Holland, Topsector Life Sciences & Health (PPP allowance; number LSHM20106). KKMK and TJdR are paid from the ABOARD project. LNCV is supported by fellowship grants from Alzheimer Nederland (WE.15-2019-05 and WE.08-2022-10) and the Amsterdam Public Health Research Institute, as well as by a grant for the LETHE-Project. The LETHE-Project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement number 101017405. This work was (partially) funded by a postdoctoral fellowship granted to LNCV by the Amsterdam Public Health Research Institute (APH Strategic Research call 2021). EMAS is a recipient of TAP-dementia, a ZonMw-funded project (number 10510032120003) in the context of the Dutch National Dementia Strategy. The sponsors had no involvement in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the manuscript for publication. LNCV has been an invited speaker at Schwabe Group; fees were paid to her institution. The research of LNCV has been funded by ZonMW, Alzheimer Nederland, Health~Holland, Topsector Life Sciences & Health, EISAI, and the Amsterdam Public Health Research Institute. All funding was paid to her institution. The other authors declare no conflicts of interest.
Keywords
- brain health
- digital tools
- diversity
- eHealth
- electronic health
- equity
- future directions
- impact evaluation
- implementation
- mHealth
- mobile health
- stage of maturity
- Humans
- Alzheimer Disease/diagnosis
- Dementia/diagnosis
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