Effectiveness of Telehealth Interventions on Cognitive Function and Quality of Life in Adults With Neurological Disorders: A Systematic Review and Meta-Analysis

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY Journal of the American Medical Directors Association Pub Date : 2025-02-25 DOI:10.1016/j.jamda.2025.105491

Yule Hu MSc , Yan Li PhD , Jiaying Li MSc , Justina Yat Wa Liu PhD , Sylvia M. Gustin PhD , Mengqi Li PhD , Angela Yee Man Leung PhD

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Abstract

Objective

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.

Design

Systematic review and meta-analysis.

Settings and Participants

Community and residential, adults with neurological disorders.

Methods

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.

Results

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).

Conclusions and Implications

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.

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目的：远程医疗是一种令人鼓舞的远程认知干预解决方案。本综述旨在确定远程医疗干预措施的特点和对患有神经系统疾病的成年人的认知功能和相关生活质量的有效性：设计：系统综述和荟萃分析：方法：6个英文数据库和2个中文数据库：方法：检索了从开始到 2024 年 8 月的 6 个英文数据库和 2 个中文数据库。符合条件的研究对象均为评估远程医疗干预对神经系统疾病成人认知功能影响的随机对照试验。荟萃分析使用 R（4.1.3 版）进行。评估偏倚风险时使用了修订版 Cochrane 随机试验偏倚风险工具（RoB 2）：纳入了 16 项研究，共有 952 名参与者，其中 14 项符合荟萃分析的条件。通过应用程序/网站进行异步远程保健并定期进行在线监督是最常用的形式。汇总结果表明，远程保健干预可显著改善整体认知功能（标准化平均差异 [SMD] = 0.95；95% 置信区间 [CI]：0.06∼1.83；0.06∼1.83）：0.06∼1.83; P = .035）、记忆力（SMD, 0.79; 95% CI: 0.36∼1.23; P = .0004）和生活质量（SMD, 0.57; 95% CI, 0.14∼1.00; P = .01）。然而，对注意力（SMD，0.12；95% CI，-0.11∼0.35，P = .31）、执行功能（SMD，0.06；95% CI，-0.30∼0.42，P = .73）或语言（SMD，0.44；95% CI，-0.01∼0.89，P = .054）的影响没有统计学意义：远程保健干预对患有神经系统疾病的成年人来说是安全、可行和可接受的，并有可能降低医疗成本。它们对整体认知功能、记忆力和生活质量都有益处。需要更多具有足够统计能力和严格设计的基于运动的远程保健干预措施，以评估其长期益处和经济影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Medical Directors Association 医学-老年医学

CiteScore

11.10

自引率

6.60%

发文量

472

审稿时长

44 days

期刊介绍： JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality