Telemedicine and telehealth initiatives improve psychological well-being and quality of life among patients with dementia, according to a review published by researchers at the World Health Organization (WHO). 

The review found that remote assistive technologies like video and phone calls reduced symptoms of depression and anxiety, enhanced cognitive and mental outcomes, and reduced caregiver burden and stress. They also reduced indoor falls by as much as 64%.

An estimated 9.1 million people in the European Union have dementia, and this figure is expected to increase to 14.3 million by 2050. The findings suggest that telemedicine initiatives could help meet Europe’s growing demands for dementia care. 

While high-income countries have integrated telehealth into dementia care, lower-income settings face challenges linked to infrastructure, cost, and digital literacy, study author David Novillo-Ortiz, PhD, unit head and regional adviser of data, artificial intelligence (AI), and digital health at the WHO’s Regional Office for Europe, told Medscape News Europe.

“The study suggests that with proper investment in training, connectivity, and data governance, wider adoption could become standard practice within the next few years, advancing the United Nations Decade of Healthy Ageing (2021-2030) goals,” he added. 

The study was published November 6 in JMIR Mental Health. 

The Review

The researchers analyzed 91 reviews investigating the impact of telemedicine on dementia care. Measures included effects on mental health, quality of life, safety, and social isolation. 

Beyond mental health and cognitive outcomes, the review found that 80%-90% of participants were “satisfied” with telehealth approaches, with many describing them as “convenient” and “accessible.” Benefits included reduced “travel-related burden” and “enhanced user support.” 

Video-conferencing systems and online peer assistive platforms were especially helpful for reducing social isolation and loneliness. One review found that 67% of caregivers observed a significant reduction in loneliness among patients with dementia through peer interactions. Poor social networking is linked to a higher risk for dementia, cognitive decline, and severe disease pathology. 

“Our review found videoconferencing systems, telephone-based consultations, virtual cognitive stimulation therapy, and online peer-support or psychoeducational platforms to be the most effective and widely used approaches,” said Novillo-Ortiz.

‘Not for Everyone’ 

Novillo-Ortiz noted that telemedicine interventions were beneficial for patients with depression, anxiety, or social isolation and those with mild-to-moderate dementia who can still meaningfully engage through video or telephone. 

“That said, telemedicine is not equally effective for everyone. Some reviews found mixed or limited benefits, especially when comparing telemedicine directly to standard in-person care,” he said. 

He noted however that even when studies reported no significant difference between telemedicine and standard care, telemedicine was generally not inferior. 

“In practice, this means telemedicine may be less beneficial for individuals with more advanced dementia, those who have significant sensory or communication impairments, or those without adequate caregiver or technological support,” he said. 

Personalizing Treatments

Commenting on the research for Medscape News Europe, Giovanni B. Frisoni, MD, professor of clinical neurosciences at the University of Geneva, said that patients with behavioral disturbances such as irritability, aggressiveness, hallucinations, delusions, and sleep disorders are likely to benefit most from online interventions. 

He noted that telemedicine could enable clinicians to monitor patients’ responses to interventions more closely, allowing them to make adjustments as needed. Frisoni was not involved in the current research. 

“I have personal experience with patients whose behavioral disturbances were treated in the ‘traditional’ way, only to elicit severe adverse effects. They were successfully treated thanks to group chats that allowed text and videos to be shared across multiple actors, and thanks to drug adjustments made daily or every few days,” he said.

Scalability 

“These interventions can be scaled effectively with minimal training when users have access to connectivity and devices,” said Novillo Ortiz. 

He noted, however, that training and technical support are crucial for this to happen, especially in low and middle-income or rural areas where infrastructure gaps remain a major obstacle. 

Frisoni noted that obstacles are not just limited to lower- and middle-income countries. In Switzerland, for example, systematic constraints mean that the amount of time that physicians can devote to patients remotely is limited, he said. 

Other obstacles include data privacy and the need for AI-based algorithms to interpret patient behavior unless a trusted caregiver can be used as a bridge to the managing physician, he added. 

More Research

More research is needed, Novillo-Ortiz acknowledged. He emphasized the need for high-quality, standardized trials with consistent outcome measures alongside longitudinal and cost-effectiveness studies. Most studies included in the review were rated as “low” or “critically low” in quality. 

Future work should investigate which telehealth solutions are most beneficial for patients with different symptoms, said Frisoni. 

“The efficacy of telemedicine approaches should be discussed on a problem-by-problem basis, similarly to the efficacy of any drug, which can be effective on some symptoms, but not on others,” he said, noting that treating anxiety in a patient with mild cognitive impairment is “drastically different” from treating a patient with advanced dementia. 

“Specific solutions should be developed and tested,” he concluded. 

The source of funding for the review was not reported. Novillo-Ortiz and Frisoni reported no financial conflicts of interest.