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https://www.sa-rj.net/index.php/sarj/article/view/47  
las principales tecnologías empleadas incluyen plataformas  
de tele rehabilitación y el uso de tecnologías móviles. La  
conclusión del estudio subraya que estas tecnologías  
representan un campo emergente que ofrece nuevas  
oportunidades para implementar programas de intervención  
Neuropsychological intervention in  
dementia  
associated  
with  
new  
technologies: a systematic literature  
review  
neuropsicológica,  
los  
cuales  
podrían  
mejorar  
significativamente la calidad de vida de los adultos mayores  
y sus familias.  
Intervención neuropsicológica en la  
demencia asociada a nuevas tecnologías:  
una revisión sistemática de literatura  
Palabras clave: adulto mayor, deterioro cognitivo leve  
(DCL), enfermedad de Alzheimer (EA), demencia,  
intervención neuropsicológica, tecnologías.  
Gloria Elisabeth Camas-Montero1  
INTRODUCTION  
1
Universidad del Azuay, Av. 24 de mayo 7-77 y Hernán Malo,  
The increase in life expectancy, known as the "longevity  
revolution," has been one of the most impactful social  
phenomena of the 20th century. This increase has led to a  
significant growth in the population of older adults, projected  
to increase from 900 million in 2015 to approximately 1400  
million by 2030 (Flores-Villavicencio et al., 2017; PAHO,  
Cuenca, Ecuador.  
Email: gcamasnpm3@es.uazuay.edu.ec  
Receipt: March 25, 2024 - Acceptance: April 30, 2024 -  
Publication: May 10, 2024.  
2
021; WHO, 2016).  
ABSTRACT  
Aging, inherent to the natural cycle of human life,  
manifests  
itself  
through  
physical,  
physiological,  
Dementia is a growing and significant problem affecting  
the elderly population worldwide, standing out both for its  
frequency and its clinical and functional impact. This study  
focused on identifying new technologies used in  
neuropsychological intervention for this condition. By  
applying the PRISMA model, relevant studies published in  
English and Spanish between the years 2014 and 2023 were  
reviewed in various academic databases such as Redalyc,  
Pubmed, Science Direct, DOAJ and Springer Link, resulting  
in the selection of 14 studies. Most of these studies focus on  
patients with Mild Cognitive Impairment (MCI) or  
Alzheimer's Disease (AD). The results indicate that the main  
technologies employed include tele-rehabilitation platforms  
and the use of mobile technologies. The conclusion of the  
study highlights that these technologies represent an  
emerging field that offers new opportunities for  
implementing neuropsychological intervention programs,  
which could significantly improve the quality of life of older  
adults and their families.  
psychological, cognitive and socio-affective changes. These  
changes increase the prevalence of diseases, reduce  
productivity and raise dependency among older adults  
(González and de la Fuente, 2014). This demographic  
transition has sparked particular interest in studying the  
epidemiological behavior of older adults, especially in  
chronic diseases such as cognitive impairment (CT) and  
dementia, which have a significant frequency and clinical  
impact (Calderón, 2018; ADI, 2016; Díaz et al., 2013;  
Márquez et al., 2020).  
Dementia is a complex neurological condition that  
impairs crucial functions such as memory, language, and  
reasoning ability. Its etiology is multifactorial, including  
advanced age, genetic diseases, and brain trauma, among  
others (Allegri et al., 2011; Allegri et al., 2015; Iadecola et  
al., 2019; Custodio et al., 2018; WHO, 2023). It currently  
affects about 50 million people globally, with projections  
indicating an increase to 152 million by 2050 (WHO, 2023).  
Alzheimer's disease is the most prevalent cause of  
dementia in the older population, followed by other  
neurodegenerative diseases such as Parkinson's and  
Huntington's (Barragán et al., 2019; PAHO, 2022; Toro et al.,  
2022; Allegri et al., 2015; Moya and Mamani, 2013). The  
consequences of dementia on quality of life are profound,  
affecting memory, communication skills, and personal  
autonomy, and increase the risks of falls and other  
complications (Hall, 2022; Canary Health Service, 2011;  
Iribarnea et al., 2020; Olazarán and Muñiz, 2017).  
Keywords: Older adult, Mild Cognitive Impairment  
(MCI),  
Alzheimer's  
Disease  
(AD),  
dementia,  
neuropsychological intervention, technologies.  
RESUMEN  
La demencia es un problema creciente y significativo  
que afecta a la población de adultos mayores a nivel mundial,  
destacándose tanto por su frecuencia como por su impacto  
clínico y funcional. Este estudio se enfocó en identificar las  
nuevas tecnologías utilizadas en la intervención  
neuropsicológica para esta condición. Mediante la aplicación  
del modelo PRISMA, se revisaron estudios pertinentes  
publicados en inglés y español entre los años 2014 y 2023 en  
diversas bases de datos académicas como Redalyc, Pubmed,  
Science Direct, DOAJ y Springer Link, resultando en la  
selección de 14 estudios. La mayoría de estos estudios se  
centran en pacientes con Deterioro Cognitivo Leve (DCL) o  
Enfermedad de Alzheimer (EA). Los resultados indican que  
Although there is no cure for dementia,  
neuropsychological interventions, such as cognitive  
stimulation therapy, offer improvements in affected  
functions. These interventions are being revolutionized by the  
use of new technologies, such as mobile applications and  
virtual reality, which provide additional tools to improve the  
effectiveness of treatments (OPS, 2020; Arroyo et al., 2012;  
Gajardo, 2016; Hall, 2022; Barrio et al., 2019; Fernandez et  
al., 2020; Garcia-Alberca, 2015; Ortega et al., 2015; Aldana  
et al., 2012; Fajardo and Guzman, 2016; Fernandez et al.,  
2
018; Fernandez et al., 2020). The integration of these  
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technologies into clinical practice represents an important  
step towards improving dementia management, crucial to  
meet the future challenges of global aging.  
Exclusion criteria: systematic reviews or literature  
reviews on the use of technology in the  
neuropsychological intervention of dementia.  
Empirical studies applied in professional or family  
caregivers.  
METHODS  
The systematic literature review was developed  
according to the PRISMA (Preferred Reporting Items for  
Systematic reviews and Meta-Analyses) model, guided by the  
research questions:  
Data extraction strategy  
Data extraction was carried out through a matrix of  
categories designed for this purpose, which included: an  
article identifier, year of publication, author(s), country, study  
title, population, DOI, objective, results and main  
conclusions.  
After extracting the data, the results went through a  
process of reading, analysis and synthesis. The diagram  
below shows the process of identifying the studies to be  
included in the literature review.  
What are the technologies that have been  
incorporated for neuropsychological intervention in  
older adults with dementia in the last ten years?  
What are the areas or tasks that the technologies  
focus on within the field of neuropsychological  
rehabilitation in dementia?  
Initially, the title and abstract of each study were  
reviewed to determine whether the article was relevant,  
taking into account the research questions. If the abstract did  
not provide sufficient information to establish whether it was  
Literature search  
Based on the research questions, search terms or  
keywords were selected to find relevant studies in two  
languages: English and Spanish. The search strings were  
constructed according to these terms, adding the Boolean  
operators AND and OR and quotation marks (") to indicate  
specific phrases in the databases, specifically in the title,  
abstract and keywords, performing a manual review of the  
articles that met the search terms (Table 1).  
a
study on the application of technology in  
neuropsychological intervention in patients with dementia, it  
was necessary to review the methodology and results, so that  
it could be clarified whether or not the inclusion and  
exclusion criteria were met.  
RESULTS  
Table 1. Search terms  
The aim of this study was to review the literature to learn  
about new technologies being used for neuropsychological  
intervention in dementia in older adults. Thus, the overall  
results of the selected studies are presented first, and then the  
results that answer the research questions are presented:  
“
technology” AND “dementia neuropsychological intervention”  
"
technology" + "dementia" + “neuropsychological intervention”  
“
“
“
“
technology AND dementia neuropsychological intervention”  
technology in dementia neuropsychological intervention”  
tecnología” + "intervención neuropsicológica" + "demencia"  
technology” + "neuropsychological rehabilitation" + "dementia"  
Table 2. Studies by year and country of publication  
The search was conducted between May 20, October 20  
Category  
Number of Studies  
Study code  
and June 18, 2023 in the following academic databases:  
Redalyc, Pubmed, Science Direct, DOAJ and Springer Link.  
Year of publication  
2
2
2
2
014  
015  
016  
017  
1
1
1
1
1
1
3
2
1
2
E8,  
E11,  
E10,  
E7,  
E4,  
E5,  
E1, E6, E14  
E2, E13,  
E12,  
Search criteria  
The search criteria considered in this research process  
include:  
2018  
2
2
2
2
019  
020  
021  
022  
Type of text: current empirical studies, with  
application of specific technologies, use of  
appropriate methods and impact on the study  
population, due to scientific rigor.  
2023  
Country  
USA  
Italy  
Australia  
Spain  
E3, E9,  
5
4
2
1
1
1
E7, E10, E11, E12, E13  
E1, E4, E8, E9  
E6, E14  
E2  
E5  
Year of publication: studies published in the last 10  
years (between 2014 and 2023).  
Language: articles published in English or Spanish.  
United Kingdom  
South Korea  
E3  
Subsequently, the summary of each study was read to  
verify that the following inclusion and exclusion criteria were  
met:  
After the search process in the six databases consulted,  
01 studies were selected, three duplicate studies were  
eliminated, as well as 82 studies that did not meet the  
inclusion and exclusion criteria, and 2 studies that were not  
suitable for full-text reading. A total of 14 studies were  
obtained.  
1
Inclusion criteria: accurate empirical studies in  
which technology is applied in neuropsychological  
intervention in older adult patients with dementia.  
The studies were mostly developed between the years  
2
020 to 2023; that is, there is a greater progress in the field of  
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research on technologies for neuropsychological intervention  
in older adults with dementia during the last few years. In  
addition, there is greater interest in the study of this topic in  
countries such as the United States and Italy.  
Table 3 presents a summary of the resulting studies with  
respect to the characteristics of the population and the clinical  
conditions of the participants in the different studies selected.  
With respect to gender, the vast majority of studies include  
both female and male patients; whereas, only one study does  
not specify the gender of older adults, because this population  
is intervened indirectly, collecting results through  
neuropsychological professionals.  
represent significantly non-institutionalized cases, with  
interventions applied at home.  
The use of technologies reported for neuropsychological  
intervention in older adults is mostly focused on tele-  
rehabilitation platforms and the use of mobile technologies  
(cell phone or Tablet) specially designed to address health  
issues, especially reminders; digital resources for the  
application of serious games are also reported. Regarding the  
areas of neuropsychological intervention, holistic approaches  
covering all areas (cognitive, emotional, sensory, physical  
and functional) are mostly observed, and specifically, the area  
most included in the studies is the cognitive (language skills  
and memory function) combined with the physical and  
functional dimension, especially for activities of daily living.  
These results are recorded in Table 4.  
The average age in most cases ranges between 71 and  
8
0 years of age; the majority clinical condition refers to  
patients with mild cognitive impairment (MCI) or  
Alzheimer's disease (AD). The intervened older adults  
Table 3. Characterization of the study population  
Category  
Number of Studies  
Study code  
Gender  
Mixed (men and women)  
Not specified  
13  
1
E1, E2, E3, E5, E6, E7, E8, E9, E10, E11, E12, E13, E14  
E4  
Average age  
6
7
8
3 – 70 years  
1 – 80 years  
1- 90 years  
2
9
2
1
E6, E11  
E1, E2, E3, E5, E9, E10, E12, E13, E14  
E7, E8  
E4  
Not specified  
Clinical condition  
Mild cognitive impairment  
Mild to moderate cognitive impairment  
Alzheimer's disease (AD)  
Mild cognitive impairment and AD  
Residence  
7
1
4
2
E1, E3, E4, E6, E11, E12, E13  
E7  
E8, E9, E10, E14  
E2, E5,  
Institutionalized  
4
9
1
E6, E7, E8, E11  
Non-institutionalized  
Mixed  
E1, E2, E3, E4, E9, E10, E12, E13, E14  
E5  
Table 4. Technologies reported in the studies  
Number of  
Studies  
Category  
Study code  
ICT description  
ICT  
Smart Aging Serious Game (SASG)  
BrightBrainer. Simulations  
Platform GRADIOR 4.5. Telecommunications (LSS-tele).  
Telerehabilitation ABILITY  
Serious games with simulations  
2
4
E1, E11  
E2, E4, E8,  
E9,  
Tele rehabilitation  
Eye-tracking  
1
1
1
1
E3  
E5  
E6  
E7  
Computerized Eye-tracking  
ATTILA  
Tele assistance  
Computerized and simulated training  
Robotic therapy  
No name specified  
PARO robotic pet  
E10, E12,  
E13, E14  
Accelerometer mHealth. Reminder SmartPrompt. App. Usage  
(Android) or Moment (iOS)  
Mobile health technology  
4
Intervention area  
Cognitive rehabilitation (linguistic skills and  
memory function)  
Global/Holistic: cognitive, emotional, sensory,  
physical and functional  
3
3
E1, E4, E8,  
E2, E7, E11  
Early identification  
1
3
3
1
E3,  
Functional in activities of daily living  
Cognitive and physical  
E5, E12, E14  
E6, E9, E10  
E13  
Cognitive and functional  
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DISCUSSION  
aligned with independence and autonomy were perceived as  
more acceptable (Irazoki et al., 2021; Lai et al., 2020).  
The recommended technological equipment are tablets  
or cell phones that can be used personally and exclusively by  
each patient, ensuring the use of specialized software that also  
contributes to the enjoyment of the older adult. It is important  
that the application of a technological resource or software is  
accompanied by prior training for its correct use, aimed at  
both the patient and his caregiver or family.  
Among the technologies that have been incorporated for  
neuropsychological intervention in older adults with  
dementia in the last ten years, tele-rehabilitation with tele-  
assistance stands out (Irazoki et al., 2021; Forsyth et al., 2019;  
Jelcic et al., 2014; Rossetto et al., 2023; Rosso et al., 2018),  
through various software that are applied through simulation  
in serious games (Burdea et al., 2015; Cabinio et al., 2020),  
mobile apps on smartphones (Hackett et al., 2022; Lai et al.,  
2
020; Scullin et al., 2022; Vidoni et al., 2016). Similar studies  
CONCLUSION  
agree with this criterion, noting that tele-rehabilitation  
occupies the first places (Arroyo et al., 2012; Garcia, 2016;  
Hernandez, 2019).  
Information and communication technologies offer new  
opportunities to support neuropsychological intervention  
programs to increase the quality of life of older adults with  
dementia or mild cognitive impairment, especially because  
they manage to capture the interest, motivation and  
enjoyment of tasks in older adults. In this sense, technologies  
become potential tools to increase the well-being of older  
adults, caregivers and family caregivers.  
However, there are still barriers associated with  
socioeconomic factors, demographics, resistant attitudes and  
poor knowledge about technologies, which hinder their  
implementation in the treatment and daily life of older adults  
with dementia. In the face of this, current trends related to  
Artificial Intelligence (AI) can help develop alternatives to  
expand the options for more accessible technologies that  
enrich any intervention with people with dementia.  
A variety of options can be found on the Internet as  
cognitive training platforms, among which Smartbrain and  
Lumosity, Nintendo® Company Limited games (DS or Wii)  
or Brain Training programs, Sudoku, etc. stand out; however,  
classic ludic games (word search, crossword puzzles, strategy  
games, logic, calculation, attention, etc.) designed for general  
public without cognitive impairment, but, which have been  
adapted according to the needs and particularities of patients  
with dementia (Arroyo et al., 2012; Hernandez, 2019).  
The tasks targeted by these technologies for  
neuropsychological rehabilitation in older adults with  
dementia are mainly to train memory and language (Cabinio  
et al., 2020; Jelcic et al., 2014; Rosso et al., 2018), executive  
functioning in activities of daily living (Burdea et al., 2015;  
Forsyth et al., 2019; Hackett et al., 2022; Irazoki et al., 2021;  
Lai et al., 2020; Petersen et al., 2017). In general, they seek  
to provide support for cognitive and functional rehabilitation  
therapy, so that it contributes to timely assessment of the  
cognitive profile (Cabinio et al., 2020; Opwonya et al., 2023);  
extend patients' treatment at home (Forsyth et al., 2019;  
Rosso et al., 2018) and intervene in daily functions to ensure  
a better lifestyle by extending their capacity for independence  
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