Engaging Older Adults With Neurocognitive Disorders in Digital Health Technologies: Scoping Review

Clinical Snapshot

Key Findings

• P Value: Not reported — scoping review with narrative synthesis only.

• Effect Size: Not applicable — no pooled effect size calculable. Narrative findings only from two heterogeneous studies.

• Primary Outcome: Engagement with digital health technologies among older adults with neurocognitive disorders is neither consistently conceptualised nor measured using validated instruments in the existing empirical literature. Observable indicators across behavioural, cognitive, and affective engagement dimensions were reported informally across both included studies.

• Nnt Or Sensitivity: Not applicable. Key qualitative findings: facilitating factors included professional support, content personalisation, and informal caregiver involvement; hindering factors included cognitive fluctuations, fatigue, technical complexity, and reliance on external support.

• Confidence Interval: Not applicable — no quantitative synthesis performed.

Clinical Application

Direct clinical application is not yet feasible given the absence of validated engagement measurement tools and the extremely limited evidence base. The review's findings are most applicable to researchers designing future digital health studies and to clinicians seeking to understand why digital health interventions may succeed or fail in this population. The identified facilitating factors (professional support, personalisation, caregiver involvement) can inform pragmatic implementation decisions. In Australia, this review is relevant to the National Dementia Action Plan, the Aged Care Quality and Safety Commission's digital inclusion agenda, and the RACGP's guidelines on dementia care. Digital health technologies for older Australians with neurocognitive disorders are increasingly relevant given the My Aged Care framework and telehealth expansion post-COVID-19. The TGA regulates software as a medical device (SaMD), and any digital cognitive intervention would require appropriate regulatory consideration. The PBS does not currently list digital therapeutics for neurocognitive disorders. The RACGP Silver Book and Dementia Australia resources align with the review's emphasis on personalised, supported engagement. Australian residential aged care settings face particular challenges with digital literacy and infrastructure that mirror the barriers identified in this review. Adults aged 65 years and older with mild to major neurocognitive disorders (including Alzheimer's disease and related dementias) in both community and residential aged care settings who are candidates for digital health technology interventions

Abstract

BACKGROUND: Population aging is associated with a growing prevalence of neurocognitive disorders among adults aged 65 years and older. Digital health technologies offer promising opportunities to support cognitive health and well-being in this population. However, their effectiveness largely depends on users' level of engagement. Despite the recognized importance of engagement in digital health, limited evidence exists on how engagement is conceptualized, measured, and related to intervention outcomes among older adults living with neurocognitive disorders. OBJECTIVE: This scoping review aimed to describe how engagement with digital health technologies among older adults with neurocognitive disorders is conceptualized and measured, examine the relationship between engagement and the effectiveness of digital health interventions, and identify factors that facilitate or hinder engagement. METHODS: A scoping review was conducted following the Joanna Briggs Institute methodological guidance and reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) checklist. A comprehensive search strategy, developed in collaboration with an information specialist, was applied to MEDLINE, Embase, CINAHL, Web of Science, and Google Scholar, without date restrictions. Empirical studies involving adults aged 65 years and older living with neurocognitive disorders and using digital health technologies were included. Study selection and data extraction were performed independently by at least 2 reviewers, and the results were synthesized narratively. RESULTS: Of the 1665 records identified after duplicate removal, 2 studies met the inclusion criteria. One study examined computerized cognitive stimulation and cognitive engagement programs among community-dwelling older adults with mild neurocognitive disorders, whereas the other explored the use of a personalized digital reminiscence application in long-term care settings among individuals with major neurocognitive disorders. No study used a validated instrument to directly measure engagement. However, observable indicators and markers related to the behavioral, cognitive, and affective components of engagement were reported. Both studies also documented concurrent cognitive or psychosocial outcomes. Factors facilitating engagement included professional support, content personalization, and involvement of informal caregivers, whereas limiting factors included cognitive fluctuations, fatigue, technical complexity, and reliance on external support. CONCLUSIONS: This scoping review highlights a significant gap in the literature regarding the explicit conceptualization and standardized measurement of engagement with digital health technologies among older adults living with neurocognitive disorders. The findings underscore the need to develop and apply multidimensional, context-sensitive engagement measurement tools tailored to this population to better understand and optimize digital health interventions.

References

1. 1.Da, S. M. A. R., Sasseville, M., Hardy, M.-S., Beogo, I., Gogovor, A., Amil, S., Yameogo, A. R., Naye, F., Yousefi, F., Bergeron, F., Giguère, A., LeBlanc, A., Plaisimond, J., Rivard-Lacroix, C., Gagnon, M.-P., & Cachinho, C. (2026). Engaging older adults with neurocognitive disorders in digital health technologies: Scoping review. JMIR Human Factors. https://doi.org/10.2196/70157