Effectiveness of telehealth interventions on cognitive function and quality of life in adults with neurological disorders : a systematic review and meta-analysis

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.