Home‐based cognitive interventions for patients with mild cognitive impairment and dementia. A systematic review

Abstract

AbstractBackgroundCurrently, there is a search for timely care and intervention on patients with dementia, which have reasonable costs and allow the sustainability and efficiency of national health and social care systems (Livingston et al., 2017). Cognitive interventions delivered in the patient’s home can be an excellent alternative, due to their feasibility(Jang et al., 2021) and accessibility (Rai et al., 2021) to the intervention. The aim of this paper is to describe the evidence on cognitive intervention performed at home for patients with MCI and mild dementia. To describe its characteristics and outcomes, and to address its feasibility and usability.MethodA systematic review was performed using the PRISMA recommendations. We reviewed 190 records from four databases: PubMed, CINAHL, Web of Science, and PsycInfo.The quality of the studies was assessed using the tool “Assessment (mERA) checklist7” (World Health Organization, 2016)ResultTen papers were included. With a mean quality score of 0.76/1 (91.7% agreement).The sample contains (N = 777) patients (MA 75.9). 80% have an education >7 years. 87.1% have a diagnosis of mild dementia. There are (N = 628) caregivers (MA 64.8). Seventy percent (n = 440) are women.Positive results were found in: 71% of studies that looked for results on cognition. 66% of the studies that looked for results on mood and behavioral symptoms. 83% of studies that looked for results on functionality/quality of life. 100% of the studies that looked feasibility, and 75% of the studies that looked for results on the caregiver.ConclusionCognitive intervention in the home of patients with MCI and early dementia showed positive results at a cognitive, emotional and behavioral levels. Likewise, in the caregiving relationship, emotional health and quality of life of caregivers.The use of assistive technologies in the home has some benefits over face‐to‐face care.Outcome‐cost ratio can be a cost‐effective solution for the sustainability and efficiency of national health and social care systems.