Clinical Interventions in Aging (Nov 2022)
Telephone and Smartphone-Based Interventions for Cognitive and Cardio-Metabolic Health in Middle-Aged and Older Adults: A Systematic Review
Abstract
Laurine Andre,1,2 Caroline Giulioli,1 Antoine Piau,1,2 Vanina Bongard,1,3 Edo Richard,4,5 Eric P Moll van Charante,4,6 Nicola Coley,1,3 Sandrine Andrieu1,3 On behalf of the PRODEMOS consortium1Center for Epidemiology and Research in Population Health (CERPOP), University of Toulouse, INSERM UMR1295, UPS, Toulouse, France; 2Pole de Geriatrie, University Hospital of Toulouse, UPS, Toulouse, F-31400, France; 3Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; 4Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; 5Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; 6Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, 1100DD, the NetherlandsCorrespondence: Laurine Andre, INSERM-University of Toulouse UMR1295, Pole de geriatrie, University Hospital of Toulouse, UPS, 37 allées Jules Guesde, Toulouse, F-31000, France, Tel +33562004344, Email [email protected]: Dementia and cardio-metabolic diseases share many risk factors. Management of these risk factors could contribute to successful aging, including the prevention of cardio-metabolic disease and dementia. The increasing use of smartphones offers an opportunity for remote preventive interventions. We provided a systematic review of telephone and smartphone-based interventions targeting the prevention of cognitive decline, dementia cardio-metabolic diseases or their risk factors among adults aged over 50 years.Patients and Methods: We searched Pubmed and the International Clinical Trials Registry Platform for experimental studies. We used the Cochrane risk-of-bias tool (Version 2) for randomized trials or TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) checklists to assess study quality for completed studies.Results: We analyzed 21 completed (3 for cognition, 18 for cardio-metabolic outcomes) and 50 ongoing studies (23 for cognition, 27 for cardio-metabolic outcomes). Smartphone interventions were used in 26 studies (3 completed, 23 ongoing). Other interventions involved telephone vocal support and text messaging. Few studies were at low risk of bias. There were heterogeneous cognitive and cardio-metabolic outcomes. The highest quality studies found no significant effects on cognition, and inconsistent results for HbA1c, blood pressure or physical activity. The lower quality-studies found effects on global cognition, working memory, memory and language and inconsistent results for clinical, biological or behavioral cardio-metabolic outcomes.Conclusion and Implications: Despite the large number of commercially available mobile health applications, the magnitude of the scientific evidence base remains very limited. Based on published studies, the added value of telephone and smartphone tools for the prevention of cardio-metabolic diseases, cognitive decline or dementia is currently uncertain, but, there are several ongoing studies expected to be completed in the coming years.Keywords: aging, telephone, smartphone, cognition, dementia, cardio, vascular outcomes
