How Telemedicine Can Improve the Quality of Care for Patients with Alzheimer’s Disease and Related Dementias? A Narrative Review

Abstract

Background and Objectives: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact.However, many patients with Alzheimer’s disease (AD) and other related dementias have limited access to effective and individualized treatment.Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. Materials and Methods: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia.A narrative synthesis was based on the seven WHO dimensions. Results: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting timesand unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues,as well as limited awareness, are significant potential barriers. Conclusions: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.

A Telehealth Home-Based Exercise Program for Community-Dwelling Older People with Dementia in Indonesia: A Feasibility Study

“…While these previous studies only report the attendance rate of the telehealth-delivered sessions without reporting the adherence rate of recommended exercise sessions being undertaken at home with carer supervision, together, these studies demonstrate that telehealth-delivered exercise programs are feasible in this population. There is also potential for use of telehealth approaches to address a range of other health problems for older people with dementia, for example, remote medication management [ 58 ]. Benefits of the telehealth approach for people living with dementia in the community include improved access to care (including those living away from metropolitan areas), and improved timeliness of access to and efficiency of services [ 59 ].…”

Importance of telemedicine in mild cognitive impairment and Alzheimer disease patients population during admission to emergency departments with COVID-19

“…The pandemic of COVID-19 has accelerated the use of telemedicine, which has promising potential to address this important gap. Angelopoulou et al [ 36 ] (2022), in a review, analyze how telemedicine can improve the quality of care for such patients, concluding that telemedicine can significantly improve all aspects of quality of care for patients with dementia. The restrictive measures introduced to contain COVID-19 infection provided a useful opportunity to adopt and concretely test the use of telemedicine interventions in the care-taking process and continuity of care.…”

Global trends in COVID-19 Alzheimer's related research: a bibliometric analysis

“…Gosse et al also reported that telemedicine might improve access to health care for people with AD and related dementias, especially during the COVID-19 pandemic ( 79 – 81 ). Telemedicine can significantly improve all aspects of care for people with Alzheimer's and dementia ( 82 , 83 ). Telemedicine can also be applied to conditions like severe asthma ( 84 , 85 ).…”