Digital Therapeutics for Mild Cognitive Impairment in Long-Term Care Facilities: A Scoping Review

As the population ages, the prevalence of dementia continues to rise year by year. According to the World Health Organization, 10 million new dementia cases emerge annually, projected to reach 153 million by 2050. Global economic losses are estimated to soar to $4.7 trillion by 2030. Dementia is globally recognized as the primary cause of disability and institutionalization among the elderly. Alzheimer's disease (AD), the most prevalent form of dementia, lacks effective drug treatments and is irreversible once developed. Mild cognitive impairment (MCI) represents the early stage of dementia, carrying a 3.3 times higher risk of progression to AD compared to cognitively healthy individuals. This makes MCI a critical window for early detection and prevention of AD. MCI practice guidelines recommend two non-pharmacological interventions: exercise programs and cognitive training. With rapid advancements in digital technology, these traditional intervention models are increasingly being integrated with digital therapeutics. The Digital Therapeutics Alliance (DTA) defines digital therapeutics (DTx) as software-driven, evidence-based health interventions for disease prevention, treatment, or management. DTx can be used independently or in combination with drugs, devices, or other therapies. Compared to traditional non-pharmacological treatments, DTx overcomes spatial and temporal constraints, offers personalized training, reduces guidance burdens, and improves participation rates. Current DTx applications among MCI patients predominantly occur in community or home settings. Nursing homes, despite higher MCI prevalence, receive insufficient attention. Elderly residents in these facilities exhibit high rates of loneliness and social isolation alongside low physical activity—established high-risk factors for dementia. Institutions offer centralized support unattainable in community or home settings, featuring stable network and device environments with immediate staff assistance, thereby enhancing intervention feasibility, adherence, and safety. DTx represents a novel and highly promising cognitive therapy for MCI patients in nursing homes. Therefore, this study aims to use a scoping review method to clarify the types of digital therapeutics applied to MCI elderly in nursing homes for cognitive improvement, as well as the facilitating and hindering factors. This is intended to provide theoretical guidance for the design, research, and implementation of DTx in the intervention or management of MCI patients in nursing homes.