IoT and AI promise untapped potential in dementia care, but current tools remain fragmented

The review outlines the escalating global burden of dementia, a progressive neurodegenerative condition that impairs memory, reasoning, behaviour, and mobility. Incidence rates increased sharply between 2000 and 2020, and projections suggest a climb from 57.4 million cases in 2020 to more than 152 million by 2050. Economic pressures mirror this rise. Global spending, estimated at USD 1.3 trillion in 2020, is set to reach USD 2.8 trillion by 2030, with countries like the United Kingdom facing a doubling of national dementia-related costs by 2040.

A global rise in dementia cases is outpacing the ability of digital health tools to support patients and caregivers, according to a detailed scientific review published in the Journal of Sensor and Actuator Networks that warns the current landscape of mobile applications, smart technologies, and IoT-based systems remains fragmented, under-validated, and unevenly designed for real-world use. The authors point out that this gap between innovation and practical support is widening just as dementia prevalence and related economic pressures reach historic levels.

The findings come from the study “Digital Dementia: Smart Technologies, mHealth Applications and IoT Devices, for Dementia-Friendly Environments,” evaluates 100 mobile apps on the Apple App Store and Google Play Store and examines the broader ecosystem of assistive technologies used in dementia care.

Growing pressure on care systems drives demand for scalable digital solutions

The review outlines the escalating global burden of dementia, a progressive neurodegenerative condition that impairs memory, reasoning, behaviour, and mobility. Incidence rates increased sharply between 2000 and 2020, and projections suggest a climb from 57.4 million cases in 2020 to more than 152 million by 2050. Economic pressures mirror this rise. Global spending, estimated at USD 1.3 trillion in 2020, is set to reach USD 2.8 trillion by 2030, with countries like the United Kingdom facing a doubling of national dementia-related costs by 2040.

As governments struggle to manage surging formal care costs and rising reliance on informal caregivers, mobile health technologies have gained attention for their accessibility and low financial barriers. The study’s systematic review of 100 dementia-related mobile applications notes that most are free-to-download and widely available, creating opportunities for remote support across age groups and regions. However, the authors emphasise that high availability does not translate into high clinical value.

The analysis categorises the apps into eight groups: Resource Apps, Cognitive Training Apps, Care Apps, Task Assistance Tools for people with dementia, Mental Wellness Apps, Memory Aids, Cognitive Assessment Tools, and one Fitness App. Resource apps and carer support tools dominate the market, while clinically relevant categories like cognitive assessments and adaptive memory aids remain sparse. Only three apps focus on cognitive assessment, and only seven serve as memory aids, despite their central role in early detection and daily functioning.

The dominance of low-complexity, education-focused apps suggests that the sector remains geared towards awareness and general support instead of clinical practice. This imbalance highlights a disconnect between what dementia care requires and what digital tools currently provide.

Digital dementia tools remain fragmented, under-validated, and limited in clinical integration

The study notes the lack of rigorous clinical validation across the mHealth landscape. Most apps have not been tested against established neuropsychological standards such as the Mini-Mental State Examination or the Montreal Cognitive Assessment. This raises doubts about their diagnostic accuracy and long-term reliability. For cognitive training apps, researchers found measurable improvements in short-term outcomes for healthy older adults, but insufficient evidence that such interventions slow or alter dementia progression.

Cognitive assessment tools show early promise for large-scale screening but often lack the validation required for clinical adoption. Digital memory aids demonstrate potential in supporting prospective memory tasks, yet they frequently lack adaptation mechanisms that respond to changing cognitive states. These limitations affect their usefulness as dementia progresses.

Mental wellness apps, including mindfulness and relaxation platforms, are widely used by carers and some patients. They can improve sleep, reduce stress, and enhance resilience, but their content is rarely tailored to people experiencing cognitive decline. As a result, their real-world applicability remains narrow.

The study also highlights significant challenges in data privacy and informed consent. Many apps provide insufficient clarity around data storage, third-party access, or compliance with global privacy regulations such as GDPR and HIPAA. Given the vulnerability of the population and the sensitivity of health data, these gaps pose serious risks.

Another barrier is the lack of integration with electronic health records. While some apps offer decision-support functions or track behavioural changes, few can exchange data with clinical systems. Developers cite interoperability issues, regulatory barriers, and complexity of clinical workflows as reasons for this gap. Without streamlined integration, digital tools cannot support early detection or ongoing monitoring in a meaningful way.

Usability issues further complicate adoption. Many apps do not follow inclusive design principles, making them unsuitable for users with visual, motor, or cognitive impairments. Error tolerance, navigation simplicity, and readability vary widely across tools. This inconsistency places an additional burden on people living with dementia and those who support them.

Smart technologies, IoT devices, and assistive robotics offer potential but remain underused

The study evaluates smart technologies that could improve dementia care through responsive environments, advanced monitoring, and context-aware assistance. It highlights the emergence of smart home systems that combine motion sensors, voice interfaces, and wearable devices to track routines, detect anomalies, and provide real-time feedback. These technologies can enhance autonomy and reduce caregiver burden by monitoring activities like sleep, movement, hydration, and medication adherence.

However, integration of IoT devices across the reviewed apps remains minimal. Only a small portion connect to wearables or smart home equipment, and when they do, the connectivity tends to be limited to basic functions such as step counting or heart rate tracking. More advanced opportunities, such as low-power sensors, intelligent lighting systems, or emotional detection tools, are rarely implemented.

The authors point to Ambient Assisted Living systems, adaptive algorithms, and emotional computing as emerging fields that could reshape dementia-friendly environments. These technologies draw on cognitive architecture and environmental psychology to design spaces that support memory, reduce stress, and promote emotional balance. Elements such as natural lighting, structured visual cues, and multisensory stimulation help reduce disorientation and agitation.

Assistive robotics is another promising domain. Robots equipped with spatial sensors and multimodal interaction capabilities can support therapeutic tasks, physical activity, and emotional engagement. Early evidence suggests that such interactions may improve stability and engagement among older adults. Wearables are also gaining traction for continuous data collection, although their energy demands and durability remain challenges for long-term use.

Virtual and augmented reality systems show particular promise for stimulating autobiographical memory, reducing disorientation, and offering safe training environments. Tools that simulate familiar settings or overlay navigational cues in real-world spaces may help individuals maintain independence. These approaches align with emerging neuroadaptive architecture, which uses AI to adjust experiences based on emotional and cognitive responses.

Despite these opportunities, the review warns that adoption remains limited. Many innovations remain in early development phases, and few are integrated into mainstream dementia care.

Future development must address fragmentation, ethics, and inclusivity

The authors call for stronger regulatory oversight, extensive clinical validation, and the adoption of co-design frameworks that bring patients, carers, and healthcare professionals into the development process.

They recommend building interoperable platforms that unify cognitive training, behavioural tracking, emotional support, and environmental monitoring. This would reduce the current need to navigate multiple apps and systems, which can overwhelm users and diminish adherence.

Addressing digital equity is another priority. Developers need to ensure multilingual support, low-bandwidth functionality, and culturally relevant content to reach diverse ageing populations. Sustainability must guide future design, with energy-efficient sensors and low-power devices that can integrate into long-term care settings without high operational costs.