Currently submitted to: Interactive Journal of Medical Research
Date Submitted: Jan 30, 2026
Open Peer Review Period: Feb 25, 2026 - Apr 22, 2026
(closed for review but you can still tweet)
NOTE: This is an unreviewed Preprint
Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).
Peer review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.
Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).
Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.
Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.
Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Scoping Review Mapping the Landscape, Evidence, Gaps, and Opportunities for Digital Mental Health Interventions for Older Adults
ABSTRACT
Background:
Mental health conditions, including depression, anxiety, and psychological distress, are prevalent among the aging population and affect their health, functioning, and quality of life. Access to proper and high-quality mental health treatment is necessary; however, mental health treatment and care remain underused due to stigma, workforce shortages, cost, and mobility limitations. Digital mental health interventions (DMHIs) are emerging as a promising strategy to improve the accessibility and effectiveness of mental health services for older adults, but older adults have historically been underrepresented in DMHI development and evaluation. Additionally, how effective different types of DMHIs are and how age-centered design approaches influence outcomes remain underexplored.
Objective:
This scoping review mapped and synthesized evidence on digital mental health interventions (DMHIs) focused on adults aged 50 and older and identified gaps in the evidence base related to study design, age-related adaptations, and clinical outcomes. Specifically, we examined (1) the technologies and therapeutic approaches used, (2) the outcomes and effectiveness of DMHIs, and (3) age-centered adaptations and their outcomes.
Methods:
This scoping review searched for studies focusing on DMHIs for older adults across PubMed, PsycINFO, Scopus, Ageline, and Web of Science published from 2000 to February 2025. Eligible studies evaluated or described the design of DMHIs targeting mental health conditions among adults aged 50 years or older. Two rounds of independent screening and data extraction were conducted by multiple reviewers. Extracted data included study design, sample characteristics, intervention features, technologies used, age-related adaptations, and clinical outcomes.
Results:
Seventy-two studies met the inclusion criteria, of which thirty-six were randomized controlled trials, and fifty-four reported clinical outcomes. Web-based cognitive behavioral therapy (CBT) was the most commonly used approach, followed by games, virtual reality, mobile apps, chatbots, and robots. Fifty-four studies reported clinically effective outcomes, most commonly reductions in depression, anxiety, or psychological distress. However, only one-third of studies incorporated age-centered design adaptations or co-design approaches, such as simplified interfaces, larger fonts, age-relevant content, or participatory development with older adults.
Conclusions:
Among studies reporting effective outcomes, DMHIs can reduce depression, anxiety, and psychological distress. However, with only half of the included studies using randomized controlled trial designs, the overall evidence base remains moderate. In addition, age-adaptive design remains underdeveloped. Future research should strengthen trial designs and systematically examine how usability and age-centered adaptations influence DMHI effectiveness.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.