Currently submitted to: Journal of Medical Internet Research
Date Submitted: Mar 5, 2026
Open Peer Review Period: Mar 10, 2026 - May 5, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited.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.
Effects of Telehealth on Specific Domains of Cognition in Community-Dwelling Older Adults Living Without Assistance: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
The accelerated rate of global population aging underscores the critical need to mitigate cognitive decline in older adults. Telehealth offers a promising solution by providing an accessible means of cognitive intervention for older adults living independently in the community.
Objective:
This study aimed to synthesize current evidence to determine the effectiveness and feasibility of telehealth in improving domain-specific cognitive functions among older adults living independently in the community.
Methods:
Comprehensive literature search was conducted across seven electronic databases (ie, PubMed, Embase, Scopus, Web of Science, Cochrane Library, CINAHL Complete and PsycINFO) to identify randomized controlled trials (RCTs) published between January 1st, 2020, and May 28th, 2025. The included studies that investigated telehealth interventions for community-dwelling older adults living without assistance.
Results:
22 RCTs were included in the systematic review, and 15 RCTs were included in the meta-analysis. The pooled effect sizes (Hedges’ g) suggested positive effects of telehealth on global cognition (g = 0.78; 95% CI = 0.10, 1.46), executive function (g = 1.06; 95% CI = 0.27, 1.85), and language (g = 0.33; 95% CI = 0.12, 0.54). There was no significant effect on memory (g = 0.17; 95% CI = -0.20, 0.54). Neither the meta-regression nor the subgroup analyses identified significant moderators to account for the substantial between-study heterogeneity observed.
Conclusions:
Among community-dwelling older adults who are living without assistance, telehealth may provide benefits for global cognition, executive function, and language function. These results highlighted the clinical utility and feasibility of telehealth. Future studies should explore integrating artificial intelligence in telehealth to optimize training effectiveness and maximize user engagement. Clinical Trial: PROSPERO CRD420251056647
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