Abstract
Alzheimer’s disease (AD) is a progressive, multifactorial, chronic, neurodegenerative disease with high prevalence and limited therapeutic options, making it a global health crisis. Being the most common cause of dementia, AD erodes the cognitive, functional, and social abilities of the individual and causes escalating medical and psychosocial needs. As yet, this disorder has no cure and current treatment options are palliative in nature. There is an urgent need for novel therapy to address this pressing challenge. Digital therapeutics (Dtx) is one such novel therapy that is gaining popularity globally. Dtx provides evidence based therapeutic interventions driven by internet and software, employing tools such as mobile devices, computers, videogames, apps, sensors, virtual reality aiding in the prevention, management, and treatment of ailments like neurological abnormalities and chronic diseases. Dtx acts as a supportive tool for the optimization of patient care, individualized treatment and improved health outcomes. Dtx uses visual, sound and other non-invasive approaches for instanceconsistent therapy, reminiscence therapy, computerised cognitive training, semantic and phonological assistance devices, wearables and computer-assisted rehabilitation environment to find applications in Alzheimer's disease for improving memory, cognition, functional abilities and managing motor symptom. A few of the Dtx-based tools employed in AD include "Memory Matters", "AlzSense", "Alzheimer Assistant", "smart robotic dog", "Immersive virtual reality (iVR)" and the most current gamma stimulation. The purpose of this review article is to summarize the current trends in digital health in AD and explore the benefits, challenges, and impediments of using Dtx as an adjunctive therapy for the management of AD.
[http://dx.doi.org/10.1002/alz.12638] [PMID: 35289055]
[http://dx.doi.org/10.1038/nrneurol.2011.2] [PMID: 21304480]
[http://dx.doi.org/10.1186/1471-2318-14-6] [PMID: 24456381]
[http://dx.doi.org/10.1111/psyg.12141] [PMID: 27148797]
[http://dx.doi.org/10.1371/journal.pone.0132168] [PMID: 26154626]
[http://dx.doi.org/10.1212/WNL.51.1_Suppl_1.S53] [PMID: 9674763]
[http://dx.doi.org/10.1177/089826439500700202] [PMID: 10172777]
[http://dx.doi.org/10.1037/0882-7974.10.4.540] [PMID: 8749581]
[PMID: 11072482]
[http://dx.doi.org/10.1093/brain/awt171] [PMID: 23824488]
[http://dx.doi.org/10.5152/npa.2017.11304] [PMID: 28566965]
[http://dx.doi.org/10.1046/j.1563-258x.2002.01127.x] [PMID: 11925775]
[http://dx.doi.org/10.1016/j.ejmcr.2022.100044]
[http://dx.doi.org/10.1016/0165-6147(91)90609-V] [PMID: 1763432]
[http://dx.doi.org/10.1016/j.biopha.2022.112746] [PMID: 35231697]
[http://dx.doi.org/10.3233/JAD-2010-1221] [PMID: 20061647]
[http://dx.doi.org/10.1016/j.neuint.2010.12.003] [PMID: 21167244]
[http://dx.doi.org/10.1016/j.npep.2015.06.008] [PMID: 26149638]
[http://dx.doi.org/10.3389/fnins.2018.00025] [PMID: 29440986]
[http://dx.doi.org/10.1073/pnas.83.13.4913] [PMID: 3088567]
[http://dx.doi.org/10.1016/S0891-5849(02)00794-3] [PMID: 12031889]
[http://dx.doi.org/10.1093/hmg/ddq160] [PMID: 20413653]
[http://dx.doi.org/10.1001/jamaneurol.2013.5847] [PMID: 24493463]
[http://dx.doi.org/10.1007/s00401-015-1387-2] [PMID: 25600324]
[http://dx.doi.org/10.1126/science.1072994] [PMID: 12130773]
[http://dx.doi.org/10.1021/cb400080f] [PMID: 23506614]
[http://dx.doi.org/10.1056/NEJMra0909142] [PMID: 20107219]
[http://dx.doi.org/10.1038/374647a0] [PMID: 7715705]
[http://dx.doi.org/10.2353/ajpath.2007.060378] [PMID: 17255335]
[http://dx.doi.org/10.1006/bbrc.1996.1197] [PMID: 8753786]
[http://dx.doi.org/10.1017/S1092852900014164] [PMID: 16273023]
[PMID: 34191703]
[http://dx.doi.org/10.3390/molecules27061816] [PMID: 35335180]
[http://dx.doi.org/10.1016/j.prmcm.2021.100030]
[http://dx.doi.org/10.1016/j.bcp.2013.12.012] [PMID: 24380887]
[http://dx.doi.org/10.1007/s11011-020-00622-2] [PMID: 32986168]
[http://dx.doi.org/10.1056/NEJMoa013128] [PMID: 12672860]
[http://dx.doi.org/10.7759/cureus.17591] [PMID: 34646644]
[PMID: 28706327]
[http://dx.doi.org/10.1016/j.biopha.2021.111623] [PMID: 33915504]
[http://dx.doi.org/10.4103/picr.PICR_89_19] [PMID: 32670828]
[http://dx.doi.org/10.12793/tcp.2019.27.1.6] [PMID: 32055575]
[http://dx.doi.org/10.1016/j.brat.2016.08.012] [PMID: 28110672]
[http://dx.doi.org/10.1080/10810730.2012.650613] [PMID: 22548601]
[http://dx.doi.org/10.1089/dia.2008.0283] [PMID: 18473689]
[http://dx.doi.org/10.2196/32759] [PMID: 35080499]
[http://dx.doi.org/10.1002/cpt.1036] [PMID: 29377057]
[http://dx.doi.org/10.1038/nbt.3495] [PMID: 26963544]
[http://dx.doi.org/10.30773/pi.2019.01.20] [PMID: 30808114]
[http://dx.doi.org/10.4103/jfmpc.jfmpc_105_20] [PMID: 32754475]
[http://dx.doi.org/10.3389/fdigh.2015.00006]
[http://dx.doi.org/10.2217/fon.13.42] [PMID: 23647287]
[http://dx.doi.org/10.1080/14740338.2018.1508447] [PMID: 30073875]
[http://dx.doi.org/10.4258/hir.2022.28.3.188] [PMID: 35982593]
[http://dx.doi.org/10.2196/12490] [PMID: 30912758]
[http://dx.doi.org/10.1016/j.cmpb.2021.106319] [PMID: 34364181]
[http://dx.doi.org/10.3389/fnhum.2018.00171] [PMID: 29780310]
[http://dx.doi.org/10.1016/j.bbr.2014.12.033] [PMID: 25541035]
[http://dx.doi.org/10.1183/13993003.03103-2020] [PMID: 33334936]
[http://dx.doi.org/10.1007/s11882-019-0840-z] [PMID: 30712150]
[PMID: 23009698]
[http://dx.doi.org/10.1080/13696998.2020.1776298] [PMID: 32468884]
[http://dx.doi.org/10.3390/ijerph18062929] [PMID: 33809308]
[http://dx.doi.org/10.2196/jmir.1151] [PMID: 19632969]
[http://dx.doi.org/10.3389/fneur.2018.00099] [PMID: 29551988]
[http://dx.doi.org/10.1093/her/cyn012] [PMID: 18682382]
[http://dx.doi.org/10.1177/1533317514545866] [PMID: 25107931]
[http://dx.doi.org/10.1001/jamapsychiatry.2017.0262] [PMID: 28384700]
[http://dx.doi.org/10.21037/jhmhp-20-103] [PMID: 34308256]
[http://dx.doi.org/10.5665/sleep.1872] [PMID: 22654196]
[http://dx.doi.org/10.1038/532020a] [PMID: 27078548]
[http://dx.doi.org/10.2196/14842] [PMID: 32134720]
[http://dx.doi.org/10.1111/epi.16317] [PMID: 31423591]
[http://dx.doi.org/10.2196/22489] [PMID: 34047709]
[http://dx.doi.org/10.1016/j.seizure.2020.03.020] [PMID: 32417687]
[http://dx.doi.org/10.1038/s41569-021-00522-7] [PMID: 33664502]
[http://dx.doi.org/10.3389/fneur.2021.690404] [PMID: 34326807]
[http://dx.doi.org/10.3389/fneur.2021.724904] [PMID: 34489858]
[http://dx.doi.org/10.3389/fnagi.2022.845825] [PMID: 35677205]
[http://dx.doi.org/10.2196/mhealth.4269] [PMID: 26323749]
[http://dx.doi.org/10.3389/fpsyt.2018.00388] [PMID: 30210370]
[http://dx.doi.org/10.1080/02687030903474255] [PMID: 21170283]
[http://dx.doi.org/10.1109/EMBC.2018.8513049]
[http://dx.doi.org/10.1111/inm.12692] [PMID: 31984570]
[http://dx.doi.org/10.1097/jnr.0000000000000233] [PMID: 29016468]
[http://dx.doi.org/10.3233/THC-2011-0628] [PMID: 21849735]
[http://dx.doi.org/10.1186/s12984-019-0492-1] [PMID: 30696453]
[http://dx.doi.org/10.2196/17167] [PMID: 32159519]
[PMID: 31686090]
[http://dx.doi.org/10.1016/S0140-6736(16)31355-1] [PMID: 27560260]
[http://dx.doi.org/10.5853/jos.2019.01963] [PMID: 31587534]
[http://dx.doi.org/10.1016/S2215-0366(19)30132-4] [PMID: 31324560]
[http://dx.doi.org/10.1007/s10865-018-9966-z] [PMID: 30825090]
[http://dx.doi.org/10.1186/1471-244X-12-189] [PMID: 23126676]
[http://dx.doi.org/10.1016/j.jamda.2015.07.010] [PMID: 26341034]
[http://dx.doi.org/10.1177/147323000903700401] [PMID: 19761679]
[http://dx.doi.org/10.3344/kjp.2021.34.3.247] [PMID: 34193631]
[http://dx.doi.org/10.2196/20049] [PMID: 32540841]
[http://dx.doi.org/10.1016/j.genhosppsych.2020.06.009] [PMID: 32688094]
[http://dx.doi.org/10.2196/18848]
[http://dx.doi.org/10.1093/geronb/gbz152] [PMID: 31781769]
[http://dx.doi.org/10.1016/j.jagp.2019.07.010] [PMID: 31402088]
[http://dx.doi.org/10.1080/08870446.2014.979823] [PMID: 25350585]
[http://dx.doi.org/10.1136/bcr-2021-242550] [PMID: 34140328]
[http://dx.doi.org/10.1177/175045891702700601] [PMID: 29239200]
[http://dx.doi.org/10.1111/cts.12910] [PMID: 33048475]
[http://dx.doi.org/10.2217/pme-2020-0071]
[http://dx.doi.org/10.1186/s13098-022-00818-9] [PMID: 35365189]
[http://dx.doi.org/10.1007/s43441-021-00288-7] [PMID: 33914297]
[http://dx.doi.org/10.1038/s41746-020-00370-8] [PMID: 33311567]
[http://dx.doi.org/10.1007/s11883-020-00889-x] [PMID: 33009975]
[http://dx.doi.org/10.1016/j.cger.2019.07.004] [PMID: 31543180]
[http://dx.doi.org/10.3233/JPD-202407] [PMID: 33646177]
[http://dx.doi.org/10.1177/0098858816658275] [PMID: 29086648]
[http://dx.doi.org/10.1016/j.socscimed.2015.04.004] [PMID: 25864149]
[http://dx.doi.org/10.1192/bjp.bp.113.142612] [PMID: 25833865]
[http://dx.doi.org/10.1111/papt.12222] [PMID: 30924316]
[http://dx.doi.org/10.1002/cpt.1100] [PMID: 29696625]
[PMID: 27762198]
[http://dx.doi.org/10.12968/hmed.2018.79.12.672] [PMID: 30526097]
[http://dx.doi.org/10.1093/geront/gnx167] [PMID: 29361069]
[http://dx.doi.org/10.1001/jama.2010.1253] [PMID: 20810376]
[http://dx.doi.org/10.1186/s12877-021-02511-4] [PMID: 34670502]
[http://dx.doi.org/10.1111/j.1532-5415.2010.02971.x] [PMID: 20662955]
[http://dx.doi.org/10.1001/jama.290.15.2015] [PMID: 14559955]
[http://dx.doi.org/10.3390/diagnostics11081473] [PMID: 34441407]
[http://dx.doi.org/10.3390/life12020275] [PMID: 35207561]
[http://dx.doi.org/10.14336/AD.2020.0312] [PMID: 33269107]
[http://dx.doi.org/10.1002/cpt.212] [PMID: 26272508]
[http://dx.doi.org/10.2196/23868] [PMID: 33079070]
[http://dx.doi.org/10.1038/s41746-021-00506-4] [PMID: 34493819]
[http://dx.doi.org/10.4108/icst.mobihealth.2014.257523]
[PMID: 27332475]
[http://dx.doi.org/10.1109/ColumbianCC.2015.7333433]
[http://dx.doi.org/10.1177/1525740114544026]
[http://dx.doi.org/10.1049/htl.2016.0057] [PMID: 28008366]
[http://dx.doi.org/10.1177/0733464815617287] [PMID: 26675353]
[http://dx.doi.org/10.1007/s12652-018-0827-y]
[http://dx.doi.org/10.2196/medinform.5587] [PMID: 29716885]
[http://dx.doi.org/10.2196/jmir.8095] [PMID: 29042342]
[http://dx.doi.org/10.1016/j.procs.2020.01.053]
[http://dx.doi.org/10.1093/pm/pnx028] [PMID: 28340247]
[http://dx.doi.org/10.3389/fnagi.2018.00117] [PMID: 29946251]
[http://dx.doi.org/10.1007/s12243-010-0165-3]
[http://dx.doi.org/10.1177/2055668317710593] [PMID: 31186930]
[http://dx.doi.org/10.1186/s12877-018-0879-z] [PMID: 30119653]
[PMID: 30061093]
[http://dx.doi.org/10.1017/S0144686X0400248X]
[http://dx.doi.org/10.1145/2668883.2668889]
[http://dx.doi.org/10.1016/j.dadm.2015.06.005] [PMID: 27239514]
[http://dx.doi.org/10.1145/3180308.3180332]
[http://dx.doi.org/10.1145/3173574.3173949]
[http://dx.doi.org/10.1155/2019/7151475] [PMID: 31032361]
[http://dx.doi.org/10.1002/14651858.CD012277.pub2] [PMID: 30864187]
[http://dx.doi.org/10.1007/s11065-022-09537-4] [PMID: 35157209]
[http://dx.doi.org/10.1002/14651858.CD011961.pub2] [PMID: 32101639]
[PMID: 34748207]
[http://dx.doi.org/10.3109/0963828820151025992]
[http://dx.doi.org/10.1016/S0010-440X(03)00006-3] [PMID: 12764709]
[http://dx.doi.org/10.1111/j.1749-6632.1996.tb34427.x] [PMID: 8624093]
[http://dx.doi.org/10.1177/1533317514539724] [PMID: 24951634]
[http://dx.doi.org/10.1016/j.jamda.2014.09.010] [PMID: 25444575]
[http://dx.doi.org/10.1016/j.jamda.2017.09.019] [PMID: 29153754]
[http://dx.doi.org/10.1111/1460-6984.12391] [PMID: 29749112]
[http://dx.doi.org/10.1016/j.trci.2018.04.003] [PMID: 29955666]
[http://dx.doi.org/10.1016/j.trci.2018.08.003] [PMID: 30258977]
[http://dx.doi.org/10.1186/s12877-020-01563-2] [PMID: 32375661]
[http://dx.doi.org/10.1038/s41393-020-00569-2] [PMID: 33077900]
[http://dx.doi.org/10.1016/j.jamda.2019.06.026]
[http://dx.doi.org/10.1371/journal.pone.0187779] [PMID: 29211727]
[http://dx.doi.org/10.1016/j.rehab.2019.04.004] [PMID: 31078706]
[http://dx.doi.org/10.1186/s12984-021-00917-0] [PMID: 34819097]
[http://dx.doi.org/10.1089/g4h.2019.0016] [PMID: 31800322]
[http://dx.doi.org/10.1093/ageing/afac175] [PMID: 35930726]
[http://dx.doi.org/10.3389/fneur.2021.683385] [PMID: 34434157]
[http://dx.doi.org/10.3389/fneur.2022.903673] [PMID: 35989930]
[http://dx.doi.org/10.1002/14651858.CD009848.pub2] [PMID: 25432016]
[http://dx.doi.org/10.1186/s13195-021-00806-7] [PMID: 33785077]
[http://dx.doi.org/10.1080/17483107.2020.1785566] [PMID: 32697614]
[http://dx.doi.org/10.1186/s13195-018-0454-z] [PMID: 30611286]
[http://dx.doi.org/10.2196/16841] [PMID: 32602841]
[http://dx.doi.org/10.3233/JAD-170667] [PMID: 29689716]
[http://dx.doi.org/10.1542/peds.2008-2357] [PMID: 19596728]
[http://dx.doi.org/10.3389/fnagi.2018.00013] [PMID: 29456501]
[http://dx.doi.org/10.3233/JAD-160268] [PMID: 27372645]
[http://dx.doi.org/10.1177/1046878114531102]
[PMID: 25852542]
[http://dx.doi.org/10.1016/j.msard.2022.103823] [PMID: 35523062]
[http://dx.doi.org/10.1016/j.msard.2020.101966] [PMID: 32045868]
[http://dx.doi.org/10.1016/j.acn.2006.04.004] [PMID: 16769198]
[http://dx.doi.org/10.1080/09084280903297891]
[http://dx.doi.org/10.2196/20049]
[http://dx.doi.org/10.4018/978-1-4666-5888-2.ch095]
[http://dx.doi.org/10.1109/38.250914] [PMID: 7757252]
[http://dx.doi.org/10.1162/1054746011470226]
[http://dx.doi.org/10.1097/00001199-200210000-00002]
[http://dx.doi.org/10.1162/1054746053967094]
[http://dx.doi.org/10.1016/j.jagp.2014.04.009] [PMID: 24998488]
[http://dx.doi.org/10.1007/s10055-014-0252-2]
[http://dx.doi.org/10.1016/j.apnu.2014.09.003] [PMID: 25634868]
[http://dx.doi.org/10.1371/journal.pone.0092804] [PMID: 24671006]
[http://dx.doi.org/10.1017/S1352465813000830] [PMID: 24103196]
[http://dx.doi.org/10.1002/da.20734] [PMID: 20734361]
[http://dx.doi.org/10.1007/978-3-319-07464-1_30]
[http://dx.doi.org/10.1007/s00127-007-0173-4]
[http://dx.doi.org/10.1089/cpb.2005.8.220] [PMID: 15971972]
[http://dx.doi.org/10.1016/j.janxdis.2014.05.010] [PMID: 25093964]
[http://dx.doi.org/10.1016/S0169-2607(03)00066-X] [PMID: 14980398]
[http://dx.doi.org/10.3389/fnhum.2014.00112] [PMID: 24624073]
[http://dx.doi.org/10.1016/j.ijpsycho.2014.11.003] [PMID: 25448267]
[PMID: 10175344]
[http://dx.doi.org/10.1016/j.neuropsychologia.2010.12.031] [PMID: 21185847]
[http://dx.doi.org/10.1016/j.arr.2014.04.004] [PMID: 24943907]
[PMID: 22408614]
[http://dx.doi.org/10.1007/978-3-642-17824-5_9]
[http://dx.doi.org/10.1016/S0003-6870(02)00020-0] [PMID: 12164509]
[http://dx.doi.org/10.1016/j.bbr.2004.10.016] [PMID: 15817181]
[http://dx.doi.org/10.1038/nature12486]
[http://dx.doi.org/10.1109/IECBES.2012.6498023]
[http://dx.doi.org/10.1515/REVNEURO.2006.17.1-2.239] [PMID: 16703955]
[http://dx.doi.org/10.1177/1545968309353328] [PMID: 19934445]
[http://dx.doi.org/10.1523/JNEUROSCI.4556-11.2012] [PMID: 22323707]
[http://dx.doi.org/10.1007/s10339-015-0646-4]
[http://dx.doi.org/10.1073/pnas.1121588109] [PMID: 22308496]
[http://dx.doi.org/10.1073/pnas.0611314104] [PMID: 17360474]
[http://dx.doi.org/10.1212/01.wnl.0000326262.67613.fe] [PMID: 18794491]
[PMID: 25834437]
[http://dx.doi.org/10.3233/JAD-2011-110014] [PMID: 21841262]
[PMID: 26029101]
[http://dx.doi.org/10.1007/s11235-018-0430-8]
[http://dx.doi.org/10.1155/2020/8822598]
[http://dx.doi.org/10.1016/j.dadm.2015.09.006] [PMID: 26878035]
[http://dx.doi.org/10.1016/j.procs.2016.08.178]
[http://dx.doi.org/10.31142/ijtsrd23656]
[http://dx.doi.org/10.1145/2744206]
[http://dx.doi.org/10.1109/ACCESS.2020.2969482]
[http://dx.doi.org/10.3390/s21124249] [PMID: 34205793]
[http://dx.doi.org/10.2196/mhealth.3136]
[http://dx.doi.org/10.1016/j.trci.2019.09.002] [PMID: 31720365]
[http://dx.doi.org/10.1109/CAIS.2018.8442010]
[http://dx.doi.org/10.33436/v30i4y202001]
[http://dx.doi.org/10.1109/SeGAH.2018.8401351]
[http://dx.doi.org/10.1159/000500445] [PMID: 31266031]
[http://dx.doi.org/10.1002/pra2.2016.14505301082]
[http://dx.doi.org/10.1016/j.ridd.2014.07.047] [PMID: 25124700]
[http://dx.doi.org/10.1017/S0144686X21001446]
[http://dx.doi.org/10.1177/0891988718819864] [PMID: 30612511]
[http://dx.doi.org/10.1007/s12652-019-01534-5]
[http://dx.doi.org/10.1109/TENCON.2017.8228294]
[http://dx.doi.org/10.1109/MIC.2018.112102418]
[http://dx.doi.org/10.1016/j.trci.2018.02.005] [PMID: 29955655]
[http://dx.doi.org/10.1016/j.irbm.2016.02.007]
[http://dx.doi.org/10.1080/23311908.2021.1968991]
[http://dx.doi.org/10.1002/alz.054218]
[http://dx.doi.org/10.1002/trc2.12178] [PMID: 34027028]