Forty-one studies were included in the review: seven studies were considered to be strong (522 participants; range 5 to 136); ten moderate (138 participants; range 3 to 26); and 24 weak (total number of participants unclear). Studies had very small sample sizes, high drop-out rates, basic statistical analyses, lack of adjustment for multiple comparisons and poor performance of the technology.
Independence, prompts and reminders: It appeared that once the evaluation moved from the laboratory, significant practical and methodological problems emerged. Generally, the reported use of the technology made little difference to practical outcomes.
Safety and security: The very weak evidence showed that common problems were associated with lack of acceptance by the user, difficulties with use, and technical reliability. Careful assessment was required to discover the likely benefit of the technology to an individual; there was a strong suggestion that the window of opportunity was quite small for the successful application of technology.
Telecare and telehealth: Although the literature did not seem to support the use of technology (in the form available) to enhance communication initiated by the person with dementia, it provided some promise that remote carer initiated communication could be used for assessment and simple therapeutic interventions. However, the included studies were not methodologically strong.
Therapeutic interventions: There was little convincing evidence to support the use of Snoezelen technology (multi-sensory stimulation exposure) over other activities to improve the wellbeing of people with dementia. The effects of simulated presence therapy appeared modest and short lived.