3rd Edition of Dementia World Conference 2026

Abstract

Background: Cognitive behavioural therapy (CBT) is an evidence-based approach that has been utilised with people living with mild cognitive impairment (MCI) or dementia to improve quality of life and reduce symptomology for a range of concerns such as anxiety, depression, and sleep difficulties. Technology assisted CBT approaches can increase access to mental health support. This systematic review aims to critically synthesise the existing evidence for the barriers and facilitators to the delivery of and engagement with CBT interventions, using both technology and non-technology assisted approaches for people living with MCI or dementia.

Methods: PRISMA reporting guidelines and Covidence data extraction were used to structure the review. A systematic search was conducted in multiple databases. We searched for CBT and modified CBT interventions within the last 20 years (2002-2022) targeting people living with MCI or dementia. Studies were restricted to those available in English. We included all empirical research studies that reported any information on barriers and facilitators to the delivery or engagement of CBT interventions for people living with MCI or dementia, such as randomized controlled trials (RCTs), case reports, mixed-methods, and qualitative studies. An inductive thematic analysis using an In-Vivo coding approach and content frequency calculations were used to examine the data.

Results: A total of 14 studies were included and 101 factors were extracted. Factors were grouped relating to stages (access, implementation, participation, maintenance), user levels (individual, carers, providers, services, system), and constructs (attitudes, abilities, support, delivery, resources, technology). Common barriers to delivery and engagement included lack of training, lack of time, and technical difficulties with technology. Common facilitators included MCI or dementia specific adaptations to interventions and technology, and being assisted by a support person.

Conclusion: The identification of barriers and application of facilitators are integral to the effective delivery of any intervention. The factors identified in this review can provide guidance for both the users and providers of CBT interventions delivered for people living with MCI or dementia. Additionally, these factors can help explain user engagement and delivery outcomes and further inform the design, development, and implementation of future psychotherapy interventions including those assisted with technology.