Effects of telemedicine interventions on cognitive function in post-stroke cognitive impairment: A systematic review and meta-analysis

BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown efficacy in improving cognitive impairment. However, a systematic review specifically evaluating telemedicine's effects on cognitive outcomes in post-stroke cognitive impairment is lacking.ObjectivesThis systematic review aimed to examine the effectiveness of telemedicine interventions for cognitive function in post-stroke cognitive impairment.MethodsA comprehensive search was performed across 10 electronic databases, including PubMed, Web of Science, CINAHL, EMBASE, Cochran library, Scopus, and ProQuest Dissertations and three Chinese-language databases (CNKI, Wan Fang, and Vip) from their respective inception dates to May 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Meta-analysis was performed by the use of Review Manager 5.3 and Stata 15.ResultsThe initial search yielded 10,365 articles, with 19 studies included in the systematic review. The results showed that telemedicine interventions had a significant moderate effect on global cognition (standardized mean difference (SMD = 0.69, Z = 4.23, P < 0.01) and significantly improved visuospatial function (SMD = 0.57, Z = 2.76, P < 0.05) and language (SMD = 0.62, Z = 2.59, P < 0.05). Sub-group analyses showed significant effects for both online tools or computer software and mobile apps, though high heterogeneity was noted. Additionally, telemedicine interventions had a significant effect on activities of daily living (SMD = 0.64, Z = 5.16, P < 0.01).ConclusionConsidering the obstacles and limitations of traditional face-to-face rehabilitation, telemedicine is an effective approach for treating post-stroke cognitive impairment that can significantly improve cognitive function. Future studies should address heterogeneity through rigorous designs, long-term follow-ups, neuroimaging, and biomarker integration to elucidate underlying mechanisms.The protocol was registered on PROSPERO (CRD42024502185).