AI-ASSISTED DEMENTIA CARE: A REVIEW OF EFFECTIVENESS AND ETHICAL CHALLENGES

Wiktoria Dybizbańska; Karolina Dziki; Agnieszka Burzej; Maciej Komenda; Julia Szklarska-Komenda; Katarzyna Garncarz; Aleksandra Marek; Krzysztof Jamroch; Mateusz Kacalak; Zofia Nowakowska

doi:10.31435/ijitss.2(50).2026.5124

Authors

Wiktoria Dybizbańska Independent Public Healthcare Institution of the Ministry of the Interior and Administration in Kraków, Kraków, Poland https://orcid.org/0009-0000-9899-7272
Karolina Dziki 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0009-0005-1720-3810
Agnieszka Burzej 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0009-0003-0066-3197
Maciej Komenda 105 Military Hospital SP ZOZ in Żary, Żary, Poland https://orcid.org/0009-0009-7327-417X
Julia Szklarska-Komenda 105 Military Hospital SP ZOZ in Żary, Żary, Poland https://orcid.org/0009-0000-9914-4917
Katarzyna Garncarz 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0009-0001-7554-2715
Aleksandra Marek Central Teaching Hospital of the Medical University of Łódź, Łódź, Poland https://orcid.org/0009-0002-3391-5082
Krzysztof Jamroch 5th Military Clinical Hospital with Polyclinic SPZOZ, Kraków, Poland https://orcid.org/0009-0003-2562-1276
Mateusz Kacalak The Nicolaus Copernicus Provincial Multispecialty Center for Oncology and Traumatology in Łódź, Łódź, Poland https://orcid.org/0009-0006-3386-0906
Zofia Nowakowska Upper Silesian Medical Center of Prof. Leszek Giec of the Silesian Medical University in Katowice, Katowice, Poland https://orcid.org/0009-0000-8030-7341

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5124

Keywords:

Dementia, Alzheimer's Disease, Artificial Intelligence, PARO, Social Robots

Abstract

Background: Dementia affects more than 57 million people worldwide and remains one of the most disabling and least treatable syndromes associated with aging. Given the lack of a pharmacological cure, there is significant interest in utilizing artificial intelligence to improve both the accessibility and quality of care. At present, AI-powered tools are applied in three main areas: early diagnosis through neuroimaging analysis, non-pharmacological management of behavioral symptoms with social robots, and continuous safety monitoring using smart home and wearable technologies.

Objective: This review synthesizes peer-reviewed evidence from PubMed published between 2015 and 2025, evaluating the practical impacts of AI tools in dementia care and examining the moral challenges associated with their use in populations experiencing progressive cognitive decline.

Key Findings: Deep learning techniques applied to brain MRI have demonstrated diagnostic validity for Alzheimer's disease that equals or exceeds the performance of specialist clinicians. However, questions remain regarding their effectiveness across diverse populations. Robotic companions, such as the PARO seal robot, have been shown to reduce agitation and depression in individuals with dementia and to significantly decrease the use of psychotropic medications. Observation technologies improve safety and alleviate caregiver anxiety, but they also introduce surveillance practices that may compromise the individual dignity and autonomy of those they are intended to protect.

Conclusions: AI provides significant clinical benefits in dementia care; however, these advantages are inseparable from the ethical conditions governing its use.

References

Arenson, M., Bahorik, A., Xia, F., et al. (2024). Understanding racial disparities in dementia prevalence among veterans. Journal of Alzheimer’s Disease, 99(4), 1225–1234. https://doi.org/10.3233/JAD-240181

Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and psychological symptoms of dementia. Frontiers in Neurology, 3, Article 73.

Chahine, L. M., et al. (2025). Ethical dilemmas in the care of patients with Alzheimer’s disease and related dementias unable to give informed consent.

Chen, S.-C., Lin, M.-F., Jones, C., et al. (2024). Effect of a group-based PARO robot intervention on cognitive function, autonomic nervous system function, and mental well-being in older adults with mild dementia: A randomized controlled trial. Journal of the American Medical Directors Association, 25(11), Article 105228. https://doi.org/10.1016/j.jamda.2024.105228

Churchill, N., Barnes, D. E., Habib, M., & Nianogo, R. A. (2024). Forecasting the 20-year incidence of dementia by socioeconomic status, race/ethnicity, and region in the US. Journal of Alzheimer’s Disease, 99(4), 1225–1234. https://doi.org/10.3233/JAD-231133

Dada, S., van der Walt, C., May, A. A., & Murray, J. (2022). Intelligent assistive technology devices for persons with dementia: A scoping review. Assistive Technology, 36(5), 338–351. https://doi.org/10.1080/10400435.2021.1992540

Fan, W., Zhao, R., Liu, X., & Ge, L. (2025). Intelligent robot interventions for people with dementia: Systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research. https://doi.org/10.2196/59892

Feast, A. R., et al. (2025). Behavioural and psychological symptoms of people with dementia in acute hospital settings: A systematic review and meta-analysis. Age and Ageing, 54(1), Article afaf013. https://doi.org/10.1093/ageing/afaf013

Franc, B., Nys, V., et al. (2025). Clinical prediction models using artificial intelligence approaches in dementia: A systematic review.

Frontiers in Digital Health. (2025). Designing for dignity: Ethics of AI surveillance in older adult care. https://doi.org/10.3389/fdgth.2025.1643238

Hinton, L., Tran, D., Peak, K., Meyer, O. L., & Quiñones, A. R. (2024). Mapping racial and ethnic healthcare disparities for persons living with dementia: A scoping review. Alzheimer’s & Dementia, 20(4), 3000–3020. https://doi.org/10.1002/alz.13612

Kisvetrová, H., Bretšnajdrová, M., Jurašková, B., & Langová, K. (2024). Personal dignity in people with early-stage dementia: A longitudinal study. Nursing Ethics, 31(7), 1258–1270. https://doi.org/10.1177/09697330241244495

Koh, W. Q., et al. (2023). The effectiveness of PARO on behavioural and psychological symptoms, medication use, total sleep time and sociability in older adults with dementia: A systematic review and meta-analysis.

Köhler, S., Biernetzky, O. A., Kirste, T., & Perry, J. (2024). Ethics, design, and implementation criteria of digital assistive technologies for people with dementia from a multiple stakeholder perspective: A qualitative study. BMC Medical Ethics, 25, Article 84. https://doi.org/10.1186/s12910-024-01080-6

Liu, S., Masurkar, A. V., Rusinek, H., et al. (2022). Generalizable deep learning model for early Alzheimer’s disease detection from structural MRIs. Scientific Reports, 12, Article 17106. https://doi.org/10.1038/s41598-022-20674-x

Livingston, G., Huntley, J., Liu, K. Y., et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing commission. The Lancet, 404, 572–628. https://doi.org/10.1016/S0140-6736(24)01296-0

Loveys, K., Prina, M., Axford, C., et al. (2022). Artificial intelligence for older people receiving long-term care: A systematic review of acceptability and effectiveness studies. Lancet Healthy Longevity, 3(4), e286–e297. https://doi.org/10.1016/S2666-7568(22)00033-5

Maust, D. T., et al. (2023). Multiple adverse outcomes associated with antipsychotic use in people with dementia: Population-based matched cohort study. BMJ. https://doi.org/10.1136/bmj-2023-076268

Mayeda, E. R., Glymour, M. M., Quesenberry, C. P., & Whitmer, R. A. (2016). Inequalities in dementia incidence between six racial and ethnic groups over 14 years. Alzheimer’s & Dementia, 12(3), 216–224.

Mmadumbu, A. C., Saeed, F., Ghaleb, F., & Qasem, S. N. (2025). Early detection of Alzheimer’s disease using deep learning methods. Alzheimer’s & Dementia, 21, Article e70175. https://doi.org/10.1002/alz.70175

Nandi, A., Counts, N., Chen, S., et al. (2022). Global and regional projections of the economic burden of Alzheimer’s disease and related dementias from 2019 to 2050. EClinicalMedicine, 51, Article 101580. https://doi.org/10.1016/j.eclinm.2022.101580

Pageau, F., Fiasse, G., Nordenfelt, L., & Mihailov, E. (2024). Care of the older person and the value of human dignity. Bioethics, 38(1), 44–51. https://doi.org/10.1111/bioe.13251

Poth, A., Penger, S., Knebel, M., et al. (2023). Empowering patients with dementia to make legally effective decisions: A randomized controlled trial on enhancing capacity to consent to treatment. Aging & Mental Health, 27(2), 292–300.

Pu, L., et al. (2019). Effectiveness of companion robot care for dementia: A systematic review and meta-analysis. The Gerontologist.

Ruiz-Fernández, M. D., et al. (2024). Ethical implications in using robots among older adults living with dementia. Frontiers in Psychiatry, 15, Article 1436273. https://doi.org/10.3389/fpsyt.2024.1436273

Scerri, A., Juul, F. S., Silva, R., et al. (2025). Ethical issues associated with assistive technologies for persons living with dementia and their caregivers: An overview of reviews. Dementia. https://doi.org/10.1177/14713012251341374

Schneider, C., Nißen, M., Kowatsch, T., & Vinay, R. (2024). Impact of digital assistive technologies on the quality of life for people with dementia: A scoping review. BMJ Open, 14(2), Article e080545.

Tampi, R. R., Tampi, D. J., Balachandran, S., & Srinivasan, S. (2016). Antipsychotic use in dementia: A systematic review of benefits and risks from meta-analyses. Therapeutic Advances in Chronic Disease, 7(5), 229–245.

van den Berg, N., et al. (2014). The experiences of people with dementia and intellectual disabilities with surveillance technologies in residential care. Scandinavian Journal of Caring Sciences.

Veneziani, I., Marra, A., Grimaldi, A., et al. (2024). Applications of artificial intelligence in the neuropsychological assessment of dementia: A systematic review. Journal of Personalized Medicine, 14(1), Article 113.

Yu, C., Sommerlad, A., Sakure, L., & Livingston, G. (2022). Socially assistive robots for people with dementia: Systematic review and meta-analysis of feasibility, acceptability and the effect on cognition, neuropsychiatric symptoms and quality of life. Ageing Research Reviews, 78, Article 101633.