Dementia is a progressive neurodegenerative condition marked by declining memory, cognitive abilities, and daily functioning, and it presents a significant global health burden [1]. According to the World Health Organization, more than 55 million people are currently affected worldwide, with nearly 10 million new cases emerging each year. This number is expected to rise to 74.7 million by 2030 and 131.5 million by 2050, underscoring the urgent need for scalable and sustainable models of care. Although the social and health care implications of dementia are increasingly recognized globally, its impact in culturally diverse and resource-limited settings, such as Nigeria, remains insufficiently examined.

Nigeria, Africa’s most populous country, is home to more than 250 ethnic groups and more than 500 languages, yet its adult literacy rate is only 62% with significant urban-rural disparities [2]. The education system faces diglossia, as English contrasts with indigenous languages, affecting health care communication and dementia care. Early-onset dementia is rare but tends to progress more rapidly [2]. Clinical presentations of dementia in Nigeria differ from those in developed countries due to cultural interpretations of aging conditions [3]. Behavioral and psychological symptoms are poorly recognized and underreported due to stigma and lack of awareness in rural areas (Figure 1).

Digital literacy worsens these issues: mobile phone adoption has increased in Nigeria, with more than 70% of the population owning at least 1 device [4]. This highlights the need to address awareness gaps for better telemedicine use in dementia care.

The article evaluates Nigeria’s telemedicine adoption for dementia care, examining sociocultural, linguistic, and technological contexts, while identifying gaps to improve outcomes [5].

Telemedicine enhances dementia care in Nigeria by providing remote clinical services. According to Louis et al [6], this system includes diagnosis and consultation via mobile phones and computers [7].

Telemedicine allows patients and caregivers to connect with health care professionals, reducing the psychological impacts of distancing [8]. During the pandemic, remote consultations, monitoring, and cognitive assessments eased isolation burdens while strengthening relationships with families and health care professionals, improving well-being and identity [9,10].

Telemedicine use in Nigeria increased during COVID-19, highlighting the need for remote care as face-to-face became limited [11]. Restrictions worsened social isolation and reduced health care access for individuals living with dementia and caregivers [12]. Telemedicine supports diagnosis, caregiver assistance, and community education [10]. In Nigeria, telemedicine provides a viable means to improve dementia care through remote services using computers and mobile phones [13,14].

Dementia remains a global health concern [15]. Increased awareness has emphasized caregiver support, with telemedicine emerging as a key intervention for COVID-19 [15,16].

This review discusses the effectiveness and challenges of telemedicine interventions for dementia care in Nigeria. It also aims to guide future development in resource-poor settings by assessing current usage [17]. Active interventions such as videoconferencing, remote assessment, and mobile apps are prioritized over passive monitoring technologies. According to Haimi [18], research highlights issues such as poor internet connectivity and technological inequality. Despite these issues, telemedicine shows promising potential for improving dementia care in Nigeria and justifies further studies [19].

The conceptual framework shows interactions between caregivers, health care professionals, individuals living with dementia, and technologies to enhance care delivery [13]. Mobile health (mHealth) app video consultations and monitoring devices improve access and integrate stakeholders into a unified system [20]. Caregivers use telemedicine tools for care management, while health care providers use them for diagnosis, treatment, and follow-up. These tools help overcome geographical barriers [21]. Technologies support caregivers in planning routines and seeking advice [22]. Video consultations address and improve specialist access, and monitoring systems track health for timely intervention [23]. This framework improves health care delivery, reduces caregiver burden, and provides an improved quality of life [24], helping stakeholders identify areas needing improvement.

Digital literacy is essential for telemedicine adoption, especially in resource-poor countries such as Nigeria [25]. It remains a challenge in urban and rural areas [26]. Mobile phone penetration is 70%, but rural digital literacy is about 30% compared to 62% in urban areas, highlighting a digital gap affecting telemedicine [23]. Urban caregivers benefit from better infrastructure, while rural caregivers face limited access, education, and training [27]. Low literacy in rural areas hinders the use of telemedicine tools, such as mHealth or video consultations for specialist care [28,29].

Despite the potential benefits, barriers hinder telemedicine use in Nigeria, especially in rural areas [30]. Technological challenges include infrastructure, internet services, and digital literacy, while nontechnological ones involve ethical concerns and funding issues [31]. This scoping review evaluates the adoption of telemedicine for dementia care in Nigeria, highlighting interventions, effectiveness, challenges, and contextual barriers. It draws on global evidence to propose culturally relevant and sustainable strategies for implementation.

This study used a scoping review methodology, guided by the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) framework. The purpose of this work was to explore the adoption of telemedicine for dementia care in Nigeria by identifying current interventions, implementation challenges, and research gaps.

Peer-reviewed articles were eligible for inclusion if they (1) focused on dementia care in Nigeria or sub-Saharan Africa; (2) included individuals living with dementia, caregivers, or health care professionals; (3) reported on telemedicine or digital health interventions (eg, mHealth apps, video consultations, or remote monitoring); (4) were published in English between January 2010 and March 2024; and (5) applied empirical methods, including qualitative, quantitative, or mixed-methods design. Conversely, studies were excluded if they (1) focused on diseases other than dementia, (2) lacked telemedicine components, (3) were purely theoretical or not empirical, or (4) were not published in English (Table 1).

The following databases were searched: PubMed, Scopus, CINAHL, PsycINFO, Cochrane Library, and Google Scholar. In addition, citation searching involved backward citation tracking from the reference lists of included articles and relevant systematic reviews to identify further relevant studies.

A comprehensive search strategy was developed using keywords such as “telemedicine,” “dementia care,” “digital health,” “remote care,” “caregiver support,” “Nigeria,” and “Sub-Saharan Africa.” Boolean operators and truncations were used to optimize search results. The full search strategy is available in Multimedia Appendix 1.

Study selection followed a 2-stage screening process in accordance with the PRISMA-ScR framework. In the first stage, 640 records were identified through searches of PubMed, Scopus, CINAHL, PsycINFO, Cochrane Library, and Google Scholar. After removing 220 duplicate records, 420 titles and abstracts were screened independently by 2 reviewers (AA and EO). In the second stage, 100 full-text articles were also independently assessed for eligibility by the same 2 reviewers. At both stages (title or abstract and full-text screening), disagreements were resolved through discussion with a third reviewer (HD).

Data were independently extracted by 2 reviewers (AA and EO) using a standardized data charting form, which was piloted and refined prior to full data extraction. Discrepancies were resolved through discussion, and when necessary, by involving a third reviewer (HD).

The following items were extracted from each included study: authorship, publication year, country, study design, target population, type of telemedicine intervention, measured outcomes, and main findings.

A narrative synthesis was used to categorize the data into 3 main themes: (1) types of telemedicine interventions, (2) barriers to adoption, and (3) facilitating factors. Where applicable, frequencies and percentages were used to summarize the distribution of study characteristics and intervention types.

The extracted data were grouped by type of telemedicine intervention. These included mHealth apps, video consultations, and remote monitoring tools. A narrative synthesis was conducted to identify patterns across studies and categorize findings into key intervention types. The goal was to compare their reported outcomes, implementation contexts, and barriers in dementia care delivery.

The reviewed studies explored a variety of telemedicine interventions applied to dementia care within Nigerian or sub-Saharan African contexts. These interventions included mHealth apps, video consultations, and remote patient monitoring systems aimed at supporting caregivers, improving access to specialist care, and enhancing patient outcomes. The included studies used diverse methodological approaches, including qualitative interviews, cross-sectional surveys, randomized controlled trials (RCTs), and mixed methods designs. Terms commonly used across the studies included “telemedicine,” “digital health,” “remote care,” “mHealth,” and “eHealth,” reflecting a broad conceptual framing of digital health delivery in dementia care.

The study selection process is outlined in Figure 2 below. Out of 640 initial records, 420 were screened, 40 full-text articles were assessed, and a total of 23 studies met the inclusion criteria and were included in the final review. An additional 8 records were identified through backward citation searching of included studies and relevant systematic reviews. All 8 records were retrieved and assessed for eligibility. However, none met the inclusion criteria due to reasons such as not focusing on dementia (n=4), lack of telemedicine components (n=2), and not being published in English (n=2).

In various regions, the primary characteristics of the studies are outlined in Table 2. A total of 23 studies were conducted mainly in Nigeria (n=7) [1,6,9,11,14,32,33], followed by the United States (n=5) [34-38], the United Kingdom (n=6) [39-44], Hong Kong (n=2) [45,46], Greece (n=1) [13], Germany (n=1) [47], and Spain (n=1) [48]. Study settings varied, individuals’ homes (n=6), health care institutions (n=10), and mixed environments (n=7).

Telemedicine interventions range from remote monitoring, mHealth apps, and video consultations, reflecting differences in health care infrastructure across urban and rural Nigeria. The intervention designs were diverse, highlighting the varied nature of telemedicine adoption.

Three studies were RCTs [46,51,52]. Five studies used quantitative methods, including observational and pretest-posttest designs [6,45,47,53,54]. Six studies used qualitative methods focusing on interviews and observational data to explore feasibility, acceptability, and implementation challenges [13,34,39,48,55,56]. Nine studies used mixed methods, combining quantitative (eg, surveys) and qualitative (eg, interviews) data for comprehensive evaluation [9,11,28,33,35,41,43,49,50]

Sample sizes varied, the largest study involving 250 participants [35] and the smallest only 11 participants [37]. Three studies reported sample sizes over 100 participants [35,45,53], with larger studies using quantitative methods and smaller ones exploring qualitative insights and feasibility. Outcome measure varied, caregiver burden was assessed in 6 studies using self-reported questionnaires [6,11,32,35,39,45]. Four studies used standardized scales to measure quality of life among individuals living with dementia, such as the QoL-AD scale [6,45,46,54]. Studies in rural areas often identified internet access and digital literacy as critical secondary outcomes [6,48]. Two studies addressed behavioral and psychological outcomes, highlighting reductions in agitation and caregiver stress [34,39]. The projected telemedicine growth in Nigeria from 2018 to 2024 shows increased use of mHealth apps, video consultations, and remote monitoring tools across urban and rural areas. Studies show mHealth apps are widely used in Nigeria for telemedicine, supporting caregivers in managing care routines, monitoring individuals living with dementia’s health [33].

Common barriers include poor internet connectivity [40], high-cost platforms, devices, and mobile data for health care professionals and caregivers [38]. High mobile phone penetration supports mHealth adoption, particularly in urban areas [49]. This study highlights the challenges and benefits of telemedicine for dementia care in Nigeria, revealing gaps in infrastructure and cultural adaptation. Table 2 summarizes the studies, detailing locations, study design, sample sizes, interventions, and outcomes.

Studies (n=23) were grouped according to the type of telemedicine intervention, including mHealth apps (n=10), video-based interventions (n=8), and remote monitoring interventions (n=5).

Four studies evaluated apps supporting caregivers [11,36,53,55]. These tools improved communication and reminders, reducing stress [55], enhancing well-being [53], and supporting telehealth and national strategies [11,36].

Three studies [36,55,58] addressed mHealth apps monitoring cognitive decline and quality of life. Yi et al [36] evaluated medication adherence and cognitive tracking, while Zou et al [57] showed reduced hospital visits, Hengst et al [41] noted improved medication adherence and socialization, while Zhu et al [47] highlighted effective symptom tracking and reduced emergency visits.

This scoping review examined telemedicine interventions for dementia care in Nigeria, focusing on video consultations, mHealth, and remote monitoring tools. Video consultations effectively improved specialist access and reduced caregiver burden [11]. mHealth apps are the most used intervention due to high mobile phone penetration [63], while remote monitoring tools face challenges in rural areas due to poor internet connectivity and digital literacy gaps [3]. Key barriers include infrastructural limitations, lack of a cohesive strategy, and cultural barriers [4]. Despite challenges, telemedicine shows potential to enhance patient outcomes, reduce caregiver burden, and improve health care access [56]. The findings align with recent studies demonstrating increased adoption of digital health in low-resource settings [26,37,52]. In addition, successful implementation models, such as remote patient monitoring in dementia care, have been demonstrated in previous studies that reported the successful implementation of remote patient monitoring for dementia care [42,57].

Video consultations address the shortage of dementia specialists by reducing caregiver travel stress and providing timely health care access [23]. However, poor internet access and inconsistent electricity supply hinder implementation in rural areas, such as other sub-Saharan nations facing infrastructural challenges [5,53]. The extensive use of mHealth apps helps caregivers manage routines and monitor health [4]. High mobile phone penetration supports mHealth adoption, particularly in urban areas, but gaps in digital literacy limit rural use. This issue is consistent with other low- and middle-income countries facing similar telemedicine challenges [64].

Remote monitoring tools, such as wearable sensors and home-based systems, support continuous health monitoring and early detection of cognitive decline, reducing hospital visits [58]. However, affordability, digital literacy, and infrastructure challenges limit their use in Nigeria, reflecting similar issues reported globally [45,58].

Cultural and linguistic diversity also impacts telemedicine adoption. Many older adults and caregivers in rural areas are not fluent in English, the primary language of most platforms [65]. Effective adoption requires multilingual support and culturally appropriate frameworks [66]. This aligns with findings from other multicultural regions emphasizing culturally tailored interventions [65].

This review has limitations. The methodological quality of studies varies, with many relying on qualitative data, limiting applicability across Nigeria [18]. The review focused on published literature, overlooking relevant gray literature [52]. Few long-term studies evaluate the lasting impact of telemedicine interventions on dementia care outcomes in Nigeria, with long-term effects still unknown, despite short-term advantages [13]. Lastly, issues with internet connectivity and digital literacy are commonly noted, but strategies to address them were not comprehensively explored [41].

This review highlights the urgent need for a comprehensive telemedicine policy framework integrating technological solutions within existing dementia care systems. Addressing infrastructural limitations, encouraging caregiver training, and developing culturally adapted tools are essential for broader acceptance. Caregiver-centered solutions can support a sustainable model for dementia care in Nigeria. Policymakers should focus on long-term evaluations, RCTs, and scalable models to bridge the digital divide. These strategies will enhance the quality of life for individuals with dementia and establish Nigeria as a leader in innovative health solutions for resource-limited settings.