Digital and Service-Based Interventions for Dementia-Related Care in Primary Care: A Systematic Review and Narrative Synthesis

Introduction
Primary care has a central role in dementia risk reduction, early recognition, cognitive assessment, referral, and longitudinal care. However, dementia-related work in primary care is constrained by limited consultation time, variable clinician confidence, fragmented pathways, and unequal access to specialist input. Digital tools, clinician education, and service-redesign interventions have been proposed to strengthen dementia care in this setting. We aimed to systematically review completed intervention studies evaluating digital, educational, screening, blended, or service-based approaches designed to improve dementia-related care in primary-care settings.

Methods
This review followed PRISMA 2020 principles and used narrative synthesis because eligible studies were clinically and methodologically heterogeneous. PubMed, Embase, and Web of Science were searched for English-language studies published from 2017 onward. Eligible studies evaluated completed interventions delivered in, embedded within, or directly implemented through primary-care services and targeting dementia risk reduction, cognitive screening, mild cognitive impairment, dementia recognition, referral, or dementia-care delivery. The protocol was approved by the King Fahad Medical City Institutional Review Board, Riyadh Second Health Cluster (IRB log number 25-437; expedited approval, 29 September 2025).

Results
The search identified 977 records. After removal of 107 duplicates, 870 records were screened. Forty-nine full-text reports were assessed for eligibility, 45 were excluded with reasons, and four completed studies were included. The studies evaluated a blended dementia risk-reduction intervention, a clinician-education intervention, a digital cognitive-screening tool, and a telehealth or integrated-care service model. Overall, the evidence suggested feasibility, acceptability, and potential utility across different points in the dementia-care pathway, but effectiveness evidence was limited and inconsistent.

Conclusion
The current evidence base is small and heterogeneous. Digital and service-based interventions may support primary care in dementia prevention, screening, education, and access to specialist input, but no intervention model can yet be recommended as clearly effective or superior. Future research should prioritize pragmatic primary-care trials, longer follow-up, patient and carer outcomes, implementation outcomes, and standardized dementia-care endpoints.