The effect of robot-based interventions on depression in older adults with cognitive impairment: A systematic review and meta-analysis.

OBJECTIVE: To assess the effectiveness of robot-based interventions in improving depressive symptoms among older adults with cognitive impairment, and to examine secondary effects on anxiety symptoms and cognitive function. DESIGN: A systematic review and meta-analysis. METHODS: Seven databases were searched from inception to December 24, 2025. Randomized controlled trials (RCTs) involving older adults with cognitive impairment were eligible. Depressive symptoms were the primary outcome, and anxiety symptoms and cognitive function were secondary outcomes. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled. Sensitivity analyses used alternative effect sizes and leave-one-out procedures. Subgroup analyses were conducted by cognitive status and intervention duration. Risk of bias and evidence certainty were assessed using RoB 2.0 and GRADE. RESULTS: Eight RCTs involving 514 participants were included. Robot-based interventions were associated with a statistically significant reduction in depressive symptoms (SMD = -0.26; 95% CI, -0.45 to -0.07, P = 0.007) and anxiety symptoms (SMD = -0.41; 95% CI, -0.73 to -0.10, P = 0.009), compared with control conditions. No statistically significant improvement was observed in cognitive function. Sensitivity analyses confirmed robustness. Subgroup analyses showed significant reductions in depressive symptoms in dementia but not MCI, and with duration ≤6 weeks but not >6 weeks. Evidence certainty was moderate for depressive symptoms, low for anxiety symptoms, and very low for cognitive function. CONCLUSION: Robot-based interventions may benefit psychological outcomes in older adults with cognitive impairment. However, evidence for cognitive outcomes remains limited and inconclusive. Larger, high-quality multicenter RCTs with longer follow-up are needed.