Technology-based Neurocognitive Assessment of the Elderly: a Mini Review

Abstract

Neurocognitive disorders in the elderly are on the rise all over the world. Neuropsychological assessment is vital to monitoring the progress of cognitive deficits. Over the years, there has been significant development in neuropsychological assessment to predict the development and progression of MCI and dementia. One such area of recent advancement in the field of neuropsychology is technology-based assessment. There are several types of technology-based assessments available based on the type of usage, site of the assessment, type of administration, type of device used for assessment, etc. Virtual reality-based assessments and digital assessments of neurocognitions for early identification of subtle cognitive deficits in patients with mild cognitive impairment (MCI) and major neurocognitive disorders (MND) represent two newly developed technologies. A few studies have demonstrated their efficacy; however, there remain several limitations and drawbacks to their usage within the elderly population. In this review, we have briefly discussed technology-based neuropsychological assessment, along with their usage and limitations.

Remote and in‐clinic digital cognitive screening tools outperform the MoCA to distinguish cerebral amyloid status among cognitively healthy older adults

“…Older adults are increasingly using both smartphones and tablets, 13 and the adoption of this technology for cognitive screening in various settings is feasible, including in older adults with no prior experience with touchscreen technology 14–16 . There are several potential advantages to using digital cognitive assessments in remote and primary care settings, including reduced practitioner burden, improved ease of repeat testing, and better cost and time effectiveness of care 17,18 . Digital cognitive assessments may also allow clinicians to reach underserved and under‐resourced populations and adapt digital assessments to numerous languages, thus addressing healthcare disparities 19 .…”

“…[14][15][16] There are several potential advantages to using digital cognitive assessments in remote and primary care settings, including reduced practitioner burden, improved ease of repeat testing, and better cost and time effectiveness of care. 17,18 Digital cognitive assessments may also allow clinicians to reach underserved and under-resourced populations and adapt digital assessments to numerous languages, thus addressing healthcare disparities. 19 Visual working memory and episodic memory measures are shown to be sensitive to early-stage AD and can be easily adapted for digital presentation with minimal need for written or auditory language.…”

“…17,22,23 Remote assessment approaches also have psychometric benefits, including increased ecological validity (ie, being at home may reduce test anxiety and better capture day-to-day cognitive abilities), easy collection of multiple data points at different times of day, and automated scoring mechanisms that reduce scoring errors, potentially leading to more reliable and sensitive detection of cognitive change over time. 18,24 Despite these benefits, there are also potential costs to be aware of, including poor adherence, and a lack of examiner control over environmental distractors or interference from others. 25 For this reason, remote digital assessments are likely best utilized as a method for screening and monitoring, but not diagnosis, of cognitive disorders.…”

“…Smartphone‐ and web‐based cognitive screening tools have the additional advantage of improving accessibility for those in rural areas or with physical or financial limitations that prevent them from visiting the clinic 17,22,23 . Remote assessment approaches also have psychometric benefits, including increased ecological validity (ie, being at home may reduce test anxiety and better capture day‐to‐day cognitive abilities), easy collection of multiple data points at different times of day, and automated scoring mechanisms that reduce scoring errors, potentially leading to more reliable and sensitive detection of cognitive change over time 18,24 . Despite these benefits, there are also potential costs to be aware of, including poor adherence, and a lack of examiner control over environmental distractors or interference from others 25 .…”