Diagnostic Accuracy of Digital Solutions for Screening for Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract

The early detection of cognitive impairment is essential in order to initiate interventions and guarantee access to healthcare services. Digital solutions are emerging in the literature as an alternative approach to cognitive screening. Our primary goal is to synthesize the evidence on digital solutions’ diagnostic ability to screen for cognitive impairment and their accuracy. A secondary goal is to distinguish whether the ability to screen for cognitive impairment varies as a function of the type of digital solution: paper-based or innovative digital solutions. A systematic review and meta-analysis of digital solutions’ diagnostic accuracy were conducted, including 25 studies. Digital solutions presented a variable diagnostic accuracy range. Innovative digital solutions offered at least 0.78 of sensitivity but showed lower specificity levels than the other subgroup. Paper-based digital solutions revealed at least 0.72 of specificity, but sensitivity started at 0.49. Most digital solutions do not demand the presence of a trained professional and include an automatic digital screening system and scoring, which can enhance cognitive screening and monitoring. Digital solutions can potentially be used for cognitive screening in the community and clinical practice, but more investigation is needed for an evidence-based decision. A careful assessment of the accuracy levels and quality of evidence of each digital solution is recommended.

Keywords

• cognitive screening
• cognitive impairment
• diagnostic accuracy
• digital solutions