Validity and usability for digital cognitive assessment tools to screen for mild cognitive impairment: a randomized crossover trial.
Min Wu, Jialin Feng, Ruini Sun and 7 others
PMID 40500744WHAT IT FOUND
Digital versions of standard cognitive tests correlated moderately with paper forms but scored lower on memory tasks.
Despite positive usability ratings, most older adults preferred paper tests. Digital assessments took longer to complete, especially for those with lower education levels.
Key findings
01The digital MMSE scored 0.79 points lower than the paper version, with the difference driven by memory tasks.
0255.26% of participants preferred paper-based tests, while only 23.68% preferred digital tools.
03Digital tests took longer to complete (7.11 minutes) than paper tests (6.21 minutes), particularly for users with lower education.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Small sample size (47) limits generalizability. Digital tests did not feature automated scoring; providers manually recorded responses, introducing potential bias. Neurological verification was only performed for screen-positive participants and a 10% sample of negatives, risking verification bias. Self-reported usability may be influenced by social desirability. Two-week washout may not fully eliminate carryover effects.
Declared interests
Funded by UK Research and Innovation and the National Science Foundation of China/Economic and Social Research Council.
The easy way to misread this
Do not assume digital cognitive tests are superior because they showed higher sensitivity and AUC for detecting impairment. The digital MMSE scored significantly lower than the paper version on memory tasks, and most participants preferred paper. The observed 'better' detection may reflect increased false positives due to lower scores, not true clinical superiority.