Precision neurocognition: An emerging diagnostic paradigm leveraging digital cognitive assessment technology.

Abstract

Strategies that may modify Alzheimer's disease (AD) and other dementia disorders are being developed. To maximize the benefits of these strategies, it is critical that indicators suggesting neurocognitive decline are identified as early as possible. 'Precision neurocognition' is a heuristic that seeks to develop methodologies capable of identifying subtle behavior(s) that may flag emerging AD and other dementia related syndromes. Recent research suggests that digital neuropsychological assessment technology may be the platform that can realize the goals of precision neurocognition, i.e., the early detection of neurocognitive difficulties that are prognostic for mild cognitive impairment (MCI) and dementia. Past research associating 100% correct or statistically within normal limits responding using neuropsychological tests with time-based parameters obtained while participants undergo assessment is reviewed. Recent research with community dwelling and memory clinic participants examined test scores obtained using commonly available neuropsychological tests. This research extracted a number of discrete latency measures that clearly dissociate between groups, despite final test scores that are either 100% correct or statistically within normal limits. In sum, past research using digitally administered neuropsychological tests suggests that the goals of precision neurocognition as related to the early identification of neurodegenerative illness may be realized via an analysis of time derived, process-based behavior using digital assessment technology. Latency or time-based parameters as described in recent research could form the basis of a range of neurocognitive biomarkers for identifying people at risk for developing AD, other dementing disorders, and MCI.