Diagnostic Accuracy of Touchscreen-Based Tests for Mild Cognitive Disorders: A Systematic Review and Meta-Analysis.

Abstract

Background/Objectives: Mild neurocognitive disorder (mNCD) is a state of vulnerability, in which individuals exhibit cognitive deficits identified by cognitive testing, which do not interfere with their ability to independently perform in daily activities. New touchscreen tools had to be designed for cognitive assessment and had to be at an advanced stage of development but their clinical relevance is still unclear. We aimed to identify digital tools used in the diagnosis of mNCD and assess the diagnostic performance of these tools. Methods: In a systematic review, we searched 4 databases for articles (PubMed, Embase, Web of science, IEEE Xplore). From 6516 studies retrieved, we included 50 articles in the review in which a touchscreen tool was used to assess cognitive function in older adults. Study quality was assessed using the QUADAS-II scale. Data from 34 articles were appropriate for meta-analysis and were analyzed using the bivariate random-effects method (STATA software version 19). Results: The 50 articles in the review totaled 5974 participants and the 34 in the meta-analysis, 4500 participants. Pooled sensitivity and specificity were 0.81 (95%CI: 0.78 to 0.84) and 0.83 (95%CI: 0.79 to 0.86), respectively. High heterogeneity among the studies led us to examine test performance across key characteristics in a subgroup analysis. Tests that are short and self-administered on a touchscreen tablet perform as well as longer tests administered by an assessor or on a fixed device. Conclusions: Cognitive testing with a touchscreen tablet is appropriate for screening for mNCD. Further studies are needed to determine their clinical utility in screening for mNCD in primary care settings and referral to specialized care. This research received no external funding and is registered with PROSPERO under the number CRD42022358725.