Computerized and on-line neuropsychological testing for late-life cognition and neurocognitive disorders: are we there yet?

Abstract

Cost-effective, valid, efficient and accessible tests for the detection of late-life neurocognitive disorders are crucial, as early identification facilitates appropriate early intervention. Proponents of computerized neuropsychological assessment devices (CNADs) assert that technology-based assessments improve upon traditional neuropsychological tests. However, there remain fundamental questions of validity, reliability, normative data and administration, raising the question of whether CNADs are appropriate alternatives. Since publication of the 2012 American Academy of Clinical Neuropsychology and National Academy of Neuropsychology joint position paper outlining appropriate standards for CNAD development, the field has not significantly advanced, with the majority of recommendations inadequately addressed. Whilst there is a pressing need for innovative and readily applicable cognitive tests, these requirements do not outweigh the necessity for valid measures. Overall, the psychometric quality, standardization, normative data and administration advice of CNADs for neurocognitive disorders are lacking. Therefore, the risk of diagnostic errors is potentially high and poor clinical decisions could potentially arise, having significant impact upon individuals in terms of their well being and access to treatment. We recommend clinicians and researchers make informed decisions about CNAD suitability for their clients and their individual requirements based upon published psychometric and other test information.