Global challenges in cognitive assessment: How technology will drive neuropsychologists to the forefront

Abstract

AbstractBackgroundAge remains the strongest risk factor for Alzheimer’s disease (AD). With the number of people over 65 now outnumbering those under the age of 5, the global burden of AD is rapidly increasing. Cognitive decline is the hallmark behavioral symptom of AD. However, accurate cognitive assessment requires consideration of a myriad of factors, including education, language, and culture. In fact, in a majority of low‐to‐middle income countries, as well as many emerging economies, there is no formalized doctoral training in neuropsychology. These circumstances necessitate embracing novel data collection methods in order to preserve the voice of the neuropsychologist. Technological advances can provide the tools to address the global realities of AD and other related disorders.MethodWe have developed a brain health monitoring platform that leverages the relatively ubiquitous use of smartphones across virtually all countries and collects behavioral measures that are inextricably linked to cognitive skills. We are applying machine learning approaches to quantify digital indices into cognitive ones. Importantly, we have strategically selected mobile applications that measure behaviors that are 1) common regardless of age, education, language and culture and 2) can be flexibly customized to circumstances.ResultWe have begun deploying versions of this high tech‐driven platform in the U.S. Further, we are starting to have an impact internationally, particularly in Asia. The health and age demographics in China make its population particularly vulnerable to AD. We present findings that speak to this risk and how our platform, and others like it, will help fill the neuropsychological expertise gap that such countries are currently experiencing.ConclusionAD is a rising epidemic. Early and accurate detection is the first step to finding disease modifying interventions and providing the context necessary for maximized efficacy. The coupling of professional neuropsychology skills and digital technology will generate solutions that can sufficiently address the impending challenge of conducting cognitive assessments universally. This potentially includes resolving longstanding health disparities by extending neuropsychologists’ reach into regions with significant economic and/or geographical constraints.