Diagnostic accuracy of digital solutions to screen for cognitive impairment: a systematic review and meta-analysis

Early detection of cognitive impairment is essential to initiate intervention and guarantee access to healthcare services. Digital solutions are emerging in literature as an alternative approach to cognitive screening. Our primary goal is to synthesize the evidence on digital solutions' diagnostic ability/accuracy to screen for cognitive impairment. A secondary goal is to distinguish whether the ability to screen cognitive impairment varies as a function of the type of digital solution: paper-based or innovative digital solutions. A systematic review and meta-analysis of digital solutions' diagnostic accuracy were conducted, including 25 studies. Digital solutions presented a variable diagnostic accuracy range. Innovative digital solutions offered at least 0.78 of sensitivity but showed lower specificity levels than the other subgroup. Paper-based digital solutions revealed at least 0.72 of specificity, but sensitivity started at 0.49. Most digital solutions do not demand the presence of a trained professional and include an automatic digital screening system and scoring, which can enhance cognitive screening and monitoring. Digital solutions are adequate for cognitive screening in the community and clinical practice showing sensitivity and specificity levels similar to traditional widely used paper and pencil tests. A detailed assessment of the accuracy levels of each digital solution is recommended.