Current State of Self-Administered Brief Computerized Cognitive Assessments for Detection of Cognitive Disorders in Older Adults: A Systematic Review.
Current State of Self-Administered Brief Computerized Cognitive Assessments for Detection of Cognitive Disorders in Older Adults: A Systematic Review.
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DOI：
10.14283/jpad.2021.11
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发表时间：
2021
影响因子：
--
通讯作者：
Possin KL
中科院分区：
文献类型：
--
作者：
Tsoy E;Zygouris S;Possin KL
老年人认知障碍的早期诊断是一项主要的卫生保健重点，对患者、家庭和卫生系统都有好处。数字技术的快速发展为开发支持早期诊断的创新诊断途径提供了潜力。简短的自我管理的计算机化认知工具尤其有望通过最大限度地减少对工作人员时间的需求来实现临床实施。在这项研究中，我们对自我管理的计算机认知评估措施进行了系统的回顾，这些措施旨在检测老年人的认知障碍。研究是通过对主要科学数据库中已发表的同行评议文献的系统搜索来确定的。所有报告简短（≤30分钟）自我给药的计算机测量方法用于检测老年人轻度认知障碍和全因痴呆的心理测量验证的研究都被纳入。17项研究报告了10种认知工具符合纳入标准，并进行了系统评价。在验证样本的特征以及信度和效度估计方面存在大量的可变性。只有2项措施评估了在预期临床环境中的可行性和可用性。与过去的综述类似，我们发现在心理测量的严谨性和在临床环境中广泛适用的潜力方面，不同测量方法存在差异。尽管自我管理的认知测试有望在临床实施中发挥作用，但这些措施在开发、验证和可行性研究方面的科学严谨性仍然存在重大差距。技术和生物标志物研究的发展为数字技术在临床护理中的应用提供了潜在的途径。本文的补充材料在10.14283/jpad.2021.11，授权用户可以访问。
Early diagnosis of cognitive disorders in older adults is a major healthcare priority with benefits to patients, families, and health systems. Rapid advances in digital technology offer potential for developing innovative diagnostic pathways to support early diagnosis. Brief self-administered computerized cognitive tools in particular hold promise for clinical implementation by minimizing demands on staff time. In this study, we conducted a systematic review of self-administered computerized cognitive assessment measures designed for the detection of cognitive impairment in older adults. Studies were identified via a systematic search of published peer-reviewed literature across major scientific databases. All studies reporting on psychometric validation of brief (≤30 minutes) self-administered computerized measures for detection of MCI and all-cause dementia in older adults were included. Seventeen studies reporting on 10 cognitive tools met inclusion criteria and were subjected to systematic review. There was substantial variability in characteristics of validation samples and reliability and validity estimates. Only 2 measures evaluated feasibility and usability in the intended clinical settings. Similar to past reviews, we found variability across measures with regard to psychometric rigor and potential for widescale applicability in clinical settings. Despite the promise that self-administered cognitive tests hold for clinical implementation, important gaps in scientific rigor in development, validation, and feasibility studies of these measures remain. Developments in technology and biomarker studies provide potential avenues for future directions on the use of digital technology in clinical care. Supplementary material is available for this article at 10.14283/jpad.2021.11 and is accessible for authorized users.
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