The Potential of Automated Assessment of Cognitive Function Using Non-Neuroimaging Data: A Systematic Review

Abstract

Background/Objectives: The growing incidence of cognitive impairment among older adults has a significant impact on individuals, family members, caregivers, and society. Current conventional cognitive assessment tools are faced with some limitations. Recent evidence suggests that automating cognitive assessment holds promise, potentially resulting in earlier diagnosis, timely intervention, improved patient outcomes, and higher chances of response to treatment. Despite the advantages of automated assessment and technological advancements, automated cognitive assessment has yet to gain widespread use, especially in low and lower middle-income countries. This review highlights the potential of automated cognitive assessment tools and presents an overview of existing tools. Methods: This review includes 87 studies carried out with non-neuroimaging data alongside their performance metrics. Results: The identified articles automated the cognitive assessment process and were grouped into five categories either based on the tools' design or the data analysis approach. These categories include game-based, digital versions of conventional tools, original computerized tests and batteries, virtual reality/wearable sensors/smart home technologies, and artificial intelligence-based (AI-based) tools. These categories are further explained, and evaluation of their strengths and limitations is discussed to strengthen their adoption in clinical practice. Conclusions: The comparative metrics of both conventional and automated approaches of assessment suggest that the automated approach is a strong alternative to the conventional approach. Additionally, the results of the review show that the use of automated assessment tools is more prominent in countries ranked as high-income and upper middle-income countries. This trend merits further social and economic studies to understand the impact of this global reality.

Keywords: artificial intelligence; automated cognitive assessment; cognitive assessment; cognitive impairment; digital cognitive assessment; technology.

Figure 1

PRISMA flow chart adapted for this study.