Validity of digital Trail Making Test and Bells Test in elderlies

Digital neuropsychological tests self-administered at home have the potential to detect early signs of cognitive decline in the elderlies, thus allowing to adopt preventive measures. Usability tests and clinical validation are required before computerized assessment could juxtapose traditional paper-and-pencil tests to spot early signs of decline. We have developed a tablet-based digitized version of two neuropsychological tests commonly used in screening for dementia: Trail Making Test (A and B versions) and Bells Test. We studied system usability and acceptance, and concurrent validity of the computerized assessment compared with the corresponding paper-and-pencil tests. Results show a very high system acceptance, notwithstanding the patients' low familiarity with technology. System validation reports a good ability of the digital tests to retain the same predictive power of the corresponding paper-based tests. Altogether, results suggest that computerized neuropsychological assessment may represent an adequate, ecological and cost-effective solution for home monitoring of the elder's cognitive status, thus supporting clinicians in the identification of early signs of cognitive decline.