A systematic review of the effectiveness of digital cognitive assessments of cognitive impairment in Parkinson's disease

Background: Digitalization in healthcare has been extended to how we examine and manage Parkinson's Disease Mild Cognitive Impairment (PD-MCI). Methods: Moyer Population (those with PD and in some cases control groups), Intervention (digital cognitive test) and Outcome (validity and reliability) (PIO) and Campbell et al. Synthesis Without Meta-analysis (SWiM) methods were employed. A literature search of MEDLINE, PsycINFO, CINAHL, OpenGrey, and ProQuest Theses and Dissertations Sources screened for articles. Results: The digital trail-making test (dTMT) was the most used measure. There was strong validity between the dTMT and pencil-paper TMT, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) scores (ranging from r = .55 to .90, p < .001). Validity between the TMT pencil-paper and digital versions were adequate (ranging from r = .51 to 90, p < .001). Reliability was demonstrated between PD and control groups' scores (ranging from r = .71 to .87). One study found excellent inter-rater reliability (ICC = .90 to .95). The dMoCA was the most used screen that assessed more than two cognitive domains. There was a range in the strength of agreement between digital and pencil-paper versions (ICC scores = .37 to .83) and only one study demonstrated adequate validity (r = .59, p < .001). Poor internal consistency (alpha = .54) and poor test re-test reliability (between PD and control groups' scores, p > .05) were found. Conclusion: This review found that digitalized cognitive tests are valid and reliable methods to assess PD-MCI. Considerations for future research are discussed.