Attention and Executive Functions in Digitalized Neuropsychological Assessments

Attention and executive functions are critical cognitive processes that enable goal-directed behavior, problem-solving, and adaptive decision-making. These functions are vulnerable to decline across lifespans, with significant impacts observed in normal aging, neurological diseases such as Alzheimer's disease (AD), and psychiatric disorders like schizophrenia and major depressive disorder. Impairments in attention and executive functions not only hinder daily performance but also serve as early indicators of cognitive decline and disease progression. To assess these cognitive processes, neuropsychologists administer neuropsychological paper-pencil assessments to: point out cognitive dysfunction, aid in diagnosis, distinguish strengths and weaknesses, and give recommendations regarding rehabilitation and adjustment (Casaletto & Heaton,2017). Despite their great impact in the field of neuropsychology, paper and pencil tests come with their drawbacks, like the interpretation of scoring, time-consuming data documentation, norms that do not get updated for decades, practice effects, and delayed diagnosis after the patient has already started to complain about symptoms (Gates et al.,2017). To compensate for the limitations of paper-pencil assessments, digitalized neuropsychological assessments are starting to replace traditional tests with the promises of earlier detection of cognitive deficits related to neurological diseases, psychiatric disorders, neurodevelopmental disorders and other disease that affects the brain. They also offer longitudinal monitoring of cognitive deficits without practice effects, accurate data capturing in tasks (like those that involve reaction times), and automatic documentation and interpretation of scores. This research is a systematic review that aims to identify the most used digitalized neuropsychological assessments. It will focus on the differences between paper-pencil assessments and digitalized assessments in testing attention and executive functions (including advantages and limitations), and discussing reliability and validity of the digitalized assessments used like Cambridge Neuropsychological Test (CANTAB), Neurocognitive Performance Test (NCPT), NIH Toolbox (NIHTB), Cogstate Computerized Battery (CCB), and Boston Cognitive Assessment (BoCA).