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Geriatrics
Special Issues
Current Issues in Cognitive Testing of Older Adults
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Current Issues in Cognitive Testing of Older Adults

A special issue of Geriatrics (ISSN 2308-3417).

Deadline for manuscript submissions: 30 June 2026 | Viewed by 8227

Special Issue Editors

Prof. Dr. Ruth Marchand Tappen

E-Mail Website
Guest Editor
College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
Interests: cognition and physical functioning; driving; sensors; care transitions and diversity issues
Prof. Dr. Mónica Rosselli

E-Mail Website
Guest Editor
Department of Psychology, College of Science, Florida Atlantic University, Boca Raton, FL 33431, USA
Interests: cross-cultural neuropsychology; bilingualism and cognitive reserve; cognition and driving

Special Issue Information

Dear Colleagues,

Current advances in the detection of subtle changes in cognition, increased use of biomarkers indicating impending cognitive decline, and movement of cognitive tests from paper and pencil to electronic versions have altered the landscape of neuropsychological testing of older adults. The fairness of using tests developed in populations other than the ones being tested continues to be a concern. Norms for those of very advanced age (90+) or for diverse populations are not available. The advantages of being computer literate, self-testing as a screening tool, use of tests by untrained auxiliary staff, participant rehearsal of tests in longitudinal studies, and even the effect of a poor score on the revocation of driving and other privileges need further examination and subsequent dissemination of the results not just to a research audience but also to clinicians who are using them.

Prof. Dr. Ruth Marchand Tappen
Prof. Dr. Mónica Rosselli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neuropsychological testing
  • culture bias in cognitive testing
  • computer-based cognitive testing
  • computer literacy in older adults
  • rehearsal effect in longitudinal studies
  • bilingualism
  • need for additional norms
  • fairness in testing
  • detection and interpretation of subtle cognitive changes
  • new approaches for early detection

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Published Papers (4 papers)

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Research

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13 pages, 613 KB  
Article
The Clock Drawing Test: A Valid Screening Instrument for Dementia Detection in Low-Educated Patients?
by Janique Boots-van der Heiden, Jos van Campen, Tessa Kooistra, Irene van de Vorst and Miriam Goudsmit
Geriatrics 2025, 10(6), 164; https://doi.org/10.3390/geriatrics10060164 - 12 Dec 2025
Viewed by 1881
Abstract
Objective: The non-verbal nature of the Clock Drawing Test (CDT) suggests it is a suitable cognitive screening instrument for populations with lower educational levels and/or language barriers. This study evaluates whether the CDT is a valid screening instrument for low-educated patients and includes [...] Read more.
Objective: The non-verbal nature of the Clock Drawing Test (CDT) suggests it is a suitable cognitive screening instrument for populations with lower educational levels and/or language barriers. This study evaluates whether the CDT is a valid screening instrument for low-educated patients and includes a qualitative analysis of CDT errors. Method: A total of 503 participants were included, divided into four groups (dementia, MCI, no cognitive impairment, and other diagnosis), based on a clinical diagnosis by a geriatrician. Educational levels were categorized into four groups: no education and low, middle, and high education. CDT scores were assessed using the seven-point scoring system (Freedman), and two cutoff points were evaluated. Results: Results showed that in all education categories, the dementia group scored significantly lower on the CDT compared to the non-dementia group. The difference was smallest in participants with no education. Two cut-off points were assessed: <4 and <3. A cut-off of <4 showed better sensitivity versus <3, particularly for low-educated groups. A cut-off of <3 provided better specificity versus <4. Error analysis showed that errors made by low-educated participants without dementia were similar to those of patients with dementia. Conclusions: These findings show that the CDT (both total score and qualitative error analysis) has limited value in dementia case-finding in low-educated groups. The CDT is recommended primarily for middle- and high-educated groups. Full article
(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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13 pages, 1124 KB  
Article
Oculometric Assessment of Sensorimotor Impairment Associated with Liver Disease Is as Sensitive as Standard of Care Cognitive Tests
by Dorion Liston, Katherine Wong, Aaron Yeoh, Shalonda Haywood, Aparna Goel, Paul Kwo, Quinn Kennedy and Philip N. Okafor
Geriatrics 2025, 10(4), 112; https://doi.org/10.3390/geriatrics10040112 - 19 Aug 2025
Viewed by 961
Abstract
Significance: Hepatic encephalopathy (HE) occurs in 20–80% of patients with liver cirrhosis, impacting attention, memory, processing speed, and visuospatial skills. HE standard-of-care psychometric assessments are time-consuming and require staff training. Oculometrics may provide a fast, non-invasive brain health assessment that can be self-administered [...] Read more.
Significance: Hepatic encephalopathy (HE) occurs in 20–80% of patients with liver cirrhosis, impacting attention, memory, processing speed, and visuospatial skills. HE standard-of-care psychometric assessments are time-consuming and require staff training. Oculometrics may provide a fast, non-invasive brain health assessment that can be self-administered in a medical environment. Purpose: We investigated whether an oculometric assessment could measure the severity of HE as accurately as standard-of-care psychometric methods. Methods: Forty-eight participants (19 with decompensated cirrhosis, 10 with compensated cirrhosis, 19 controls) completed a previously validated five-minute oculometric test and the standard-of-care psychometric hepatic encephalopathy (PHE) battery. The oculometric test consists of following a dot as it moves across a computer screen and generates 10 metrics including a summary score called nFit. The PHE battery entails five standard cognitive tests, generating seven metrics including a PHE composite score (PHES). Results: The oculometric summary score, nFit, correlated with the current diagnostic standard, the PHES (r = 0.51, p < 0.001), the presence or absence of HE as determined by PHES composite (r = −0.44, p < 0.001), as well as the severity of cirrhosis (r = −0.59, p < 0.001). Additionally, performance on both nFit and PHES distinguished compensated (ROC: nFit: 0.71, PHES: 0.68) and decompensated (ROC: nFit: 0.88, PHES: 0.85) patient groups from control participants comparably. Finally, compared to participants with decompensated cirrhosis, control participants had better scores for almost all oculometrics: acceleration, catch-up saccade amplitude, proportion smooth, direction noise, and speed noise. Conclusions: Patients with liver disease showed impairment on multiple aspects of visual processing compared to a control group. These functional visual processing impairments correlate with the presence or absence of HE, showing significant sensitivity in distinguishing people with HE from controls. Oculometric tests provide a quick, non-invasive functional assessment of brain health in patients with liver disease, with sensitivity indistinguishable from standard-of-case psychometric tests. Full article
(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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Review

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29 pages, 4117 KB  
Review
Cognitive Testing in Spanish Older Adults: A Scoping Review
by Lucía Sáez-González, Luis A. Martínez, Gema Blázquez-Abellán, José Antonio Carbajal de Lara, Rosa M. Martinez-Garcia and Lucía Castro-Vázquez
Geriatrics 2026, 11(2), 45; https://doi.org/10.3390/geriatrics11020045 - 10 Apr 2026
Viewed by 365
Abstract
Background/Objectives: Cognitive impairment is a major concern in aging populations. Early detection through validated neuropsychological tests is essential for dementia risk stratification and preventive interventions. This scoping review (PRISMA-ScR, 2013–2023, registration protocol: 10.17605/OSF.IO/8NHJF) evaluated cognitive testing trends in aging research and identified the [...] Read more.
Background/Objectives: Cognitive impairment is a major concern in aging populations. Early detection through validated neuropsychological tests is essential for dementia risk stratification and preventive interventions. This scoping review (PRISMA-ScR, 2013–2023, registration protocol: 10.17605/OSF.IO/8NHJF) evaluated cognitive testing trends in aging research and identified the most frequently used neuropsychological screening tests in Spanish populations. Methods: Searches in PubMed and Web of Science (March 2024) yielded 730 records; 156 were reviewed in full, and 15 met inclusion criteria for Spanish adults ≥65 years. Results: The Mini-Mental State Examination was the most-used test, followed by verbal fluency and Trail Making Test. No test covered all six DSM-5 cognitive domains, and social cognition was never assessed in any of the studies. The Montreal Cognitive Assessment was underused despite its superior sensitivity. Conclusions: Findings support developing a tailored, multidomain battery combining global and domain-specific tests. Social cognition assessments should be included to ensure a complete cognitive domain coverage. Full article
(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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Other

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14 pages, 924 KB  
Systematic Review
A Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection
by Felipe Webster-Cordero and Lydia Giménez-Llort
Geriatrics 2025, 10(3), 65; https://doi.org/10.3390/geriatrics10030065 - 9 May 2025
Cited by 4 | Viewed by 3887
Abstract
Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review [...] Read more.
Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article
(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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