Dijital Nöropsikoloji: Yaşlı Bireylerin Bilişsel İşlevlerinin Değerlendirilmesinde Kullanılan Teknolojik Yaklaşımlar

Abstract

Nüfusun yaşlanması ile paralel olarak demans tanılı kişilerin sayısı artmaktadır. Demans seyrinin iyileştirilmesi için kritik bir öneme sahip olan bilişsel bozuklukların erken saptanmasında nöropsikolojik değerlendirmenin büyük bir rolü olduğu kabul edilmektedir. Sıklıkla klasik kâğıt- kalem testleri ile uygulanan nöropsikolojik değerlendirme, günümüzde gelişen teknoloji ile birlikte dijitalleşmeye başlamıştır. Özellikle de Covid–19 pandemisi ile birlikle bu dijitalleşme ivme kazanmıştır. Bu çalışmada, yaşlı bireylerin nöropsikolojik değerlendirmelerinde kullanılan dijital yaklaşımların incelenmesi amaçlanmaktadır. Bu kapsamda, telenöropsikoloji, bilgisayarlı nöropsikolojik değerlendirme bataryaları, mobil teknoloji ya da web temelli değerlendirme araçları ve sanal gerçeklik, arttırılmış gerçeklik gibi yenilikçi teknolojik yöntemlere dayanan ölçümleri içeren dijital yaklaşımların eleştirel bir değerlendirmesi yapılmıştır. Sıklıkla videokonferans aracılığı ile nöropsikolojik testlerin uzaktan uygulanmasına odaklanan telenöropsikoloji çalışmaları ile ilgili sonuçlar bu yöntemin güvenilir ve geçerli olduğunu belirtmektedir. Bilgisayarlı bataryalar ve mobil teknolojiye dayanan yöntemler, klinik dışı bireysel uygulamaya olanak sağlamakta ve geniş örneklemli takip çalışmaları için altyapı hazırlamaktadır. Sanal gerçeklik gibi yeni teknolojilerin kullanıldığı değerlendirme yöntemler ise henüz emekleme aşamasında olsa da daha hassas ölçümlerin yapılması için büyük potansiyel taşımaktadır. Ulaşılabilirliğin artması ve ölçümlerin standartlaşması gibi avantajlar taşıyan dijital yaklaşımlar içinde sıklıkla kullanılan yöntemlerin büyük bir kısmının klasik kağıt-kalem testleri ve hastaların tanıları ile tutarlı olduğu gösterilmiştir. Fakat dijital yaklaşımların detaylı psikometrik analizlerinin yapılması ve iyi uygulama rehberlerinin geliştirmesi konusunda çeşitli eksiklikler bulunmaktadır. Buna ek olarak, dijital yaklaşımların uzman-hasta ilişkisinde zorluk yaratabileceği ve hastanın test sırasında gözlemlenmesi konusunda kısıtlılıklar taşıdığı belirtilmektedir. Her ne kadar dijital nöropsikoloji uygulamalarının yarattığı kısıtlılıklar mevcut olsa da, dijital yaklaşımlar hastalar, alandaki uzmanlar ve sağlık sistemi açısından önemli faydalar sağlama potansiyeline sahiptir. Bu nedenle, tüm taraflar açısından fayda sağlayacak akademik ve klinik çalışmaların yapılması önem taşımaktadır.

Keywords

• Nöropsikoloji
• dijital teknoloji
• yaşlanma
• demans

Digital Neuropsychology: Technological Approaches for the Assessment of Cognitive Functions in Older Adults

Abstract

Consistent with the growth in aging population, the number of individuals with dementia is increasing. There is an agreement regarding the essential role of neuropsychological assessment in the early detection of cognitive decline, which is crucial in improving the course of dementia. Neuropsychological assessment that is usually applied with classical paper–pencil tests became digitalized with advancing technology. This digitalization spread rapidly, especially with the COVID-19 pandemic. This study aimed to investigate the digital approaches that are used in the neuropsychological assessment of older adults. In this context, a critical review of digital approaches, including teleneuropsychology, computerized neuropsychological assessment batteries, mobile technology or web-based assessment tools, and innovative technological methods, such as virtual and augmented reality has been conducted. The results of teleneuropsychology studies, which focused on remote administration of neuropsychological tests usually via videoconference, indicated that this method is reliable and valid. Computerized batteries and methods based on mobile technology provide an opportunity for self-testing in nonclinical settings and a background for follow-up studies with large samples. Although assessment methods using new technologies, such as virtual reality, are still in their infancy, they have great potential for more sensitive measurements. The majority of the methods involved in digital approaches, which have advantages such as increased accessibility and standardization of measurements, revealed consistent results with classical paper–pencil tests and patients’ diagnosis. However, a detailed psychometric analysis and best practice guidelines of the digital approaches are still lacking. Moreover, digital approaches can present a challenge in the clinician–patient relationship and have limitations in patient observation during testing. Despite the limitations due to digital neuropsychology applications, digital approaches have the potential to provide important benefits to patients, professionals in the area, and the health system. In this respect, academic and clinical studies that would benefit all parties are important

Keywords

• Neuropsychology
• digital technology
• aging
• dementia

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