20 February 2018

Pen-and-paper vs. computerised testing: which method do older adults prefer?

Exciting new research shows not only that web-based cognitive assessments are suitable for older adults but, for many, computerised assessments are actually preferable to traditional pen-and-paper tasks.

The National Seniors, Flinders Business School and University of Western Australia recently published a study entitled: Better ways of assessing cognitive health. The study investigated better ways of assessing cognitive health in two stages; one of which employed our cloud-based platform ‘CANTAB Connect. A key finding from the study was that the older adults who were surveyed typically preferred to be assessed at home, using a computer.

Stage one: exploring older adults’ opinions on computerised assessments

The first stage of the study surveyed 547 older adults living in Australia. As part of the survey, adults aged 55-96 years old were asked for their opinion on different methods of cognitive assessment. The survey found that most adults (54.3%) preferred a computerised cognitive assessment to pen-and-paper (9.9%; figure 1).

Figure 1. 547 older adults were asked: what type of assessment would you prefer? Data from Earl, Gerrans, and Hunter (2017). Graphic produced by Cambridge Cognition.


The survey suggested that the preferred location for cognitive test administration is at-home (73.8%; figure 2). Furthermore, very few of the older adults who were surveyed expressed a desire to be accompanied by a community nurse during an at-home assessment (3.6%). Although, it is worth nothing, the authors suggest that clinically-relevant feedback should be delivered by healthcare professionals (Earl, Gerrans, & Hunter, 2017). Older adults’ combined preference for computerised, unaccompanied and at-home cognitive assessments makes web-based testing a compelling method of delivery.

Figure 2. 530 older adults were asked: where would you most prefer to complete an assessment? Data from Earl, Gerrans, and Hunter (2017). Graphic produced by Cambridge Cognition.

Stage two: researching the feasibility of delivering web-based assessments using CANTAB Connect

The second stage of the study trialled Cambridge Cognition’s CANTAB Connect as a web-based assessment of cognitive function. The older adults typically responded well to CANTAB, particularly as the method facilitates home-based testing. However, some participants struggled with device and browser compatibility. At the time of the study, CANTAB Connect was only validated for a limited number of browsers. The authors commented:

“When the CANTAB assessments are further developed in the near future to be compatible with a wider scope of browsers, delivery of the assessments to older adults in the field will be simplified, improving the likely uptake of online assessment as a viable delivery methodology for cognitive screening.”

(Earl, Gerrans, & Hunter, 2017; pg 31)  

In response to this feedback, Cambridge Cognition has since expanded the number of validated browsers for CANTAB Connect.

In conclusion, this large scale study demonstrates that computerised cognitive assessments are suitable for older adults and, for many, are the preferred method of delivery.


Earl, J. K., Gerrans, P., & Hunter, M. (2017). Better ways of assessing cognitive health. Brisbane: National Seniors.

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