###### Abstract  
The early detection of cognitive impairment is essential in order to initiate interventions and guarantee access to healthcare services. Digital solutions are emerging in the literature as an alternative approach to cognitive screening. Our primary goal is to synthesize the evidence on digital solutions' diagnostic ability to screen for cognitive impairment and their accuracy. A secondary goal is to distinguish whether the ability to screen for cognitive impairment varies as a function of the type of digital solution: paper-based or innovative digital solutions. A systematic review and meta-analysis of digital solutions' diagnostic accuracy were conducted, including 25 studies. Digital solutions presented a variable diagnostic accuracy range. Innovative digital solutions offered at least 0.78 of sensitivity but showed lower specificity levels than the other subgroup. Paper-based digital solutions revealed at least 0.72 of specificity, but sensitivity started at 0.49. Most digital solutions do not demand the presence of a trained professional and include an automatic digital screening system and scoring, which can enhance cognitive screening and monitoring. Digital solutions can potentially be used for cognitive screening in the community and clinical practice, but more investigation is needed for an evidence-based decision. A careful assessment of the accuracy levels and quality of evidence of each digital solution is recommended. cognitive screening; cognitive impairment; diagnostic accuracy; digital solutions 20242024142640. [[https://doi.org/10.3390/app14062640](https://doi.org/10.3390/app14062640)]([https://doi.org/10.3390/app14062640](https://doi.org/10.3390/app14062640))  
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[PERSON], [PERSON], [PERSON], [PERSON], [PERSON], [PERSON], J.  
MCI is critical to effectively initiate the intervention (including counseling, psychoeducation, cognitive training, and medication [12]), and guarantee to both patients and relatives access to relevant healthcare services [13]. However, MCI is significantly misdiagnosed due to a diverse set of barriers, namely the high prevalence of comorbidities among older adults, a lack of expertise or limited confidence of the practitioners, the short duration of most primary care visits, limitations of the assessment instruments, or the inadequacy of electronic health record systems in terms of the integration of cognitive assessments, which limits the ability to track an individual's cognitive function over time [7]. Despite these barriers, there are many screening tests that provide a quick evaluation of cognitive and functional aspects. At present, two of the most well-known cognitive screening tests are the Mini-Mental State Examination (MMSE) [14] and the Montreal Cognitive Assessment (MoCA) [15], which include tasks for assessing multiple cognitive domains. In addition to MMSE and MoCA, other currently available cognitive tests also encompass multiple cognitive domains, including the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) [16], the Saint Louis University Mental Status examination (SLUMS) [17], the Self-Administered Gerocognitive Examination (SAGE) [18], or Addenbrooke's Cognitive Examination III (ACE-III) [19]. In turn, screening tests such as the Alzheimer Quick Test (AQT) [20], Scenery Picture Memory Test (SPMT) [21], Memory Impairment Screen (MIS) [22], Mini-Cog [23; 24], or Clock Drawing [25] measure one or two cognitive domain (i.e., attention for the AQT, episodic memory for the SPMT, memory and orientation for the MIS, memory and visuospatial abilities for the Mini-Cog, or executive functions and visuospatial abilities for the Clock Drawing), but require less than five minutes to be applied [26]. Computerized solutions to support neuropsychological tests have existed for several decades and might use different types of interaction devices, be it computers, handheld devices, or virtual reality [27].