Try paying a bill on your phone. You open the banking app, enter your password and wait for a security code. A message arrives. You switch screens, memorise the digits and return to the payment. Then someone asks you a question. Where were you?
That supposedly simple payment is a memory task, an attention task and a planning task, all squeezed onto a small screen. This is where much of our thinking happens today: between apps, passwords, notifications and decisions.
So what should a cognitive assessment look like in a world like this?
That question drives my new paper in Brain and Cognition. I make the case for technological neuropsychology: an approach to understanding memory, attention and other mental abilities through the technologies woven into everyday life.
Life has moved online. Have our tests kept up?
In the paper, I introduce Maria, an imagined 68-year-old retired teacher. In a quiet assessment room, she remembers words, copies drawings and completes familiar cognitive tasks. Her scores fall within the expected range. At home, things look different. Online banking has become confusing. Following directions on her phone is harder. Video calls with her grandchildren leave her struggling to keep up. Her story captures a gap between performance in the testing room and the demands of daily life.
Traditional cognitive tests tell us important things about how someone thinks. Everyday activities ask those abilities to work together, often under pressure and with distractions. Booking an appointment online means finding the right page, understanding instructions, remembering information and recovering when something goes wrong.
For many people, managing these small digital journeys is now part of living independently. Cognitive assessment needs to take them seriously.
One screen, many demands
A smartphone looks simple: a rectangle of glass that responds to a touch. Using it can be anything but simple. You need to recognise symbols, understand what an app lets you do, remember where things are, and decide what to try next. A messaging app adds another layer: who is speaking, what do they mean, and how should you respond?
Earlier research from our group helps explain why different technologies deserve closer attention. In a brain-imaging study, 29 young adults watched videos of people using mechanical and digital tools. Mechanical tools more strongly engaged brain systems involved in action and physical reasoning. Digital tools engaged other regions more strongly, including areas associated with meaning and social understanding.
The emerging picture is of several brain systems working together, with different tasks making different demands. Understanding a screwdriver and navigating a smartphone interface call on different combinations of skills.
When your phone becomes part of your memory
Think about the last appointment you remembered because your phone reminded you. Or the shopping list you checked in the supermarket. Or the route you followed through an unfamiliar city.
Psychologists call this cognitive offloading: letting something outside your mind carry part of the mental load. We have done it for centuries with diaries, maps and written notes. Digital devices make that help available almost everywhere.
For someone with memory difficulties, a well-chosen reminder can turn an intention into action: leaving for an appointment on time, making an important call, or completing a daily task. This gives assessment another useful question. Alongside measuring what a person remembers unaided, we should examine what they can accomplish with the right support.
Remembering an appointment and successfully getting there are connected, but they are not the same achievement.
What we do with technology matters
Debates about technology and the brain often reduce everything to hours spent looking at a screen. But an hour learning a language, an hour talking to friends and an hour jumping between notifications are very different experiences.
Research on ageing makes that distinction especially interesting. A large analysis of 57 studies involving more than 411,000 adults over 50 found that digital technology use was associated with lower odds of cognitive impairment and slower cognitive decline. Causation remains unclear: people with better cognitive health may also find it easier to keep using technology. But the findings raise an important question about the role of digital life in cognitive health.
The same phone can help us learn something demanding, keep us connected or interrupt us every few minutes. Understanding someone's digital habits means looking at what those habits involve.
Taking assessment into everyday life
Imagine an assessment that follows the story more closely. A clinic appointment could be complemented by brief, smartphone-based activities over several days, revealing how performance changes over time and across contexts. Practical tasks could explore how someone learns an unfamiliar interface or follows a sequence of digital instructions.
Virtual reality could recreate a shopping trip or a journey through an unfamiliar place, allowing an examiner to see how memory, attention and planning work together.
Brain scans could add another source of information. Carefully developed artificial intelligence tools could help clinicians bring these findings together and estimate how a person's abilities might change over time.
These are the directions the paper proposes. The ambition is to build a fuller picture of someone’s abilities, the challenges they face and the support that helps them function.
Of course, struggling with a device does not automatically mean that something is wrong with your brain. Poor design, unfamiliar technology, small text and awkward controls can make an everyday task unnecessarily difficult. A useful assessment must distinguish between those obstacles and changes in a person's abilities. Someone who has rarely used online banking starts from a different place from someone who has managed it confidently for years. And if digital tools become part of assessment, people should understand what information is being collected and retain control over it.
The question behind the score
Return to Maria. Her test results are part of the picture. So are the payments she can no longer manage, the journeys she finds difficult and the conversations she wants to enjoy. A useful assessment would explore what has changed and what would help her regain confidence and independence. That is the promise of technological neuropsychology: bringing our understanding of cognition closer to the places where people actually use it. We increasingly remember, plan, learn and connect through technology. Cognitive assessment needs to understand that life.
Turning this vision into clinical practice requires more than new devices. I propose four priorities:
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Assess technological cognition as a clinical domain. Develop validated tasks for mechanical problem-solving, digital navigation, learning from demonstration and object-function knowledge, with norms that also consider technology exposure and digital literacy.
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Embed measurement in everyday life. Combine the clinic session with repeated, ecologically grounded data where appropriate, and validate digital signals against conventional measures and meaningful functional outcomes.
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Integrate brain-based evidence responsibly. Combine cognitive and imaging data at the individual level without letting a scan replace independent cognitive norms or careful clinical reasoning.
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Use machine learning for transparent prediction and personalisation. Build open, multi-site, externally validated models that communicate uncertainty, support clinicians and are tested for fairness across populations.
Read the paper
- Federico, G. (2026). Technological neuropsychology: Assessing cognition in a digital world. Brain and Cognition, 199, 106473.