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This peer-reviewed review examines a central tradeoff in the rapid shift from examiner-led cognitive and functional assessment to fully digital, self-administered systems. Digital delivery can broaden access, reduce administration burden, support remote and repeated measurement, and automate scoring and data capture. At the same time, the authors consider what may be lost when an examiner or trainer is no longer present, including opportunities for clarification, encouragement, observation, and engagement. The paper treats these issues as design and validation questions that can be addressed as digital systems mature.

The LASSI is used as a concrete example of productive digital migration. The progression from the examiner-administered LASSI-L cognitive challenge test to the self-administered LASSI-D™ illustrates how a measure designed to detect vulnerability to semantic interference can be made more scalable and standardized. Positively, the review presents LASSI-D™ as a promising route to wider and more efficient cognitive assessment while underscoring the value of clear instructions, usability support, careful validation, and thoughtful decisions about when human contact should remain part of the assessment pathway.

This longitudinal study asked whether blood-based Alzheimer’s disease biomarkers and cognitive challenge testing provide complementary information about real-world decline. The investigators followed 159 adults, ages 54–98, who had cognitive impairment without dementia for at least three annual visits (mean follow-up, 41.5 months). They modeled change in the Clinical Dementia Rating–Sum of Boxes and examined plasma p-tau217, GFAP, and neurofilament light alongside two LASSI-L indicators: Cued B2 recall and Cued B2 intrusion errors, which capture failure to recover from proactive semantic interference.

The biomarker and cognitive findings contributed different, clinically useful signals. Plasma p-tau217 was most informative about baseline impairment, neurofilament light predicted longitudinal worsening, and poorer LASSI-L performance independently predicted the rate of cognitive and functional decline after adjustment for demographic factors, APOE ε4, and amyloid status. The positive value of the LASSI-L is its ability to show how underlying pathology is being expressed cognitively: adding this brief challenge test to plasma biomarkers improved the prediction and monitoring of meaningful decline during pre-dementia stages.

This study examined episodic memory in 88 women with the FMR1 premutation and 84 matched controls, all between 30 and 55 years of age. Participants completed the LASSI-L, allowing the researchers to evaluate proactive semantic interference, recovery from interference, and intrusion errors. The analysis also tested whether CGG repeat length and college education modified performance, with particular attention to the midlife period before the usual onset of fragile X–associated tremor/ataxia syndrome.

Women with the premutation showed poorer LASSI-L performance across several sensitive memory processes, while college education buffered these differences. The strongest education-related effects appeared among women with mid-range CGG expansions of approximately 80–100 repeats. These results position the LASSI-L as a useful tool for detecting subtle midlife vulnerability outside the traditional Alzheimer’s disease setting. Its process-level measures may support earlier cognitive monitoring and more personalized risk assessment in women whose conventional testing could otherwise appear relatively intact.

This cross-sectional study compared 157 patients with post-COVID condition and 74 healthy controls to clarify which episodic-memory processes are affected. Participants completed a comprehensive neuropsychological evaluation that included the LASSI-L, the Free and Cued Selective Reminding Test, the Open-Trial Selective Reminding Test, and a questionnaire about subjective cognitive difficulties. The design allowed the researchers to examine encoding, acquisition, storage, retrieval, and semantic-interference effects rather than relying on a single memory score.

Patients with post-COVID condition performed worse than controls across the memory measures, with evidence of problems in several stages of memory and significant susceptibility to retroactive semantic interference. Among the tests, LASSI-L performance showed the strongest association with subjective memory complaints. The positive contribution of the LASSI-L was its process-level sensitivity and ecological relevance: it helped connect patients’ lived experience of memory difficulty with measurable interference effects, offering a richer profile that may guide characterization and future intervention studies in post-COVID cognitive dysfunction.

This study evaluated whether literacy and years of education influence LASSI-L performance in 83 Black/African American older adults: 43 with amnestic mild cognitive impairment and 40 who were cognitively unimpaired. Literacy was measured with the WRAT-IV, and the LASSI-L was administered independently of the diagnostic process to avoid circular classification. The cognitively unimpaired group performed better across LASSI-L measures, and the final model classified cognitive status with 81% overall accuracy.

Education and literacy were associated with some correct-recall scores, but not with semantic intrusion errors, and literacy effects were limited among participants with amnestic MCI. This is a particularly positive feature of the LASSI-L: its intrusion-error measures remained informative when educational opportunity and reading proficiency varied. The findings support a more culturally responsive use of LASSI-L process scores and suggest that semantic intrusion errors can help identify clinically meaningful impairment without relying as heavily on educationally sensitive total-recall performance.

This validation study assessed 355 Mexican adults age 60 and older who were classified as cognitively healthy, as having mild cognitive impairment, or as having mild Alzheimer’s disease. Participants completed the LASSI-L and a broader neuropsychological battery. The investigators evaluated construct, concurrent, and predictive validity through group comparisons, correlations with the Hopkins Verbal Learning Test, and regression models that controlled for age, education, and medical comorbidity.

LASSI-L scores differed significantly across the three diagnostic groups, and recovery from proactive interference provided the strongest discrimination between cognitively healthy participants and those with MCI or mild Alzheimer’s disease. Semantically cued recall and free recall were robust predictors independent of education, while correlations with the Hopkins test supported concurrent validity. The study provides direct evidence that the LASSI-L is a valid and accessible tool for older adults in Mexico and may be especially valuable for earlier detection in settings where PET, cerebrospinal-fluid, or blood biomarkers are not readily available.

The investigators studied 158 older adults who completed the LASSI-L, including 108 people with amnestic mild cognitive impairment. Within the aMCI group, 58 were plasma p-tau217 positive and 50 were below the positivity threshold. The analysis focused on semantic intrusion errors produced while learning a competing word list and, importantly, adjusted for age, global cognition, and each participant’s maximum learning capacity on the initial list.
Even after accounting for initial learning strength, the p-tau217-positive aMCI group made more semantic intrusion errors on both competing-list trials. Older age, APOE ε4 status, and higher p-tau217 also predicted elevated intrusion errors. The LASSI-L therefore supplied cognitive evidence that was closely aligned with biological Alzheimer’s disease risk but not reducible to a general inability to learn. Its structured interference paradigm helps reveal problems with inhibition, source memory, and self-monitoring that can sharpen interpretation of a positive blood biomarker.

This study addressed the underrepresentation of Black/African American older adults in Alzheimer’s disease research by evaluating 56 participants who received independent clinical and cognitive assessments. Thirty-five were cognitively unimpaired and p-tau217 negative, while 21 had amnestic mild cognitive impairment and were p-tau217 positive. The LASSI-L was not used to assign participants to groups, allowing its recall, interference, and intrusion-error measures to be evaluated without circularity.
The aMCI/p-tau217-positive group performed worse on free recall of the competing list and recovery from proactive semantic interference, and produced a higher percentage of intrusion errors. A model using LASSI-L Free B1 Recall and Cued B2 percentage of intrusion errors distinguished the groups with 80% sensitivity and 91.7% specificity. The results support the LASSI-L as a sensitive cognitive complement to p-tau217 and show how pairing cognitive expression with a biological marker may improve early detection while helping address disparities in Alzheimer’s diagnosis and care.