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Muner LC, Rodrigues JDC, Becker N. Adaptation of the Cognitive Screening Test (Triagem Cognitiva - TRIACOG) for computer-mediated assessments: TRIACOG-Online. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 39227317 DOI: 10.1080/23279095.2024.2398118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
This study aims to present the adaptation, evidence of content validity and results of a pilot study of the Cognitive Screening Test - Online (TRIACOG-Online) in a clinical sample of patients after stroke. The process comprised four stages: 1) Adaptation of the instructions, stimulus and responses; 2) Seven experts analyzed the equivalence between the previous printed version and the online version; 3) A pilot study was carried out with seven adults who had experienced a stroke in order to check the comprehension and feasibility of the items; and 4) The development of the final version of TRIACOG-Online. Expert validity testing of the questionnaire yielded a content validity index (CVI) of 100% for correspondence and construct in 13 items, and a CVI of 87.71% in four items. In the pilot study, problems related to the internet led to the decision to use a single section form. No difficulties were observed in carrying out the tasks and understanding the instructions. Participants reported being able to adequately visualize the stimuli and remain motivated to complete the tasks presented. It was shown that TRIACOG-Online evaluated the same constructs as the pencil-and-paper version, can be used in remote neuropsychological assessments and face-to-face settings.
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Tsiakiri A, Koutzmpi V, Megagianni S, Toumaian M, Geronikola N, Despoti A, Kanellopoulou S, Arampatzi X, Margioti E, Davila A, Zoi P, Kalligerou F, Liozidou A, Tsapanou A, Sakka P. Remote neuropsychological evaluation of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:796-803. [PMID: 35595233 DOI: 10.1080/23279095.2022.2074850] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
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Affiliation(s)
- A Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
- Hellenic Neuropsychological Society, Athens, Greece
| | - V Koutzmpi
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - S Megagianni
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - M Toumaian
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis," Athens, Greece
| | - N Geronikola
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Despoti
- Hellenic Neuropsychological Society, Athens, Greece
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - X Arampatzi
- Athens Alzheimer's Association, Athens, Greece
| | - E Margioti
- Athens Alzheimer's Association, Athens, Greece
| | - A Davila
- Athens Alzheimer's Association, Athens, Greece
| | - P Zoi
- Athens Alzheimer's Association, Athens, Greece
| | - F Kalligerou
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Liozidou
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, The Scientific College of Greece. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens
| | - A Tsapanou
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, USA
| | - P Sakka
- Athens Alzheimer's Association, Athens, Greece
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Kaufman JR, Fatima H, Lacritz LH, Cullum CM. Utility of a Short-Form Phonemic Fluency Task. Arch Clin Neuropsychol 2024; 39:770-774. [PMID: 38516816 PMCID: PMC11345109 DOI: 10.1093/arclin/acae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/08/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE to establish a proof-of-concept and ascertain the reliability of an abbreviated 30-second (30s) phonemic fluency measure as a cognitive screening tool in older adults. METHODS in all, 201 English-speaking individuals with normal cognition (NC; n = 119) or cognitive impairment (CI; mild CI or dementia; n = 82) were administered a standard 60s phonemic fluency task (FAS/CFL) with discrete 30s intervals denoted. RESULTS for all letters, 30s trial scores significantly predicted 60s scores for the same letter, R2 = .7-.9, F(1, 200) = 850-915, p < .001. As with 60s total scores, 30s cumulative scores (for all three trials) were significantly different between NC and CI groups (p < .001). Receiver operating characteristic analyses showed that 30s total scores distinguished NC and CI groups as effectively (AUC = .675) as 60s total scores (AUC = .658). CONCLUSIONS these findings support the utility and reliability of a short-form phonemic fluency paradigm, as 30s performance reliably predicted 60s/trial totals and was equally accurate in distinguishing impaired/non-impaired groups.
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Affiliation(s)
- Jack R Kaufman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hudaisa Fatima
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Laura H Lacritz
- Departments of Psychiatry and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Departments of Psychiatry, Neurology, and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Carcel C, Clancy L, Harris K, Peters R, Byrne A, Bassett K, Freed R, Hoyos CM, Rodgers A, Lindley R, Chalmers J, Xu Y, Woodward M, Ouyang M, Naismith SL, Anderson C. Randomised controlled decentralised feasibility trial of a fixed low-dose combination antihypertensive drug strategy to attenuate cognitive decline in high-risk adults. BMJ Open 2024; 14:e080862. [PMID: 39181551 PMCID: PMC11344491 DOI: 10.1136/bmjopen-2023-080862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 08/02/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVES The Action To promote brain HEalth iN Adults study aimed to determine the feasibility and applicability of recruitment using home blood pressure (BP) monitoring, routine blood biochemistry and videoconference measures of cognition, in adults at high risk of dementia. DESIGN A decentralised double-blind, placebo-controlled, randomised feasibility trial with a four-stage screening process. SETTING Conducted with participants online in the state of New South Wales, Australia. PARTICIPANTS Participants were aged 50-70 years with moderately elevated BP (systolic >120 and <160 mm Hg or diastolic >80 and <95 mm Hg) and ≥1 additional enrichment risk factor of monotherapy treatment of hypertension, diabetes mellitus, elevated low-density lipoprotein cholesterol, obesity, current smoking or a first degree relative with dementia, which indicated an elevated risk for future cognitive decline. INTERVENTION Triple Pill (active antihypertensive treatment of telmisartan 20 mg, amlodipine 2.5 mg and indapamide 1.25 mg) or placebo Triple Pill (blinded study capsules). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was feasibility of the study expressed as the percentage of participants randomised from those who were screened. Secondary outcomes were the applicability of videoconference measures of cognition and the overall trial, tolerability of the Triple Pill, safety outcomes and medication adherence. RESULTS The proportion (95% CI) of patients randomised to those screened was 5% (2%-10%). The applicability of the trial expressed as percentage of those who completed all remote assessments over the number of randomised participants was 67% (95% CI 05 to 22%). There were no serious adverse events or withdrawals from treatment. All participants adhered to study medication, except for one person who had two capsules left at the end of the study period. CONCLUSIONS The feasibility of this decentralised trial on BP lowering in patients at high risk for dementia is low. However, the applicability of remote assessments of cognitive function is acceptable. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000121864.
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Affiliation(s)
- Cheryl Carcel
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Lauren Clancy
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Katie Harris
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ruth Peters
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, Sydney, New South Wales, Australia
| | - Aisling Byrne
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Kimberley Bassett
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ruth Freed
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Camilla M Hoyos
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Anthony Rodgers
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard Lindley
- Westmead Applied Research Centre, University of Sydney, Sydney, New South Wales, Australia
| | - John Chalmers
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ying Xu
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Mark Woodward
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, UK
| | - Menglu Ouyang
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Sharon L Naismith
- Brain and Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
| | - Craig Anderson
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- Department of Neurology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- The George Institute for Global Health China, Beijing, China
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González-Osornio MG, Medina-Rivera MV, Orta-Castañeda L. Teleneuropsycological adaptation of the NEUROPSI Breve screening test. J Telemed Telecare 2024; 30:1132-1139. [PMID: 36131389 DOI: 10.1177/1357633x221123412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Teleneuropsychology refers to the application of neuropsychology using video teleconferencing (VTC) techniques, whose methodology facilitates access to remote populations, a need that has increased due to the COVID-19 pandemic. Numerous investigations have documented the equivalence of different screening assessments (Mini Mental State Examination, Montreal Cognitive Assessment (MoCA) test and the Repeatable Battery for the Assessment for Neuropsychological Status) when applied via teleneuropsychology. The goal of the present work is to test the equivalence of the Brief Neuropsychological Battery in Spanish (NEUROPSI Breve), a neuropsychological screening instrument standardized for Spanish-speaking population that has reported a high sensitivity (91.6%) for identifying dementia, when applied in the VTC modality. METHOD In total, 32 Mexicans between 16 and 70 years were assessed, both in traditional (face-to-face) and VTC format with a 20 min wait between each application. Each participant was randomly assigned into one of four groups that were generated from the established conditions: the first application could be face-to-face or by VTC modality and an adapted or original version of NEUROPSI Breve would be applied; for the second application, the remaining modality and instrument would be used. Statistical analysis was carried out using the IBM Statistical Package for the Social Sciences (SPSS) software (v. 25). RESULTS The Wilcoxon signed-rank test presented statistically significant differences (Z = -2.79, P = .005). However, when applied to each one of the four evaluation groups, the Wilcoxon signed-rank test showed no statistically significant differences; the same results were found when starting with the original or adapted instrument, and when starting with the face-to-face modality (P < .005). However, differences are shown when starting with the online (VTC) modality (groups B and C) (P = .028). CONCLUSIONS The NEUROPSI Breve is applicable in both modalities, satisfying the needs of the population and the evaluation guidelines.
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Brown AD, Kelso W, Eratne D, Loi SM, Farrand S, Summerell P, Neath J, Walterfang M, Velakoulis D, Stolwyk RJ. Investigating Equivalence of In-Person and Telehealth-Based Neuropsychological Assessment Performance for Individuals Being Investigated for Younger Onset Dementia. Arch Clin Neuropsychol 2024; 39:594-607. [PMID: 38251841 PMCID: PMC11269892 DOI: 10.1093/arclin/acad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/24/2023] [Accepted: 12/06/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVE Given the rapid shift to in-home teleneuropsychology models, more research is needed to investigate the equivalence of non-facilitator models of teleneuropsychology delivery for people with younger onset dementia (YOD). This study aimed to determine whether equivalent performances were observed on neuropsychological measures administered in-person and via teleneuropsychology in a sample of people being investigated for YOD. METHOD Using a randomized counterbalanced cross-over design, 43 participants (Mage = 60.26, SDage = 7.19) with a possible or probable YOD diagnosis completed 14 neuropsychological tests in-person and via teleneuropsychology, with a 2-week interval. Repeated measures t-tests, intraclass correlation coefficients (ICC), and Bland Altman analyses were used to investigate equivalence across the administration conditions. RESULTS No statistical differences were found between in-person and teleneuropsychology conditions, except for the Hospital Anxiety and Depression Scale Anxiety subtest. Small to negligible effect sizes were observed (ranging from .01 to .20). ICC estimates ranged from .71 to .97 across the neuropsychological measures. Bland Altman analyses revealed that the Wechsler Adult Intelligence Scale-Fourth Edition Block Design subtest had slightly better overall performance in the in-person condition and participants reported higher levels of anxiety symptoms during the teleneuropsychology condition; however, average anxiety symptoms remained within the clinically normal range. Participants reported a high level of acceptability for teleneuropsychology assessments. CONCLUSIONS These results suggest that performances are comparable between in-person and teleneuropsychology assessment modalities. Our findings support teleneuropsychology as a feasible alternative to in-person neuropsychological services for people under investigation of YOD, who face significant barriers in accessing timely diagnoses and treatment options.
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Affiliation(s)
- Aimee D Brown
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Wendy Kelso
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
| | - Dhamidhu Eratne
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Samantha M Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Sarah Farrand
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
| | | | - Joanna Neath
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
| | - Mark Walterfang
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Australia
| | | | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
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Sachs BC, Latham LA, Bateman JR, Cleveland MJ, Espeland MA, Fischer E, Gaussoin SA, Leng I, Rapp SR, Rogers S, Shappell HM, Williams BJ, Yang M, Craft S. Feasibility of Remote Administration of the Uniform Data Set-Version 3 for Assessment of Older Adults With Mild Cognitive Impairment and Alzheimer's Disease. Arch Clin Neuropsychol 2024; 39:635-643. [PMID: 38291734 DOI: 10.1093/arclin/acae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE Assess the feasibility and concurrent validity of a modified Uniform Data Set version 3 (UDSv3) for remote administration for individuals with normal cognition (NC), mild cognitive impairment (MCI), and early dementia. METHOD Participants (N = 93) (age: 72.8 [8.9] years; education: 15.6 [2.5] years; 72% female; 84% White) were enrolled from the Wake Forest ADRC. Portions of the UDSv3 cognitive battery, plus the Rey Auditory Verbal Learning Test, were completed by telephone or video within ~6 months of participant's in-person visit. Adaptations for phone administration (e.g., Oral Trails for Trail Making Test [TMT] and Blind Montreal Cognitive Assessment [MoCA] for MoCA) were made. Participants reported on the pleasantness, difficulty, and preference for each modality. Staff provided validity ratings for assessments. Participants' remote data were adjudicated by cognitive experts blinded to the in person-diagnosis (NC [N = 44], MCI [N = 35], Dementia [N = 11], or other [N = 3]). RESULTS Remote assessments were rated as pleasant as in-person assessments by 74% of participants and equally difficult by 75%. Staff validity rating (video = 92%; phone = 87.5%) was good. Concordance between remote/in-person scores was generally moderate to good (r = .3 -.8; p < .05) except for TMT-A/OTMT-A (r = .3; p > .05). Agreement between remote/in-person adjudicated cognitive status was good (k = .61-.64). CONCLUSIONS We found preliminary evidence that older adults, including those with cognitive impairment, can be assessed remotely using a modified UDSv3 research battery. Adjudication of cognitive status that relies on remotely collected data is comparable to classifications using in-person assessments.
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Affiliation(s)
- Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lauren A Latham
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - James R Bateman
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary Jo Cleveland
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark A Espeland
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Eric Fischer
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Iris Leng
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samantha Rogers
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Heather M Shappell
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Benjamin J Williams
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mia Yang
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Tsiaras Y, Koutsonida M, Varthi MA, Galliou I, Zoubouli C, Aretouli E. Development of a self-administered online battery for remote assessment of executive functions and verbal memory: equivalence with face-to-face administration, preliminary norms, and acceptance. J Clin Exp Neuropsychol 2024:1-15. [PMID: 38984860 DOI: 10.1080/13803395.2024.2376839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored. METHODS A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants' performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures. RESULTS No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418-.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced. CONCLUSION SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.
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Affiliation(s)
- Yiannis Tsiaras
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Myrto Koutsonida
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Maria-Ameriso Varthi
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Iliana Galliou
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Christina Zoubouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Eleni Aretouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
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Garland SN, Tulk J, Savard J, Rash JA, Browne S, Urquhart R, Seal M, Thoms J, Laing K. Randomized Controlled Trial of Virtually Delivered Cognitive Behavioral Therapy for Insomnia to Address Perceived Cancer-Related Cognitive Impairment in Cancer Survivors. J Clin Oncol 2024; 42:2094-2104. [PMID: 38552188 DOI: 10.1200/jco.23.02330] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/18/2023] [Accepted: 02/07/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE Comorbid insomnia and cancer-related cognitive impairment (CRCI) are experienced by up to 26% of individuals diagnosed with cancer. This study examined the efficacy and durability of cognitive behavioral therapy for insomnia (CBT-I) on perceived CRCI in cancer survivors. METHODS Atlantic Canadian cancer survivors with insomnia and CRCI were randomly assigned to receive seven weekly virtual CBT-I sessions (n = 63) or placed in a waitlist control group (n = 69) to receive treatment after the waiting period. Participants completed assessments at baseline, 1 month (mid-treatment), and 2 months (post-treatment). Age- and education-adjusted mixed-effects models using intention-to-treat principles assessed change at post-treatment. Data from both groups were then pooled to assess the durability of effects at 3 and 6 months. A mediation analysis examined whether change in insomnia symptoms mediated the effect of CBT-I on cognitive outcomes. RESULTS The mean age of the sample was 60 years, 77% were women, and breast cancer was the most common diagnosis (41%). The treatment group reported an 11.35-point reduction in insomnia severity, compared with a 2.67-point reduction in the waitlist control group (P < .001). The treatment group had a greater overall improvement than the waitlist control on perceived cognitive impairment (P < .001; d = 0.75), cognitive abilities (P < .001; d = 0.92), and impact on quality of life (P < .001; d = 1.01). These improvements were maintained at follow-up. Change in insomnia symptoms fully mediated the effect of CBT-I on subjective cognitive outcomes. CONCLUSION Treating insomnia with CBT-I produces clinically meaningful and durable improvements in CRCI. There is an urgent need increase access to evidence-based treatment for insomnia in cancer centers and the community.
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Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
| | - Josée Savard
- School of Psychology, Université Laval, Quebec, QC, Canada
- CHU de Québec-Université Laval Research Center, Quebec, QC, Canada
| | - Joshua A Rash
- Department of Psychology, Faculty of Science, Memorial University, St John's, NL
| | | | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS
| | - Melanie Seal
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - John Thoms
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
| | - Kara Laing
- Discipline of Oncology, Faculty of Science, Memorial University, St John's, NL
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Yıldırım E, Büyükişcan ES, Kalem ŞA, Gürvit İH. Remote Neuropscyhological Assessment: Teleneuropsychology. Noro Psikiyatr Ars 2024; 61:167-174. [PMID: 38868842 PMCID: PMC11165610 DOI: 10.29399/npa.28535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/18/2023] [Indexed: 06/14/2024] Open
Abstract
Introduction Teleneuropsychology, which includes the remote application of neuropsychological tests to patients via telephone or videoconferencing, can expand access to health services for patients who reside in distant areas or have mobility restrictions. With the emergence of the COVID-19 pandemic, there has been a significant increase in the use of teleneuropsychology in cognitive assessment. In this review, the aim was to critically review the results of studies conducted in the field of teleneuropsychology and the fundamental principles related to tele-neuropsychological assessment. Additionally, the "guideline for home-based teleneuropsychology" developed for Türkiye's practices is outlined in this review. Method A literature search was conducted using the Web of Science and PubMed databases to include all types of articles related to the subject. Results The results of studies on in-clinic and home-based teleneuropsychological assessment indicate that tests that assess cognitive functions such as attention, memory, executive functions, and language, particularly those based on verbal administration, can be reliably applied through teleneuropsychological assessment. However, there are factors to consider when referring patients for teleneuropsychological assessment, selecting tests for assessment, and making ethical considerations. Additionally, it is important to follow recommended steps for both the clinician and the patient and/or their caregiver before and during the interview in order for the assessment to be carried out effectively. Conclusion Although direct contact with the patient is an essential element in clinical neuropsychology practice, when necessary, teleneuropsychological assessment performed by trained experts following appropriate application procedures can be a good alternative to face-to-face evaluations.
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Affiliation(s)
- Elif Yıldırım
- Işık University, Department of Psychology, Istanbul, Turkey
| | | | - Şükriye Akça Kalem
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - İ. Hakan Gürvit
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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DesRuisseaux LA, Gereau Mora M, Suchy Y. Computerized assessment of executive functioning: Validation of the CNS Vital Signs executive functioning scores in a sample of community-dwelling older adults. Clin Neuropsychol 2024:1-23. [PMID: 38763890 DOI: 10.1080/13854046.2024.2354953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/09/2024] [Indexed: 05/21/2024]
Abstract
Objective: Computerized assessment of cognitive functioning has gained significant popularity over recent years, yet options for clinical assessment of executive functioning (EF) are lacking. One computerized testing platform, CNS Vital Signs (CNS-VS), offers tests designed to measure EF but requires further validation. The goal of the present study was to validate CNS-VS executive scores against standard clinical measures of EF. We also sought to determine whether a modified CNS-VS composite score that included variables purported to measure inhibition, switching, and working memory would outperform the currently available CNS-VS Executive Function Index. Method: A sample of 73 cognitively healthy older adults completed four tests from the Delis-Kaplan Executive Function System, the Digit Span subtest from the Wechsler Adult Intelligence Scale-fourth edition, and three CNS-VS tasks purported to measure inhibition, switching, and working memory. Results: Performances on the CNS-VS tests were predicted by performances on standard paper-and-pencil measures. Although the currently available CNS-VS Executive Function Index predicted unique variance in a well-validated paper-and-pencil EF composite score, our Modified CNS-VS EF composite accounted for unique variance above and beyond the original CNS-VS Executive Function Index, while the reverse was not true. Conclusions: The present results support the construct validity of CNS-VS EF tests but also suggest that modifications to their current composite scores would improve the prediction of EF performance.
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Affiliation(s)
| | | | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Bettencourt C, Pires L, Almeida F, Vilar M, Cruz H, Leitão J, Allen Gomes A. Chronotype, Time of Day, and Children's Cognitive Performance in Remote Neuropsychological Assessment. Behav Sci (Basel) 2024; 14:310. [PMID: 38667106 PMCID: PMC11047315 DOI: 10.3390/bs14040310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
Research on the influence of chronotype and time of day (TOD) on cognitive performance, especially in children, is limited. We explored potential interactive effects, hypothesizing that performance differs when comparing preferred vs. non-preferred TOD. In total, 76 morning-type (MT = 37) or evening-type (ET = 39) children from the third and fourth grades (48.7% girls; M age = 8.05; SD age = 0.51), identified through the Children Chronotype Questionnaire, completed two 30-min neuropsychological assessment sessions via videoconference on the first (9:00) or last hour (16:00) of the school day. The protocol included neuropsychological tests targeting memory, language, and attention/executive domains. The results revealed an interactive effect of medium size between chronotype and TOD on a Rapid Alternating Stimulus (Naming) Task. MT and ET performed faster in asynchrony conditions (morning for ET; afternoon for MT). Additionally, ET outperformed MT in a Backward Digit Span Task, irrespective of TOD. TOD also influenced performance on an Alternating Verbal Fluency Task, with both MT and ET children performing better in the morning. These results underscore the importance of chronotype and TOD in children's cognitive performance, particularly in working memory and verbal fluency. Children assessed during non-preferred TOD exhibited better performance on some cognitive tasks, challenging the assumption that optimal times always yield superior results.
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Affiliation(s)
- Catarina Bettencourt
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
- Laboratory of Chronopsychology and Cognitive Systems (ChronCog), University of Coimbra, 3000-115 Coimbra, Portugal
| | - Luís Pires
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
- Laboratory of Chronopsychology and Cognitive Systems (ChronCog), University of Coimbra, 3000-115 Coimbra, Portugal
- Department of Psychology and Education, Faculty of Human and Social Sciences, University of Beira Interior, 6200-209 Covilhã, Portugal
| | - Filipa Almeida
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
- Laboratory of Chronopsychology and Cognitive Systems (ChronCog), University of Coimbra, 3000-115 Coimbra, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
| | - Hugo Cruz
- Interdisciplinary Research Centre for Education and Development (CeiED), Lusófona University, 1700-284 Lisboa, Portugal;
| | - José Leitão
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
- Laboratory of Chronopsychology and Cognitive Systems (ChronCog), University of Coimbra, 3000-115 Coimbra, Portugal
| | - Ana Allen Gomes
- Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (L.P.); (F.A.); (M.V.); (J.L.); (A.A.G.)
- Centre for Research in Neuropsychology and Cognitive Behavioral Intervention, University of Coimbra, 3000-115 Coimbra, Portugal
- Laboratory of Chronopsychology and Cognitive Systems (ChronCog), University of Coimbra, 3000-115 Coimbra, Portugal
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13
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Giromini L, Pignolo C, Zennaro A, Sellbom M. Using the MMPI-2-RF, IOP-29, IOP-M, and FIT in the In-Person and Remote Administration Formats: A Simulation Study on Feigned mTBI. Assessment 2024:10731911241235465. [PMID: 38468147 DOI: 10.1177/10731911241235465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Our study compared the impact of administering Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs) in in-person versus remote formats and assessed different approaches to combining validity test results. Using the MMPI-2-RF, IOP-29, IOP-M, and FIT, we assessed 164 adults, with half instructed to feign mild traumatic brain injury (mTBI) and half to respond honestly. Within each subgroup, half completed the tests in person, and the other half completed them online via videoconferencing. Results from 2 ×2 analyses of variance showed no significant effects of administration format on SVT and PVT scores. When comparing feigners to controls, the MMPI-2-RF RBS exhibited the largest effect size (d = 3.05) among all examined measures. Accordingly, we conducted a series of two-step hierarchical logistic regression models by entering the MMPI-2-RF RBS first, followed by each other SVT and PVT individually. We found that the IOP-29 and IOP-M were the only measures that yielded incremental validity beyond the effects of the MMPI-2-RF RBS in predicting group membership. Taken together, these findings suggest that administering these SVTs and PVTs in-person or remotely yields similar results, and the combination of MMPI and IOP indexes might be particularly effective in identifying feigned mTBI.
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14
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Giacona JM, Bates BM, Sundaram V, Brinker S, Moss E, Paspula R, Kassa S, Zhang R, Ahn C, Zhang S, Basit M, Burkhalter L, Cullum CM, Carlew A, Kelley BJ, Plassman BL, Vazquez M, Vongpatanasin W. Preventing cognitive decline by reducing BP target (PCOT): A randomized, pragmatic, multi-health systems clinical trial. Contemp Clin Trials 2024; 138:107443. [PMID: 38219797 DOI: 10.1016/j.cct.2024.107443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Growing evidence suggests that intensive lowering of systolic blood pressure (BP) may prevent mild cognitive impairment (MCI) and dementia. However, current guidelines provide inconsistent recommendations regarding optimal BP targets, citing safety concerns of excessive BP lowering in the diverse population of older adults. We are conducting a pragmatic trial to determine if an implementation strategy to reduce systolic BP to <130 and diastolic BP to <80 mmHg will safely slow cognitive decline in older adults with hypertension when compared to patients receiving usual care. METHODS The Preventing Cognitive Decline by Reducing BP Target Trial (PCOT) is an embedded randomized pragmatic clinical trial in 4000 patients from two diverse health-systems who are age ≥ 70 years with BP >130/80 mmHg. Participants are randomized to the intervention arm or usual care using a permuted block randomization within each health system. The intervention is a combination of team-based care with clinical decision support to lower home BP to <130/80 mmHg. The primary outcome is cognitive decline as determined by the change in the modified Telephone Interview for Cognitive Status (TICS-m) scores from baseline. As a secondary outcome, patients who decline ≥3 points on the TICS-m will complete additional cognitive assessments and this information will be reviewed by an expert panel to determine if they meet criteria for MCI or dementia. CONCLUSION The PCOT trial will address the effectiveness and safety of hypertension treatment in two large health systems to lower BP targets to reduce risk of cognitive decline in real-world settings.
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Affiliation(s)
- John M Giacona
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA; Department of Applied Clinical Research, School of Health Professions, University of Texas Southwestern Medical Center, USA
| | - Brooke M Bates
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
| | | | - Stephanie Brinker
- Division of General Internal Medicine, University of Texas Southwestern Medical Center, USA
| | - Elizabeth Moss
- Ambulatory Clinical Pharmacy Services, Parkland Health & Hospital System, USA
| | - Raja Paspula
- Geriatrics and Senior Care Center, Parkland Health & Hospital System, USA
| | - Sentayehu Kassa
- Vickery Health Center, Parkland Health & Hospital System, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, USA; Department of Neurology, UT Southwestern Medical Center, USA
| | - Chul Ahn
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, USA
| | - Song Zhang
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, USA
| | - Mujeeb Basit
- Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA
| | - Lorrie Burkhalter
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, USA
| | - C Munro Cullum
- Department of Neurology, UT Southwestern Medical Center, USA; Psychology Division, Department of Psychiatry, University of Texas Southwestern Medical Center, USA
| | - Anne Carlew
- Psychology Division, Department of Psychiatry, University of Texas Southwestern Medical Center, USA
| | | | - Brenda L Plassman
- Behavioral Medicine & Neurosciences Division, Department of Psychiatry, Duke University School of Medicine, USA
| | - Miguel Vazquez
- Nephrology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA.
| | - Wanpen Vongpatanasin
- Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, USA.
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Gierzynski TF, Gregoire A, Reader JM, Pantis R, Campbell S, Bhaumik A, Rahman-Filipiak A, Heidebrink J, Giordani B, Paulson H, Hampstead BM. Evaluation of the Uniform Data Set version 3 teleneuropsychological measures. J Int Neuropsychol Soc 2024; 30:183-193. [PMID: 37366070 PMCID: PMC10751395 DOI: 10.1017/s1355617723000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Few studies have evaluated in-home teleneuropsychological (teleNP) assessment and none, to our knowledge, has evaluated the National Alzheimer's Coordinating Center's (NACC) Uniform Data Set version 3 tele-adapted test battery (UDS v3.0 t-cog). The current study evaluates the reliability of the in-home UDS v3.0 t-cog with a prior in-person UDS v3.0 evaluation. METHOD One hundred and eighty-one cognitively unimpaired or cognitively impaired participants from a longitudinal study of memory and aging completed an in-person UDS v3.0 and a subsequent UDS v3.0 t-cog evaluation (∼16 months apart) administered either via video conference (n = 122) or telephone (n = 59). RESULTS We calculated intraclass correlation coefficients (ICCs) between each time point for the entire sample. ICCs ranged widely (0.01-0.79) but were generally indicative of "moderate" (i.e., ICCs ranging from 0.5-0.75) to "good" (i.e., ICCs ranging from 0.75-0.90) agreement. Comparable ICCs were evident when looking only at those with stable diagnoses. However, relatively stronger ICCs (Range: 0.35-0.87) were found between similarly timed in-person UDS v3.0 evaluations. CONCLUSIONS Our findings suggest that most tests on the UDS v3.0 t-cog battery may serve as a viable alternative to its in-person counterpart, though reliability may be attenuated relative to the traditional in-person format. More tightly controlled studies are needed to better establish the reliability of these measures.
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Affiliation(s)
| | - Allyson Gregoire
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | - Rebecca Pantis
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Stephen Campbell
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Arijit Bhaumik
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Bruno Giordani
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Henry Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, USA
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Lampis V, Dondena C, Mauri C, Villa M, Salandi A, Molteni M, Cantiani C, Mascheretti S. Comparing remote versus in-person assessment of learning skills in children with specific learning disabilities. Digit Health 2024; 10:20552076241254453. [PMID: 39148815 PMCID: PMC11325472 DOI: 10.1177/20552076241254453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 08/17/2024] Open
Abstract
Background Interactive telemedicine applications have been progressively introduced in the assessment of cognitive and literacy skills. However, there is still a lack of research focusing on the validity of this methodology for the neuropsychological assessment of children with Specific Learning Disorder (SLD). Methods Seventy-nine children including 40 typically developing children (18 males, age 11.5 ± 1.06) and 39 children with SLD (24 males, age 12.3 ± 1.28) were recruited. Each participant underwent the same neuropsychological battery assessing reading accuracy, speed, and comprehension, writing, numerical processing, computation, and semantic numerical sense, twice (once during an in-person session (I) and once during a remote (R) home-based videoconference session). Four groups were subsequently defined based on the administration order. Repeated-measure-ANOVAs with assessment type (R vs. I testing) as within-subject factor and diagnosis (SLD vs. TR) and administration order (R-I vs. I-R) as between-subject factors, and between-group t-tests comparing the two assessment types within each time of administration, were run. Results No differences emerged between I and R assessments of reading accuracy and speed, numerical processing, and computation; on the contrary, potential biases against R assessment emerged when evaluating skills in writing, reading comprehension, and semantic numerical sense. However, regardless of the assessment type, the scores obtained with I and R assessments within the same administration time point overlapped. Discussion These results partially support the validity and reliability of the assessment of children's learning skills via a remote home-based videoconferencing system. Implementing telemedicine as an assessment tool may increase timely access to primary health care and to support research activity.
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Affiliation(s)
- Valentina Lampis
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Chiara Dondena
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Chiara Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Martina Villa
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
- The Connecticut Institute for Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, USA
- Yale Child Study Center Language Sciences Consortium, New Haven, CT, USA
| | - Antonio Salandi
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Chiara Cantiani
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Sara Mascheretti
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Tanev KS, Camprodon JA, Caplan DN, Dickerson BC, Chemali Z, Eldaief MC, Kim DD, Josephy-Hernandez SE, Kritzer MD, Moo LR, Newhouse A, Perez DL, Ramirez Gomez LA, Razafsha M, Rivas-Grajales AM, Scharf JM, Schmahmann JD, Sherman JC. Telemedicine-Based Cognitive Examinations During COVID-19 and Beyond: Perspective of the Massachusetts General Hospital Behavioral Neurology & Neuropsychiatry Group. J Neuropsychiatry Clin Neurosci 2023; 36:87-100. [PMID: 38111331 DOI: 10.1176/appi.neuropsych.20220154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Telehealth and telemedicine have encountered explosive growth since the beginning of the COVID-19 pandemic, resulting in increased access to care for patients located far from medical centers and clinics. Subspecialty clinicians in behavioral neurology & neuropsychiatry (BNNP) have implemented the use of telemedicine platforms to perform cognitive examinations that were previously office based. In this perspective article, BNNP clinicians at Massachusetts General Hospital (MGH) describe their experience performing cognitive examinations via telemedicine. The article reviews the goals, prerequisites, advantages, and potential limitations of performing a video- or telephone-based telemedicine cognitive examination. The article shares the approaches used by MGH BNNP clinicians to examine cognitive and behavioral areas, such as orientation, attention and executive functions, language, verbal learning and memory, visual learning and memory, visuospatial function, praxis, and abstract abilities, as well as to survey for neuropsychiatric symptoms and assess activities of daily living. Limitations of telemedicine-based cognitive examinations include limited access to and familiarity with telecommunication technologies on the patient side, limitations of the technology itself on the clinician side, and the limited psychometric validation of virtual assessments. Therefore, an in-person examination with a BNNP clinician or a formal in-person neuropsychological examination with a neuropsychologist may be recommended. Overall, this article emphasizes the use of standardized cognitive and behavioral assessment instruments that are either in the public domain or, if copyrighted, are nonproprietary and do not require a fee to be used by the practicing BNNP clinician.
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Affiliation(s)
- Kaloyan S Tanev
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Joan A Camprodon
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - David N Caplan
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Bradford C Dickerson
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Zeina Chemali
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Mark C Eldaief
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - David Dongkyung Kim
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Sylvia E Josephy-Hernandez
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Michael D Kritzer
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Lauren R Moo
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Amy Newhouse
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - David L Perez
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Liliana A Ramirez Gomez
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Mahdi Razafsha
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Ana Maria Rivas-Grajales
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Jeremiah M Scharf
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Jeremy D Schmahmann
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
| | - Janet C Sherman
- Division of Neuropsychiatry, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston (Tanev, Camprodon, Chemali, Eldaief, Josephy-Hernandez, Kritzer, Newhouse, Perez, Razafsha, Rivas-Grajales, Scharf, Sherman); Division of Cognitive Behavioral Neurology (Camprodon, Caplan, Dickerson, Chemali, Eldaief, Josephy-Hernandez, Moo, Perez, Ramirez Gomez, Rivas-Grajales, Scharf, Schmahmann, Sherman) and Division of Movement Disorders (Scharf), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Adult Neurodevelopmental and Geriatric Psychiatry Division, Center for Addiction and Mental Health, Toronto (Kim); Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Newhouse); Department of Psychiatry, Boston University School of Medicine and Boston Medical Center, Boston (Rivas-Grajales); Psychology Assessment Center, Massachusetts General Hospital, Harvard Medical School, Boston (Sherman)
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19
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Zadik L, Perlman S, Barak O, Ziv-Baran T. Evaluation of Montreal Cognitive Assessment (MoCA) Administered via Videoconference. J Am Med Dir Assoc 2023; 24:1942-1947.e3. [PMID: 37709260 DOI: 10.1016/j.jamda.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES Telemedicine provides much potential for promoting health care. The Montreal Cognitive Assessment (MoCA) is a screening tool for identifying mild cognitive impairment. This study aims to evaluate the agreement between MoCA assessed face-to-face vs via videoconference using a mobile phone. DESIGN A randomized crossover study. SETTING AND PARTICIPANTS A randomly selected sample of patients admitted to the geriatric rehabilitation department in a large tertiary medical center in 2021-2022. METHODS The MoCA was conducted twice for each patient, with a 10- to 20-day interval between assessments. To avoid a learning effect, alternate MoCA versions were used for each patient. Intraclass correlation coefficient (ICC), kappa, weighted kappa, and the Bland-Altman plot were used to evaluate the agreement between administration methods. To identify variables associated with low agreement, data on participant characteristics, order of administration methods, and test versions were collected, and univariate and multivariable analyses were performed. RESULTS Forty-four patients were included in the study. The median age was 83 years [interquartile range (IQR 76-87)] and 75% were females. Median overall MoCA score was 24 points (IQR 21-26) when administered face-to-face, and 23.5 points (IQR 21-26) via videoconference. Excellent agreement (ICC = 0.89) was observed in the total MoCA score. Moderate-substantial agreement was observed in subsection scores (kappa 0.436-0.686), except for the language subsection where fair agreement was observed (kappa 0.331). Anxiety was assessed by Hospital Anxiety and Depression Scale and associated with lower agreement (ICC = 0.76 in patients with anxiety vs ICC = 0.92 in patients without anxiety). None of the other studied variables were associated with a difference between administration methods. CONCLUSIONS AND IMPLICATIONS Conducting a MoCA via videoconference using a mobile phone is another method of providing medical care to people without significant visual or hearing impairment that restricts their use of a mobile phone, during routine times and in emergencies where social distancing is needed.
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Affiliation(s)
- Limor Zadik
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Geriatric Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Saritte Perlman
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orly Barak
- Geriatric Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Ziv-Baran
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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20
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Brown T, Zakzanis KK. A review of the reliability of remote neuropsychological assessment. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38000083 DOI: 10.1080/23279095.2023.2279208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
The provision of clinical neuropsychological services has predominately been undertaken by way of standardized administration in a face-to-face setting. Interpretation of psychometric findings in this context is dependent on the use of normative comparison. When the standardization in which such psychometric measures are employed deviates from how they were employed in the context of the development of its associated norms, one is left to question the reliability and hence, validity of any such findings and in turn, diagnostic decision making. In light of the current COVID-19 pandemic and resultant social distancing direction, face-to-face neuropsychological assessment has been challenging to undertake. As such, remote (i.e., virtual) neuropsychological assessment has become an obvious solution. Here, and before the results from remote neuropsychological assessment can be said to stand on firm scientific grounds, it is paramount to ensure that results garnered remotely are reliable and valid. To this end, we undertook a review of the literature and present an overview of the landscape. To date, the literature shows evidence for the reliability of remote administration and the clinical implications are paramount. When and where needed, neuropsychologists, psychometric technicians and examinees may no longer need to be in the same physical space to undergo an assessment. These findings are most relevant given the physical distancing practices because of COVID-19. And whilst remote assessment should never supplant face-to-face neuropsychological assessments, it does serve as a valid alternative when necessary.
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Affiliation(s)
- Tyler Brown
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Scarborough, ON, Canada
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21
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Smith V, Younes K, Poston KL, Mormino EC, Young CB. Reliability of remote National Alzheimer's Coordinating Center Uniform Data Set data. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12498. [PMID: 38034852 PMCID: PMC10687343 DOI: 10.1002/dad2.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION The National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS) neuropsychological battery is being used to track cognition in participants across the country, but it is unknown if scores obtained through remote administration can be combined with data obtained in person. METHODS The remote UDS battery includes the blind version of the Montreal Cognitive Assessment (MoCA), Number Span, Semantic and Phonemic Fluency, and Craft Story. For these tests, we assessed intraclass correlation coefficients (ICCs) between in-person and remote scores in 3838 participants with both in-person and remote UDS assessments, and we compared annual score changes between modalities in a subset that had two remote assessments. RESULTS All tests exhibited moderate to good reliability between modalities (ICCs = 0.590-0.787). Annual score changes were also comparable between modalities except for Craft Story Immediate Recall, Semantic Fluency, and Phonemic Fluency. DISCUSSION Our findings generally support combining remote and in-person scores for the majority of UDS tests.
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Affiliation(s)
- Viktorija Smith
- Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Kyan Younes
- Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Kathleen L. Poston
- Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoCaliforniaUSA
| | - Christina B. Young
- Department of Neurology and Neurological SciencesStanford University School of MedicinePalo AltoCaliforniaUSA
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22
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Montemurro S, Mondini S, Pucci V, Durante G, Riccardi A, Maffezzini S, Scialpi G, Signorini M, Arcara G. Tele-Global Examination of Mental State (Tele-GEMS): an open tool for the remote neuropsychological screening. Neurol Sci 2023; 44:3499-3508. [PMID: 37248426 PMCID: PMC10226870 DOI: 10.1007/s10072-023-06862-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
Tele-neuropsychology, i.e., the application of remote audio-visual technologies to neuropsychological evaluation or rehabilitation, has become increasingly popular and widespread during and after the COVID-19 pandemic. New tools with updated normative data and appropriate methodological developments are necessary. We present Tele-GEMS, a telephone-based cognitive screening developed on N = 601 Italian participants. It yields a global score tapping on orientation, memory, spatial representation, language, and pragmatic abilities. Its administration lasts about 10 min. Clinical cut-offs are provided, accounting for demographic variables (age, education, and sex) and also for a comprehensive index taking into account cognitively stimulating life experiences that can build up a cognitive reserve. Tele-GEMS shows good internal consistency and a good inter-rater agreement. The test includes the thresholds for estimating a significant change after repeated measurements. Tele-GEMS has a good construct validity as assessed with MoCA and a suitable criterion validity assessed with its in-person version (GEMS). All the materials and the instructions, including scripts and an online Application for the automatic calculation of cut-offs, are accessible on OSF at https://osf.io/t3bma/ under a Creative Commons license.
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Affiliation(s)
| | - Sara Mondini
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
- Centro di Ateneo Servizi Clinici Universitari Psicologici (SCUP), Università di Padova, Padova, Italy
- Human Inspired Technology Research Centre HIT, University of Padova, Padova, Italy
| | - Veronica Pucci
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
- Human Inspired Technology Research Centre HIT, University of Padova, Padova, Italy
| | - Giorgia Durante
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), Università di Padova, Padova, Italy
| | - Alice Riccardi
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
| | - Sabrina Maffezzini
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
| | - Graziana Scialpi
- Multiple Sclerosis Centre, Department of Neurosciences-DNS, Università di Padova, Padova, Italy
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23
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Takakura Y, Otsuki M, Takagi R, Houkin K. A validation study for wide-range remote assessment of cognitive functions in the healthy older Japanese population: a pilot randomised crossover trial. BMC Geriatr 2023; 23:575. [PMID: 37723429 PMCID: PMC10507887 DOI: 10.1186/s12877-023-04275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The assessment of a wide range of cognitive functions using video teleconference (VTC) systems cannot be applied in practice yet. We aimed to determine the feasibility and reliability of previously unvalidated remote cognitive function tests in Japan using common information and communication technology (ICT) devices, software, and VTC systems compared with face-to-face (FTF) assessment. METHODS The sample consisted of 26 participants from senior citizens clubs and an employment service centre in Sapporo Japan, including 11 females and 15 males (age averaged 78.6 ± 6.8 years). Tests included the RCPM, Story recall, 10/36 spatial recall, selective reminding test, SDMT, PASAT, FAB, TMT-A, TMT-B, visual cancellation task, digit span, tapping span. The experimental design was a counterbalanced crossover randomised controlled trial. Intraclass correlations (ICCs), paired-samples t-tests, Cohen's Kappa (κ) coefficients, and Wilcoxon signed-rank test were calculated to compare the scores between VTC and FTF assessments. RESULTS All ICCs were significant and ranged from 0.47 (RCPM time) to 0.92 (RCPM score and PASAT), with a mean ICC of 0.75. Digit span using Cohen's Kappa (κ) coefficient was significant, but the tapping span was not. Paired samples t-test showed statistically significant differences in SDMT, RCPM time, and cancellation time. CONCLUSIONS The results suggest that remote video conference-based neuropsychological tests even using familiar devices and software may be able to assess a wide range of cognitive functions in the Japanese older population. As for the processing speed tasks, we need to create our own standards for the remote condition. For the tapping span, we should consider increasing the number of trials.
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Affiliation(s)
- Yuki Takakura
- Faculty of Health Sciences, Hokkaido University, N-12,W-5, Kita-Ku, Sapporo, 060-0812, Japan
| | - Mika Otsuki
- Faculty of Health Sciences, Hokkaido University, N-12,W-5, Kita-Ku, Sapporo, 060-0812, Japan.
| | - Ryo Takagi
- Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Kiyohiro Houkin
- Emeritus Professor, Hokkaido University, Sapporo, Hokkaido, Japan
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24
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Ibarra AJ, Butters MA, Lim G, Jeyabalan A, Li R, Balasubramani GK, Catov JM. Longitudinal cognitive evaluation before and after delivery among people with preeclampsia. Am J Obstet Gynecol MFM 2023; 5:100966. [PMID: 37084869 PMCID: PMC10876122 DOI: 10.1016/j.ajogmf.2023.100966] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Cognitive impairments related to preeclampsia after pregnancy have been reported; however, it is not known if weaknesses in cognition occur before and shortly after delivery. OBJECTIVE This study aimed to assess the feasibility of longitudinal cognitive testing before and after delivery, and to investigate whether those with preeclampsia have cognitive weaknesses during the third trimester of pregnancy and at 1 and 3 months postpartum. We hypothesized that people with preeclampsia would have lower cognition scores across all time points compared with normotensive people. STUDY DESIGN This longitudinal, prospective, observational study in a single institution enrolled people (N=30) at ≥28 weeks of gestation with preeclampsia (N=16) or normotension (N=14). People with chronic hypertension, neurologic or developmental disabilities, moderate or severe depression or anxiety, or current substance use were excluded. Subjective (Everyday Cognition Scale) and objective assessment of executive function (Stroop Color-Word Interference Test, Trail-Making Test), attention and working memory (Digit Span subtest), and information processing speed (Digit Symbol Substitution Test) was conducted, and Z-scores were calculated. Baseline characteristics (eg, prepregnancy body mass index) were collected from the medical record. Generalized linear models were used to estimate associations. RESULTS We enrolled 37% (30/81) of eligible people and retained 80% (24/30) and 53% (16/30) at 1 and 3 months postpartum, respectively. People with preeclampsia reported more memory problems (ß=0.87; 95% confidence interval, 0.44-1.31), and scored worse on attention and working memory (ß=-0.94; 95% confidence interval, -1.42 to -0.45) and executive function (Stroop test ß=-0.86; 95% confidence interval, -1.53 to -0.19) domains compared with normotensive people after adjusting for time, age, education, and prepregnancy body mass index. CONCLUSION Longitudinal assessment of cognition in pregnant preeclamptic and normotensive people is feasible. People with preeclampsia reported worse subjective memory and had lower scores in attention, working memory, and executive function.
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Affiliation(s)
- Andrea J Ibarra
- Departments of Anesthesiology and Perioperative Medicine (Drs Ibarra and Lim).
| | | | - Grace Lim
- Departments of Anesthesiology and Perioperative Medicine (Drs Ibarra and Lim)
| | - Arun Jeyabalan
- Obstetrics, Gynecology and Reproductive Sciences (Drs Jeyabalan and Catov), University of Pittsburgh, Pittsburgh, PA
| | - Runjia Li
- Departments of Epidemiology (Ms Li and Dr Catov)
| | | | - Janet M Catov
- Obstetrics, Gynecology and Reproductive Sciences (Drs Jeyabalan and Catov), University of Pittsburgh, Pittsburgh, PA; Departments of Epidemiology (Ms Li and Dr Catov); Magee-Womens Research Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA (Dr Catov)
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Saini G, Malhotra S, Rajan R, Vishnu VY, Mani K, Bhatia R, Bhushan M, Srivastava MVP, Gupta A. Video Teleconference Administration of the Addenbrooke's Cognitive Examination-III for the Assessment of Neuropsychological Status: An Experience in Indian Subjects with Cognitive Dysfunction. Ann Indian Acad Neurol 2023; 26:447-452. [PMID: 37970289 PMCID: PMC10645197 DOI: 10.4103/aian.aian_97_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/17/2023] [Accepted: 05/02/2023] [Indexed: 11/17/2023] Open
Abstract
Objective To determine the feasibility, reliability, and acceptability of video teleconference (VTC)-based neuropsychological assessment using Addenbrooke's cognitive examination-III (ACE-III). Methods This study was performed from January 2022 to April 2022, during the third wave of the COVID-19 pandemic in India. We administered ACE-III using video-teleconferencing and compared the scores to face-to-face (FTF) testing for the eligible participants. We also conducted a participant's satisfaction survey of VTC-administered ACE-III compared to FTF-administered ACE-III, using a 7-point Likert scale. Results We screened 37 participants and 24 (64.9%) successfully underwent ACE-III testing through VTC. We included 20 patients (mean age: 62.7 ± 10 years, mean education: 12.0 ± 4.6 years, 85% men) for final analysis, (who completed both VTC and FTF-administered ACE-III). Nine patients had major neurocognitive disorder (dementia), eight had mild neurocognitive disorder (MCI), and three had subjective cognitive decline (SCD). The two tests were administered at a median gap of 36 (18,74.5) days. The Intraclass correlation coefficients (ICC) of ACE-3 total scores (0.97) and the subdomain scores was high (>0.8). There was "very low" to "no" bias on the Bland-Altman plots, across all domains. The mean overall satisfaction score was 4.1, indicating that VTC is "as good as" FTF. Conclusions Results support the feasibility and acceptability of remote administration of ACE-III via VTC. There is a good agreement between the ACE-III scores across VTC and in-person conditions.
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Affiliation(s)
- Garima Saini
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Simran Malhotra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Erickson CM, Chin NA, Rosario HL, Peterson A, Johnson SC, Clark LR. Feasibility of virtual Alzheimer's biomarker disclosure: Findings from an observational cohort. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12413. [PMID: 37521522 PMCID: PMC10382796 DOI: 10.1002/trc2.12413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 08/01/2023]
Abstract
Introduction Increased availability of Alzheimer's disease (AD) biomarker tests provides older adults with opportunities to seek out and learn results. We evaluated the feasibility of virtually returning AD biomarker results. Methods Trained study clinicians disclosed amyloid positron emission tomography (PET) results and provided dementia risk-reduction counseling via televideo to cognitively unimpaired participants already enrolled in AD research (n = 99; mean age ± SD: 72.0 ± 4.8; 67% women; 95% White; 28% amyloid elevated). Results Our study demonstrated acceptable levels of retention (93%), compliance (98%), adherence (98%), clinician competence (97%), education comprehension (quiz scores 14/15), and virtual visit functionality (rating 9.4/10). Depression, anxiety, and suicidality remained low and did not differ by amyloid result. Discussion Virtual return of amyloid PET results to cognitively unimpaired research participants is feasible and does not result in increased psychological symptoms. Technological barriers for some participants highlight the need for flexibility. These findings support the use of televideo in AD biomarker disclosure, although our study sample and design have important limitations for generalizability.
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Affiliation(s)
- Claire M. Erickson
- Department of Medical Ethics and Health PolicyUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaPennsylvaniaUSA
| | - Nathaniel A. Chin
- Department of MedicineDivision of Geriatrics & GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Hannah L. Rosario
- Department of MedicineDivision of Geriatrics & GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Amanda Peterson
- Department of MedicineDivision of Geriatrics & GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Department of MedicineDivision of Geriatrics & GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Lindsay R. Clark
- Department of MedicineDivision of Geriatrics & GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
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Loring DW, Lah JJ, Goldstein FC. Telehealth equivalence of the Montreal cognitive assessment (MoCA): Results from the Emory healthy brain study (EHBS). J Am Geriatr Soc 2023; 71:1931-1936. [PMID: 36762513 PMCID: PMC10258135 DOI: 10.1111/jgs.18271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/10/2023] [Accepted: 01/15/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND We investigated potential differences between in-person cognitive testing and video telehealth administration of the Montreal Cognitive Assessment (MoCA). In addition to the MoCA, the Patient Health Questionnaire-8 (PHQ-8) and Generalized Anxiety Disorder-7 (GAD-7) were administered. METHODS MoCA scores from participants in the Emory Health Brain Study (EHBS) were contrasted based upon whether they were administered the MoCA in the standard face-to-face (F2F) assessment setting (n = 1205) or using a video telehealth administration (n = 491). All EHBS participants were self-reported to be cognitively normal. RESULTS MoCA scores did not differ across administration method (F2F MoCA = 26.6, SD = 2.4; telehealth MoCA = 26.5, SD = 2.4). The 95% confidence interval for difference in administration was small (CI = -0.16 to 0.34). When examining MoCA domain scores, administration differences were either associated with no statistically significant effect, or if present due to large sample sizes, were associated with small effects and differences <0.5 point. Telehealth patients reported slightly lower PHQ-8 scores (F2F PHQ-8 = 2.0, SD = 2.5; telehealth PHQ-8 = 1.6, SD = 2.1), although these scores are well within the normal range. No group difference in GAD-7 scores was present (F2F GAD-7 = 1.4, SD = 2.4; telehealth PHQ-8 = 1.4, SD = 2.4). DISCUSSION This report with its large sample size and between subject cohort provides complementary evidence to smaller test-retest studies, further supporting equivalence of MoCA telehealth testing to F2F MoCA administration. These findings provide additional reassurance that administration mode does not introduce systematic performance differences for MoCA test administration, thereby permitting telehealth MoCA testing to be applied confidently for both clinical and research applications.
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Affiliation(s)
- David W. Loring
- Department of Neurology, Emory University School of Medicine
- Department of Pediatrics, Emory University School of Medicine
| | - James J. Lah
- Department of Neurology, Emory University School of Medicine
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Muili AO, Mustapha MJ, Offor MC, Oladipo HJ. Emerging roles of telemedicine in dementia treatment and care. Dement Neuropsychol 2023; 17:e20220066. [PMID: 37261258 PMCID: PMC10229090 DOI: 10.1590/1980-5764-dn-2022-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/20/2022] [Accepted: 01/20/2023] [Indexed: 06/02/2023] Open
Abstract
Dementia is a neurological disorder that affects memory, thinking, orientation, and other important functions of the brain; telemedicine is a part of the healthcare delivery system involving diagnosis and consultation over telecommunications devices such as mobile phones and computers. In this review, we assessed the impact, accessibility, and possible improvements in telemedicine in dementia treatment. Regarding the use of telemedicine in the treatment, we evaluated its impact on the management of the disease (i.e., diagnosis and follow-up). We also evaluated studies on the current improvements and accessibility of telemedicine in dementia treatment. The review findings showed that it is effective in diagnosing patients, monitoring their progress during treatment, and providing caregiver support. However, studies have revealed a lack of accessibility and improvement in telemedicine among the elderly, particularly in West African countries. Finally, lasting solutions were provided to address the problems in the review permanently.
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Duricy E, Durisko C, Dickey MW, Fiez JA. Comparing the Reliability of Virtual and In-Person Post-Stroke Neuropsychological Assessment with Language Tasks. Arch Clin Neuropsychol 2023; 38:557-569. [PMID: 36537281 PMCID: PMC10202548 DOI: 10.1093/arclin/acac100] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE Neuropsychological testing is essential for both clinical and basic stroke research; however, the in-person nature of this testing is a limitation. Virtual testing overcomes the hurdles of geographic location, mobility issues and permits social distancing, yet its validity has received relatively little investigation, particularly in comparison with in-person testing. METHOD We expand on our prior findings of virtual testing feasibility by assessing virtual versus in-person administration of language and communication tasks with 48 left-hemisphere stroke patients (21 F, 27 M; mean age = 63.4 ± 12; mean years of education = 15.3 ± 3.5) in a quasi-test-retest paradigm. Each participant completed two testing sessions: one in their home and one in the research lab. Participants were assigned to one of the eight groups, with the testing condition (fully in-person, partially virtual), order of home session (first, second) and technology (iPad, Windows tablet) varied across groups. RESULTS Across six speech-language tasks that utilized varying response modalities and interfaces, we found no significant difference in performance between virtual and in-person testing. However, our results reveal key considerations for successful virtual administration of neuropsychological tests, including technology complications and disparities in internet access. CONCLUSIONS Virtual administration of neuropsychological assessments demonstrates comparable reliability with in-person data collection involving stroke survivors, though technology issues must be taken into account.
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Affiliation(s)
- Erin Duricy
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
| | - Corrine Durisko
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Michael Walsh Dickey
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, USA
| | - Julie A Fiez
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Center for the Neural Basis of Cognition, Pittsburgh, PA 15213, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Negrini D, Schmidt SL. Comparing online and face-to-face administration of a neuropsychological computerized attention test: Assessment modality does not influence performance. Front Psychol 2023; 14:1134047. [PMID: 37179859 PMCID: PMC10169630 DOI: 10.3389/fpsyg.2023.1134047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
Background The cognitive impairment associated with the COVID-19 pandemic highlighted the need for teleneuropsychology (1). Moreover, neurologic diseases associated with mental deterioration usually require the use of the same neuropsychological instrument to assess cognitive changes across time. Therefore, in such cases, a learning effect upon retesting is not desired. Attention and its subdomains can be measured using Go/no-go tests, such as, the Continuous Visual Attention Test (CVAT). Here, we administered the CVAT to investigate the effect of modality (online vs. face-to-face) on attentional performance. The variables of the CVAT measures four attention domains: focused-attention, behavioral-inhibition, intrinsic-alertness (reaction time, RT), and sustained-attention (intra-individual variability of RTs, VRT). Methods The CVAT was applied face-to face and online in 130 adult Americans and 50 adult Brazilians. Three different study designs were used: (1) Between-subjects design: healthy Americans were tested face-to-face (n = 88) or online (n = 42). We verified if there were any differences between the two modalities. (2) Within-subjects design: Brazilians participants (n = 50) were tested twice (online and face-to-face). For each CVAT variable, repeated measures ANCOVAs were performed to verify whether modality or first vs. second tests differ. Agreement was analyzed using Kappa, intraclass correlation coefficients, and Bland-Altman plots. (3) Paired comparisons: we compared Americans vs. Brazilians, pairing subjects by age, sex, and level of education, grouping by modality. Results Assessment modality did not influence performance using two independent samples (between-subjects design) or the same individual tested twice (within-subjects design). The second test and the first test did not differ. Data indicated significant agreements for the VRT variable. Based on paired samples, Americans did not differ from Brazilians and a significant agreement was found for the VRT variable. Conclusion The CVAT can be administered online or face-to-face without learning upon retesting. The data on agreement (online vs. face-to-face, test vs. retest, Americans vs. Brazilians) indicate that VRT is the most reliable variable. Limitations High educational level of the participants and absence of a perfect balanced within-subjects design.
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Affiliation(s)
- Daniel Negrini
- Department of Anesthesiology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
- School of Medicine, Fluminense Federal University, Niterói, Brazil
| | - Sergio L. Schmidt
- Department of Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Seubert-Ravelo AN, Serrano-Juárez CA, Cabañas-Tinajero JÁ, González-Gutiérrez FA, Moreno-Villagómez J, Prieto-Corona B, Reyes-Méndez C, Téllez-Rodríguez M, Yáñez-Téllez MG. Teleneuropsychology during the COVID-19 pandemic in Mexico: the perspective from a middle-income country. J Clin Exp Neuropsychol 2023; 45:12-30. [PMID: 36912340 DOI: 10.1080/13803395.2023.2189229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION The use of teleneuropsychology (TeleNP) increased as a result of the COVID-19 pandemic; however, there have been no studies of the benefits and difficulties with this modality in middle-income countries. This study aimed to assess the current use of TeleNP in Mexico. METHOD Mexican neuropsychologists were invited to participate in an online survey regarding the use of TeleNP during the COVID-19 pandemic. The survey was based on issues from a literature review and consisted of 36 questions requiring yes/no, multiple choice, or ordinal answers. The survey was created using Google Forms and asked respondents to provide informed consent. A total of 107 clinical neuropsychologists completed the survey. RESULTS 82% of participants currently use TeleNP, and most reported learning about TeleNP through personal experience, literature research, and colleagues. Brief evaluations, delivery of results, and intervention were the principal services provided, most frequently on a home-to-home basis. Almost 30% of clinicians reported not requiring informed consent for use of the modality. Consultations included children, adolescents, and adults in similar numbers; older adults were less frequent. Technological limitations were the most frequent reason for ruling out the modality with particular patients. Perceived benefits included the ability to continue consultations despite social distancing measures, lesser risk of COVID-19 infection, and the possibility of seeing patients with limited access to neuropsychological services. Reasons for not using TeleNP included a lack of standardized instruments, not feeling comfortable with the modality, and lack of technological resources and skills. CONCLUSIONS Despite the socioeconomic differences between Mexico and high-income countries, most of our findings were similar to reports from those countries. However, technological limitations were common, and smartphones were commonly used, contrary to recommendations in the literature. The future use of TeleNP in Mexico should include formal training and ethical guidelines.
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Affiliation(s)
- Ana Natalia Seubert-Ravelo
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carlos Alberto Serrano-Juárez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - José-Ángel Cabañas-Tinajero
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Fátima Aideé González-Gutiérrez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Julieta Moreno-Villagómez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Belén Prieto-Corona
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carolina Reyes-Méndez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Marybeth Téllez-Rodríguez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Ma Guillermina Yáñez-Téllez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
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Vaccaro R, Aglieri V, Rossi M, Pettinato L, Ceretti A, Colombo M, Guaita A, Rolandi E. Remote testing in Abbiategrasso (RTA): results from a counterbalanced cross-over study on direct-to-home neuropsychology with older adults. Aging Clin Exp Res 2023; 35:699-710. [PMID: 36710319 PMCID: PMC9884598 DOI: 10.1007/s40520-023-02343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic forced to rethink teleneuropsychology, since neuropsychological assessments started to be performed by phone or videoconference, with personal devices and without direct assistance from the clinician, a practice called "Direct-To-Home NeuroPsychology" (DTH-NP). AIMS The present study, employing a counterbalanced cross-over design, was aimed at evaluating (1) the feasibility and (2) the acceptability of DTH-NP in Italian older adults without previously diagnosed neurocognitive disorder, (3) the comparability between remote and face-to-face administration of selected neuropsychological tests. METHODS Fifty-eight community-dwelling older adults (65-85 years) were randomly assigned to one of two groups performing a complete neuropsychological assessment remotely (via phone call and videoconference) and face-to-face, in a counterbalance order, 8 weeks apart. The study recruitment rate was calculated, and the number of uncompleted tests and acceptability questionnaire responses were compared between the two administration modalities. Comparability was defined as good reliability of DTH-NP (intraclass correlation coefficient) and agreement between remote and face-to-face scores (Bland-Altman plots). RESULTS Recruitment rate was 81%, with a preference for telephonic contact (79%). The acceptability analysis did not reveal any issues related to the DTH-NP assessment, even if most participants would rather repeat it face-to-face. Tests assessing short-term memory, language, and reasoning showed good comparability. DISCUSSION AND CONCLUSION Our results point out to a good recruitment rate in a DTH-NP study in an Italian population of older adults (mean age = 80), satisfying acceptability of DTH-NP and remote-face-to-face comparability of certain verbally mediated tests. Further studies including larger samples in videoconference modality, and outpatients, could better clarify its strengths and limits.
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Affiliation(s)
- Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Virginia Aglieri
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy.
| | - Michele Rossi
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Laura Pettinato
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
- Camillo Golgi Geriatric Institute, Abbiategrasso, Milan, Italy
| | - Arcangelo Ceretti
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Mauro Colombo
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Koay JM, Spat-Lemus J, Cornwell MA, Sacks-Zimmerman A, Mandelbaum S, Kohn A, McLean E, Meli G, Bender HA. The Evolving Need for Neuropsychology in Neurosurgical Settings: Challenges Facing Transformative Care. World Neurosurg 2023; 170:277-285. [PMID: 36782426 DOI: 10.1016/j.wneu.2022.09.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/10/2023]
Abstract
Clinical neuropsychology has been a valuable asset to neurologic surgery, contributing to lateralization and localization of pathologic brain tissue, identification of eloquent cortex, and evaluation of postoperative neuropsychological functioning. Moreover, neuropsychologists provide empirically driven interventions aimed at supporting preparation and/or recovery of neurosurgery patients. Nonetheless, several challenges may limit the reliability, validity, and generalizability of the assessment data obtained and reduce the usefulness of other neuropsychological services provided. Specifically, linguistic, cultural, educational, and other biases associated with demographic characteristics can lead to a narrowed view of an individual's life experiences, which must be confronted to fulfill the mission of ensuring that all patients have access to care that is appropriate to their needs. Instead of perceiving these challenges as insurmountable barriers, such issues can be viewed as opportunities to catalyze change and foster innovation for the future of neuropsychological care in neurosurgical settings. In addition to reviewing the possible mechanisms of these obstacles, the current article offers tangible solutions at both a macro level (e.g., discipline-wide transformations) and micro level (e.g., individualized patient-centric approaches). Outlined are practical techniques to potentially improve consensus and standardization of methods, advance and globalize research, expand representativeness of measures and practices to serve diverse individuals, and increase treatment adherence through engagement of patients and their families.
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Affiliation(s)
- Jun Min Koay
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Erin McLean
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
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Sumpter R, Camsey E, Meldrum S, Alford M, Campbell I, Bois C, O'Connell S, Flood J. Remote neuropsychological assessment: Acceptability and feasibility of direct-to-home teleneuropsychology methodology during the COVID-19 pandemic. Clin Neuropsychol 2023; 37:432-447. [PMID: 35505636 DOI: 10.1080/13854046.2022.2056922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To determine the acceptability and feasibility of telephone and video-conference calls to complete cognitive assessments during the COVID-19 pandemic. METHOD In rapid response to the pandemic, evidence-based adaptations were made to routine face-to-face (FTF) practice, delivering teleneuropsychology (TNP) within a National Health Service (NHS) Scotland neuropsychology service. Caldicott guardian approval was obtained to complete a six month study (April to October 2020) from the early stages of the first United Kingdom (UK) lockdown. Assessments were completed with patients in their own homes (direct-to-home) via remote connections. Neuropsychology clinicians, service-users and referring agents were approached for structured feedback and qualitative comment. RESULTS Data was captured for 212 referrals assessed by seven clinical psychologists; with responses from 70 (33%) service-users and 14 (58%) referring agents. 94% of referrals were assessed remotely and discharged. TNP reduced defaulted appointment discharge rates. Gender, socioeconomic deprivation and age did not affect access to information technology (IT) equipment.Clinicians agreed that remote assessment allowed them to complete initial interview (96%) and formulate (77%) cases appropriately. Service-users agreed they were comfortable with equipment (84%), the process was straightforward (74%), and would recommend TNP to others (68%). Referring agents were satisfied with the service provided (100%). Limitations included evidence-based remote test availability, technical issues and home distractions. CONCLUSIONS Study findings evidence the acceptability and efficiency of TNP; increasing service accessibility, while reducing infection risk, defaulted appointments and travel. The results advocate for a post-pandemic mixed model of service delivery encompassing both FTF and TNP approaches.
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Affiliation(s)
| | | | | | - Max Alford
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | | | | | | | - John Flood
- NHS Greater Glasgow & Clyde, Glasgow, UK
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Kohli M, Fisher A, Sun-Suslow N, Heaton A, Dawson MS, Marquie J, Franklin DR, Marquine M, Iudicello JE, Heaton RK, Moore DJ. Concurrent validity and reliability of at-home teleneuropsychological evaluations among people with and without HIV. J Int Neuropsychol Soc 2023; 29:193-204. [PMID: 36510855 PMCID: PMC10205080 DOI: 10.1017/s1355617722000777] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To determine the reliability of teleneuropsychological (TNP) compared to in-person assessments (IPA) in people with HIV (PWH) and without HIV (HIV-). METHODS Participants included 80 PWH (Mage = 58.7, SDage = 11.0) and 23 HIV- (Mage = 61.9, SDage = 16.7). Participants completed two comprehensive neuropsychological IPA before one TNP during the COVID-19 pandemic (March-December 2020). The neuropsychological tests included: Hopkins Verbal Learning Test-Revised (HVLT-R Total and Delayed Recall), Controlled Oral Word Association Test (COWAT; FAS-English or PMR-Spanish), Animal Fluency, Action (Verb) Fluency, Wechsler Adult Intelligence Scale 3rd Edition (WAIS-III) Symbol Search and Letter Number Sequencing, Stroop Color and Word Test, Paced Auditory Serial Addition Test (Channel 1), and Boston Naming Test. Total raw scores and sub-scores were used in analyses. In the total sample and by HIV status, test-retest reliability and performance-level differences were evaluated between the two consecutive IPA (i.e., IPA1 and IPA2), and mean in-person scores (IPA-M), and TNP. RESULTS There were statistically significant test-retest correlations between IPA1 and IPA2 (r or ρ = .603-.883, ps < .001), and between IPA-M and TNP (r or ρ = .622-.958, ps < .001). In the total sample, significantly lower test-retest scores were found between IPA-M and TNP on the COWAT (PMR), Stroop Color and Word Test, WAIS-III Letter Number Sequencing, and HVLT-R Total Recall (ps < .05). Results were similar in PWH only. CONCLUSIONS This study demonstrates reliability of TNP in PWH and HIV-. TNP assessments are a promising way to improve access to traditional neuropsychological services and maintain ongoing clinical research studies during the COVID-19 pandemic.
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Affiliation(s)
- Maulika Kohli
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Arin Fisher
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Ni Sun-Suslow
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Anne Heaton
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Matthew S Dawson
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Jennifer Marquie
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Donald R Franklin
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
| | - Maria Marquine
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Jennifer E Iudicello
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Robert K Heaton
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - David J Moore
- HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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Development and Evaluation of a Virtual Model for Fetal Alcohol Spectrum Disorder (FASD) Assessment and Diagnosis in Children: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020196. [PMID: 36832325 PMCID: PMC9955009 DOI: 10.3390/children10020196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 01/22/2023]
Abstract
The diagnostic process for fetal alcohol spectrum disorder (FASD) involves a multi-disciplinary team and includes neurodevelopmental, physical, and facial assessments and evidence of prenatal alcohol exposure during the index pregnancy. With the increased use of virtual care in health care due to the pandemic, and desire of clinics to be more efficient when providing timely services, there was a need to develop a virtual diagnostic model for FASD. This study develops a virtual model for the entire FASD assessment and diagnostic process, including individual neurodevelopmental assessments. It proposes a virtual model for assessment and diagnosis of FASD in children and evaluates the functionality of this model with other national and international FASD diagnostic teams and caregivers of children being assessed for FASD.
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Nakamura ZM, Deal AM, Park EM, Stanton KE, Lopez YE, Quillen LJ, O'Hare Kelly E, Heiling HM, Nyrop KA, Ray EM, Dees EC, Reeder-Hayes KE, Jolly TA, Carey LA, Abdou Y, Olajide OA, Rauch JK, Joseph R, Copeland A, McNamara MA, Ahles TA, Muss HB. A phase II single-arm trial of memantine for prevention of cognitive decline during chemotherapy in patients with early breast cancer: Feasibility, tolerability, acceptability, and preliminary effects. Cancer Med 2023; 12:8172-8183. [PMID: 36645168 PMCID: PMC10134315 DOI: 10.1002/cam4.5619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Cognitive difficulties have been described after chemotherapy for breast cancer, but there is no standard of care to improve cognitive outcomes in these patients. This trial examined the feasibility, tolerability, acceptability, and preliminary effects of memantine to prevent cognitive decline during chemotherapy for breast cancer. METHODS Patients with stage I-III breast cancer, scheduled for neo/adjuvant chemotherapy, completed a cognitive battery prior to and 4 weeks after completing chemotherapy. Memantine (10 mg BID) was administered concurrent with chemotherapy. Our primary cognitive outcome was visual working memory assessed by the Delayed Matching to Sample test. We used the Brief Medication Questionnaire to assess acceptability. RESULTS Of 126 patients approached, 56 (44%) enrolled. Forty-five (80%) received ≥1 dose of memantine and completed pre-post assessments. Seventy-six percent reported taking ≥90% of scheduled doses. Participants were mean age of 56, 77% White, and 57% had stage I disease. Sixty-four percent had stable or improved Delayed Matching to Sample test scores. Stable or improved cognition was observed in 87%-91% across objective cognitive domain composite measures. Sixty-six percent self-reported stable or improved cognitive symptoms. There were seven greater than or equal to grade 3 adverse events; two were possibly related to memantine. Only 5% reported that taking memantine was a disruption to their lives. CONCLUSIONS Memantine was well-tolerated and consistently taken by a large majority of patients receiving breast cancer chemotherapy. The majority demonstrated stable or improved cognition from pre- to post-assessment. Randomized trials are needed to determine memantine's efficacy to ameliorate cognitive loss. TRIAL REGISTRATION ClinicalTrials.gov NCT04033419.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Eliza M Park
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kate E Stanton
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yesy E Lopez
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Laura J Quillen
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin O'Hare Kelly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily M Ray
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - E Claire Dees
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Katherine E Reeder-Hayes
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Trevor A Jolly
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lisa A Carey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Yara Abdou
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Julia K Rauch
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Ranjit Joseph
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Anureet Copeland
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Megan A McNamara
- Rex Hematology Oncology Associates, Rex Cancer Care, Raleigh, North Carolina, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Rizzi E, Vezzoli M, Pegoraro S, Facchin A, Strina V, Daini R. Teleneuropsychology: normative data for the assessment of memory in online settings. Neurol Sci 2023; 44:529-538. [PMID: 36197578 PMCID: PMC9533275 DOI: 10.1007/s10072-022-06426-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/22/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has forced significant changes in clinical practice. Psychologists and neuropsychologists had to modify their settings to assess patients' abilities, switching from an in-person modality to a remote setting by using video calling platforms. Consequently, this change brought about the need for new normative data tailored to remote settings. AIM AND METHODS The study aimed to develop normative data for the online assessment of neuropsychological memory tests and to compare it with the published norms obtained in standard settings. Two hundred and four healthy Italian volunteers performed three verbal memory tests through the Google Meet platform: the Digit Span (Backward and Forward), the Rey Auditory Verbal Learning, and the Verbal Paired Associated Learning Test. RESULTS This research provides specific norms that consider the influence of demographic characteristics. Their comparison with published norms shows a medium to high agreement between systems. The present study provides a reference for the clinical use of neuropsychological instruments to assess verbal memory in a remote setting and offers specific recommendations.
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Affiliation(s)
- Ezia Rizzi
- Department of Social and Human Science, University of Salento, Studium 2000, Via di Valesio, 73100 Lecce, Italy ,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Michela Vezzoli
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Sara Pegoraro
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Alessio Facchin
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Veronica Strina
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Roberta Daini
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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Lu AD, Veet CA, Aljundi O, Whitaker E, Smith WB, Smith JE. A Systematic Review of Physical Examination Components Adapted for Telemedicine. Telemed J E Health 2022; 28:1764-1785. [PMID: 35363573 DOI: 10.1089/tmj.2021.0602] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction: The COVID-19 pandemic ushered in a rapid, transformative adoption of telemedicine to maintain patient access to care. As clinicians made the shift from in-person to virtual practice, they faced a paucity of established and reliable clinical examination standards for virtual care settings. In this systematic review, we summarize the accuracy and reliability of virtual assessments compared with traditional in-person examination tools. Methods: We searched PubMed, Embase, Web of Science, and CINAHL from inception through September 2019 and included additional studies from handsearching of reference lists. We included studies that compared synchronous video (except allowing for audio-only modality for cardiopulmonary exams) with in-person clinical assessments of patients in various settings. We excluded behavioral health and dermatological assessments. Two investigators abstracted data using a predefined protocol. Results: A total of 64 studies were included and categorized into 5 clinical domains: neurological (N = 41), HEENT (head, eyes, ears, nose, and throat; N = 5), cardiopulmonary (N = 5), musculoskeletal (N = 8), and assessment of critically ill patients (N = 5). The cognitive assessment within the neurological exam was by far the most studied (N = 19) with the Mini-Mental Status Exam found to be highly reliable in multiple settings. Most studies showed relatively good reliability of the virtual assessment, although sample sizes were often small (<50 participants). Conclusions: Overall, virtual assessments performed similarly to in-person exam components for diagnostic accuracy but had a wide range of interrater reliability. The high heterogeneity in population, setting, and outcomes reported across studies render it difficult to draw broad conclusions on the most effective exam components to adopt into clinical practice. Further work is needed to identify virtual exam components that improve diagnostic accuracy.
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Affiliation(s)
- Amy D Lu
- Division of General Internal Medicine, Denver Health and Hospital Authority, Denver, Colorado, USA.,Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Clark A Veet
- Lehigh Valley Health Network, Allentown, Pennsylvania, USA
| | - Omar Aljundi
- Palo Alto Medical Foundation Medical Group, San Carlos, California, USA
| | - Evans Whitaker
- School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - William B Smith
- San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.,Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Janeen E Smith
- San Francisco Veterans Affairs Health Care System, San Francisco, California, USA.,Department of Medicine, University of California San Francisco, San Francisco, California, USA
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Gonzalez JA, Clark US, Byrd D, Clarke Y, Greenwood K, Tell E, Carrion-Park C, Pizzirusso M, Burgess R, Morgello S. Preliminary Findings from a Telephone-Based Cognitive Screening of an Adult HIV Research Cohort during the COVID-19 Pandemic. Arch Clin Neuropsychol 2022; 37:1710-1719. [PMID: 35780306 PMCID: PMC9278200 DOI: 10.1093/arclin/acac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Few publications have documented the utility of in-home telephone-based cognitive screeners during COVID-19. This manuscript describes the adaptation of select face-to-face (FTF) neuropsychological tests to telephonic administration in a longitudinal cohort of people with HIV (PWH). Using the cohort's pre-pandemic neuropsychological data, we explore the utility of telephonic administration in this population. METHODS Of a longitudinal cohort of 170 adult PWH, 59 completed telephonic medical and cognitive screenings with comparable pre-pandemic FTF data. Telephone screeners and FTF evaluations were compared using repeated measures ANCOVAs to examine whether test performance differed between administration types and levels of pre-pandemic cognitive performance. Individuals with pre-pandemic test scores more than a standard deviation below the demographically-corrected mean were categorized as "below average" cognitive performance (n = 23), and the remainder as "average" (n = 36). RESULTS Over 90% of participants gave positive feedback about the telephone encounter. The average cognitive performance group scored higher than the below average group on all measures across both administration types. Telephone and FTF test scores did not differ significantly for measures of category fluency, letter fluency, and verbal learning. However, the below average group scored higher on a verbal memory measure administered via telephone compared with FTF. CONCLUSIONS Support for telephonic adaptation of select FTF measures in longitudinal research is mixed, with verbal fluency tasks showing the strongest equivalency. When employed carefully with a clear understanding of their limitations, telephone adaptations can provide an opportunity to continue study objectives, promote equity, and monitor participant well-being during times of duress.
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Affiliation(s)
- Jairo A Gonzalez
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Uraina S Clark
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Psychology, Queens College & The Graduate Center, The City University of New York, New York City, NY, USA
| | - Yusuf Clarke
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Kaitlyn Greenwood
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Elizabeth Tell
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Cira Carrion-Park
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Maria Pizzirusso
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Rhonda Burgess
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Neuroscience, The Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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Fox-Fuller JT, Ngo J, Pluim CF, Kaplan RI, Kim DH, Anzai JAU, Yucebas D, Briggs SM, Aduen PA, Cronin-Golomb A, Quiroz YT. Initial investigation of test-retest reliability of home-to-home teleneuropsychological assessment in healthy, English-speaking adults. Clin Neuropsychol 2022; 36:2153-2167. [PMID: 34311660 PMCID: PMC8789947 DOI: 10.1080/13854046.2021.1954244] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Prior teleneuropsychological research has assessed the reliability between in-person and remote administration of cognitive assessments. Few, if any, studies have examined the test-retest reliability of cognitive assessments conducted in sequential clinic-to-home or home-to-home teleneuropsychological evaluations - a critical issue given the state of clinical practice during the COVID-19 pandemic. This study examined this key psychometric question for several cognitive tests administered over repeated videoconferencing visits 4-6 months apart in a sample of healthy English-speaking adults. A total of 44 participants (ages 18-75) completed baseline and follow-up cognitive testing 4-6 months apart. Testing was conducted in a home-to-home setting over HIPAA-compliant videoconferencing meetings on participants' audio-visual enabled laptop or desktop computers. The following measures were repeated at both virtual visits: the Controlled Oral Word Association Test (FAS), Category Fluency (Animals), and Digit Span Forward and Backward from the Wechsler Adult Intelligence Scale, Fourth Edition. Intraclass correlation coefficients (ICC), Pearson correlations, root mean square difference (RMSD), and concordance correlation coefficients (CCC) were calculated as test-retest reliability metrics, and practice effects were assessed using paired-samples t-tests. Some tests exhibited small practice effects, and test-retest reliability was marginal or worse for all measures except FAS, which had adequate reliability (based on ICC and r). Reliability estimates with RMSD suggested that change within +/- 1 SD on these measures may reflect typical test-retest variability. The included cognitive measures exhibited questionable reliability over repeated home-to-home videoconferencing evaluations. Future teleneuropsychology test-retest reliability research is needed with larger, more diverse samples and in clinical populations.
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Affiliation(s)
- Joshua T. Fox-Fuller
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Julie Ngo
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Celina F. Pluim
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rini I. Kaplan
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Dong-Ho Kim
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Juliana A. U. Anzai
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Defne Yucebas
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Soibifaa M. Briggs
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Paula A. Aduen
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Yakeel T. Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Gold D, Stockwood J, Boulos K, Kasha S, Vyshedskiy A, deTorres L, Ostrovsky S, Durakovic D, Savchenko A, Piryatinsky I. The Boston cognitive assessment: Psychometric foundations of a self-administered measure of global cognition. Clin Neuropsychol 2022; 36:2313-2330. [PMID: 34075854 DOI: 10.1080/13854046.2021.1933190] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: The Boston Cognitive Assessment (BoCA) is a novel, computerized, self-administered assessment of global cognition. This work sought to establish the validity and reliability of the BoCA. Method: Two studies were conducted. The first study used a sample of 43 outpatients from a clinic in eastern Massachusetts to evaluate the content validity and internal consistency of the BoCA. The second study used a sample of 38 patients seen at an outpatient specialty neurological clinic to evaluate the BoCA's test-retest reliability after one week. Results: In the first study, participants without cognitive diagnoses scored significantly higher on both the BoCA and the Telephone Interview for Cognitive Status (TICS) compared to those with mild Neurocognitive Disorders. Correlational analyses revealed moderate correlations between several of the BoCA tasks and measures of related abilities. Exploratory factor analysis of the BoCA tasks revealed one robust factor accounting for a plurality (i.e., 42%) of variance in participant scores. The BoCA demonstrated good internal consistency (α = 0.79) and strong correlations (r = 0.80, p < 0.01) with the TICS. The second study revealed strong (r = 0.89, p < 0.001) test-retest reliability of the total BoCA score one week after participants' initial administration. Conclusions: This work provides evidence of the BoCA's psychometric properties as a self-administered screener of global cognition, and supports its implementation in clinical practice and future studies. Clinical implications, future directions, and limitations are discussed.
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Affiliation(s)
- Dov Gold
- Department of Clinical Psychology, William James College, Newton, MA, USA
| | - Jennifer Stockwood
- Department of Clinical Psychology, William James College, Newton, MA, USA
| | - Kirolos Boulos
- Department of Clinical Psychology, William James College, Newton, MA, USA
| | - Sabrina Kasha
- Department of Clinical Psychology, William James College, Newton, MA, USA
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John SE, Evans SA, Kim B, Ozgul P, Loring DW, Parker M, Lah JJ, Levey AI, Goldstein FC. Examination of the reliability and feasibility of two smartphone applications to assess executive functioning in racially diverse older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:1068-1086. [PMID: 34382482 PMCID: PMC8837703 DOI: 10.1080/13825585.2021.1962790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
Inclusion of Black participants in clinical research is a national priority. Mobile applications and remote data collection may increase study access for diverse populations. This study examined the reliability and feasibility of two mobile smartphone application-based cognitive measures in a diverse middle aged and older adult sample. Black (n = 44; Mage = 59.93) and non-Hispanic white (NHW; n = 50; Mage = 61.06) participants completed traditional paper-based neuropsychological testing and two app-based measures, Arrows and Number Match. Intraclass correlations demonstrated poor to moderate reliability (range: .417-.569) between performance on the app-based versions and performance on the traditional versions. Performance score differences by racial group were not statistically significant. Both Black and NHW participants rated the app-based measures as feasible and acceptable, though Black participants endorsed a stronger likelihood of future use. These findings add to the growing literature on remote cognitive testing .
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Affiliation(s)
- Samantha E. John
- Department of Brain Health, School of Integrated Health Sciences, UNLV, Las Vegas, NV, USA
| | - Sarah A. Evans
- Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Bona Kim
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Petek Ozgul
- Emory Goizueta Alzheimer’s Disease Research Center, Atlanta, GA, USA
| | - David W. Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Monica Parker
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - James J. Lah
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Emory Goizueta Alzheimer’s Disease Research Center, Atlanta, GA, USA
| | - Allan I. Levey
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Emory Goizueta Alzheimer’s Disease Research Center, Atlanta, GA, USA
| | - Felicia C. Goldstein
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Emory Goizueta Alzheimer’s Disease Research Center, Atlanta, GA, USA
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Equivalency of In-Person Versus Remote Assessment: WISC-V and KTEA-3 Performance in Clinically Referred Children and Adolescents. J Int Neuropsychol Soc 2022; 28:835-844. [PMID: 34569463 PMCID: PMC9026666 DOI: 10.1017/s1355617721001053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Teletesting has the potential to reduce numerous barriers to patient care which have only become exacerbated during the COVID-19 pandemic. Although telehealth is commonly utilized throughout medicine and mental health practices, teletesting has remained limited within cognitive and academic evaluations. This may be largely due to concern for the validity of test administration via remote assessment. This cross-sectional study examined the equivalency of cognitive [Wechsler Intelligence Scales for Children - Fifth Edition (WISC-V)] and academic [Kaufman Test of Educational Achievement - Third Edition (KTEA-3)] subtests administered via either teletesting or traditional in-person testing within clinically referred youth. METHOD Chart review using a retrospective, cross-sectional design included a total of 893 children and adolescents, ranging from 4 to 17 years (Mean age = 10.2 years, SD = 2.9 years) who were administered at least one subtest from the aforementioned cognitive or academic assessments. Of these, 285 received teletesting, with the remaining (n = 608) receiving in-person assessment. A total of seven subtests (five from the WISC-V and two from the KTEA-3) were examined. A series of inverse probability of exposure weighted (IPEW) linear regression models examined differences between groups for each of the seven subtests after adjustment for numerous demographic, diagnostic, and parent-reported symptom variables. RESULTS Only two significant differences were found, such that WISC-V Visual Puzzles (p < .01) and KTEA-3 Math Concepts (p = .03) scores were slightly higher in the teletesting versus in-person groups. However, these differences were quite small in magnitude (WISC-V Visual Puzzles, d = .33, KTEA-3 Math Concepts, d = .18). CONCLUSIONS Findings indicate equivalency across methods of service delivery without clinically meaningful differences in scores among referred pediatric patients.
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Messler A, Hargrave D, Sordahl J. VA psychologists' professional practices and attitudes toward tele-neuropsychology among a tele-neuropsychology interest group within the Veterans Health Administration. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 36041462 DOI: 10.1080/23279095.2022.2115911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To provide understanding of practices and attitudes toward tele-neuropsychology (teleNP) among Veterans Health Administration (VA) psychologists who have joined a related community of practice. METHODS Several VA psychologists (the authors) developed this survey to better understand dissemination of teleNP and attitudes toward teleNP among those involved in a VA teleNP community of practice. We contacted VA psychologists within this group to complete the survey. The survey was open from July to August 2021, during which time a total of 62 VA psychologists participated. RESULTS Response rate was estimated to be 41% of those receiving the survey (62 respondents). Approximately two thirds of those completing the survey reported current practice of teleNP (68%; n = 42). In contrast, only 25% of the entire sample (n = 15) conducted any teleNP pre-pandemic. Job satisfaction related to being able to perform teleNP is high. Support for continued and increased use of teleNP is high, with most respondents (84%) indicating they will be at least somewhat likely to practice teleNP post-pandemic. CONCLUSIONS The survey provides increased support for the use of teleNP by VA psychologists who responded to the survey, with significantly increased adoption since the Covid-19 pandemic, and greater likelihood of intention to use teleNP post pandemic.
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Affiliation(s)
- Ana Messler
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - David Hargrave
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - Jeffrey Sordahl
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
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Lasprilla JCA, Rodríguez-Irizarry W, Oliveras-Rentas RE, Ramos-Usuga D, Gonzalez I, Perez PK, Romero-García I. Hispanic neuropsychologists in the United States: What do we know about them and how can the field address their needs? NeuroRehabilitation 2022; 51:101-121. [DOI: 10.3233/nre-210333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Despite numerous calls throughout the years for an increase in ethnic, cultural, and racial diversity within the field of psychology, it remains an elusive reality for Hispanic neuropsychology practitioners in the United States (U.S.). OBJECTIVE: 1. Determine the background and current work situation of Hispanic clinical neuropsychologists in the U.S. (e.g., professional training, assessment and diagnostic procedures used, rehabilitation techniques employed, populations targeted, teaching responsibilities, and research activities), and 2. Examine issues related to perceived discrimination in the field of neuropsychology and what this means for our profession. METHODS: The sample consisted of 107 Hispanic neuropsychologists residing among the 50 United States, District of Columbia, and Puerto Rico who took a survey of professional practices and experiences in clinical neuropsychology. RESULTS: Our findings confirm that Hispanic neuropsychologists in the U.S. are culturally diverse, present with varied levels of bilingualism, have been faced with discrimination during training and in their workplace, and compare favorably with non-Hispanic neuropsychologists in terms of education and clinical training. CONCLUSIONS: Transforming neuropsychology into a diverse and inclusive field requires intentional, strategic, and systematic interventions in education, academia, training, professional organizations and in research.
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Affiliation(s)
| | - Walter Rodríguez-Irizarry
- Inter American University of Puerto Rico, San Germán Campus, San Germán, Puerto Rico
- Ponce Health Sciences University, Ponce, Puerto Rico
| | | | - Daniela Ramos-Usuga
- Biomedical Research Doctorate Program, University of the Basque Country, Leioa, Spain
| | - Isabel Gonzalez
- Baptist Health South Florida, Miami, FL, USA
- Insight Neurocognitive & Behavioral Center, Miami, FL, USA
| | - Paula Karina Perez
- University of Miami, Miller School of Medicine, Mailman Center for Child Development, Miami, FL, USA
| | - Ivonne Romero-García
- Inter American University of Puerto Rico, San Germán Campus, San Germán, Puerto Rico
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Poppe M, Duffy L, Marchant NL, Barber JA, Hunter R, Bass N, Minihane AM, Walters K, Higgs P, Rapaport P, Lang IA, Morgan-Trimmer S, Huntley J, Walker Z, Brodaty H, Kales HC, Ritchie K, Burton A, Wenborn J, Betz A, Cooper C. The APPLE Tree programme: Active Prevention in People at risk of dementia through Lifestyle, bEhaviour change and Technology to build REsiliEnce-randomised controlled trial. Trials 2022; 23:596. [PMID: 35883143 PMCID: PMC9315085 DOI: 10.1186/s13063-022-06557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large-scale trials of multidomain interventions show that modifying lifestyle and psychological risk factors can slow cognitive decline. We aim to determine if a lower intensity, personally tailored secondary dementia prevention programme for older people with subjective or mild objective memory decline, informed by behaviour change theory, reduces cognitive decline over 2 years. METHODS A multi-site, single-blind randomised controlled trial recruiting 704 older adults at high dementia risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Participants are randomised using 1:1 allocation ratio to the APPLE Tree intervention versus control arm (dementia prevention information), stratified by site. The intervention explores and implements strategies to promote healthy lifestyle, increase pleasurable activities and social connections and improve long-term condition self-management. Two facilitators trained and supervised by a clinical psychologist deliver ten, 1-h group video call sessions over 6 months (approximately every fortnight), video-call 'tea breaks' (less structured, facilitated social sessions) in intervening weeks and individual goal-setting phone calls every 2 weeks. From 6 to 12 months, participants meet monthly for 'tea breaks', with those not attending receiving monthly goal-setting phone calls. Participants receive a food delivery, pedometer and website access to cognitive training and information about lifestyle modification. Follow-ups for all outcome measures are at 12 and 24 months. The primary outcome is cognition (Neuropsychological Test Battery (NTB) score) at 24 months. Secondary outcomes are quality of life, cost per quality-adjusted life year (QALY) and wellbeing and lifestyle factors the intervention targets (diet, vascular risk, body weight, activity, sleep, anxiety, depression, social networks and loneliness, alcohol intake and smoking). Participants from purposively selected sites participate in qualitative process evaluation interviews, which will be analysed using thematic analytic methods. DISCUSSION If effective, the intervention design, involving remote delivery and non-clinical facilitators, would facilitate intervention roll-out to older people with memory concerns. TRIAL REGISTRATION ISRCTN17325135 . Registration date 27 November 2019.
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Affiliation(s)
- M Poppe
- UCL Division of Psychiatry, University College London, London, UK
| | - L Duffy
- UCL Division of Psychiatry, University College London, London, UK
| | - N L Marchant
- UCL Division of Psychiatry, University College London, London, UK
| | - J A Barber
- Department of Statistical Science, University College London, London, UK
| | - R Hunter
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - N Bass
- UCL Division of Psychiatry, University College London, London, UK
| | - A M Minihane
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Walters
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - P Higgs
- UCL Division of Psychiatry, University College London, London, UK
| | - P Rapaport
- UCL Division of Psychiatry, University College London, London, UK
| | - I A Lang
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - S Morgan-Trimmer
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - J Huntley
- UCL Division of Psychiatry, University College London, London, UK
| | - Z Walker
- UCL Division of Psychiatry, University College London, London, UK
| | - H Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - H C Kales
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA
| | - K Ritchie
- Institut de Neurosciences de Montpellier (INM), Montpellier, France
| | - A Burton
- Department of Behavioural Science and Health, University College London, London, UK
| | - J Wenborn
- UCL Division of Psychiatry, University College London, London, UK
| | - A Betz
- Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK
| | - C Cooper
- Queen Mary University London, Centre for Psychiatry and Mental Health, Wolfson Institute for Population Health, London, UK.
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Scheerbaum P, Book S, Jank M, Hanslian E, DellO'ro M, Schneider J, Scheuermann JS, Bösl S, Jeitler M, Kessler C, Graessel E. Computerised cognitive training tools and online nutritional group counselling for people with mild cognitive impairment: study protocol of a completely digital, randomised, controlled trial. BMJ Open 2022; 12:e060473. [PMID: 35777882 PMCID: PMC9252202 DOI: 10.1136/bmjopen-2021-060473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION People with mild cognitive impairment (MCI) are at increased risk of decreasing cognitive functioning. Computerised cognitive training (CCT) and nutrition have been shown to improve the cognitive capacities of people with MCI. For each variable, we developed two kinds of interventions specialised for people with MCI (CCT: 'individualised' CCT; nutrition: a whole-food, plant-based diet). Additionally, there are two kinds of active control measures (CCT: 'basic' CCT; nutrition: a healthy diet following the current guidelines of the German Nutrition Society). The aim of this study is to investigate the effects of the two interventions on cognition in people with MCI in a 2×2 randomised controlled trial with German participants. METHODS AND ANALYSIS Participants will be community-dwelling individuals with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination. With N=200, effects with an effect size of f≥0.24 (comparable to Cohen's d≥0.48) can be detected. Screening, baseline, t6 and t12 testing will be conducted via a videoconferencing assessment, telephone, and online survey. Participants will be randomly allocated to one of four groups and will receive a combination of CCT and online nutritional counselling. The CCT can be carried out independently at home on a computer, laptop, or tablet. Nutrition counselling includes 12 online group sessions every fortnight for 1.5 hours. The treatment phase is 6 months with follow-ups after six and 12 months after baseline. ETHICS AND DISSEMINATION All procedures were approved by the Friedrich-Alexander-Universität Erlangen-Nürnberg Ethics Committee (Ref. 21-318-1-B). Written informed consent will be obtained from all participants. Results will be published in peer-reviewed scientific journals, conference presentations. TRIAL REGISTRATION NUMBER ISRCTN10560738.
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Affiliation(s)
- Petra Scheerbaum
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie Book
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jank
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Genesis Mediware GmbH, Hersbruck, Germany
| | - Etienne Hanslian
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Melanie DellO'ro
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia Schneider
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia-Sophia Scheuermann
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sophia Bösl
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Elmar Graessel
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Ceslis A, Mackenzie L, Robinson GA. Implementation of a Hybrid Teleneuropsychology Method to Assess Middle Aged and Older Adults During the COVID-19 Pandemic. Arch Clin Neuropsychol 2022; 37:1644-1652. [PMID: 35670292 PMCID: PMC9384241 DOI: 10.1093/arclin/acac037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Hybrid teleneuropsychology has emerged as a useful assessment method to manage physical distancing requirements during the COVID-19 pandemic. We describe the development of a hybrid teleneuropsychology clinic and compare results of six neuropsychological tasks across testing modalities, as well as a participant experience survey. Method Healthy middle-aged and older adults completed a face-to-face assessment two years previously. Participants either completed reassessment face-to-face or via the hybrid setup. Results were compared across time points and delivery modality. Results There were no significant differences in scores at reassessment between face-to-face and a hybrid setup on nonverbal fluid intelligence, verbal memory, visual memory, language, working memory or verbal initiation. Retest reliability was moderate to excellent for verbal and visual memory, attention and naming. Results of an anonymous survey indicated that participants felt comfortable and established good rapport with the examiner. Conclusions This hybrid method of teleneuropsychology can be used to obtain high quality and reliable results including on tasks yet to be evaluated for teleneuropsychology, including the Graded Naming Test and the Topographical Recognition Memory Test.
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Affiliation(s)
- Amelia Ceslis
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Lisa Mackenzie
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane, Australia.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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