Tele-neuropsychology in culturally and linguistically diverse populations within the U.S. and U.S. territories: A scoping review1

Objective: Tele-neuropsychology (teleNP) has the potential to deliver assessment to people who face limited access to culturally and linguistically appropriate services, health disparities, and negative social determinants of health (SDOH). We reviewed to what extent teleNP has been examined in racially and ethnically diverse samples within the U.S. and U.S. territories and describe validity, feasibility, barriers, and facilitators. Method: A scoping review was conducted to examine factors relevant to teleNP with racially/ethnically diverse samples, using Google Scholar and PubMed®. Key words referenced "tele-neuropsychology," racial/ethnic populations within the U.S. and territories, and relevant constructs (e.g. "validity," "feasibility"). Studies included in the final analysis were empirical, addressed teleNP, and included racially/ethnically diverse individuals within the U.S. The search resulted in 10,312 articles total, with 9,670 following removal of duplicates. We excluded 9,600 following abstract review, and an additional 54 articles following full-text review. Thus, 16 studies were included in the final analysis. Results: Results showed the greatest number of studies supporting feasibility and utility of teleNP with older LatinX/Hispanic adults. Limited reliability and validity data suggested that, for the most part, teleNP and face-to-face neuropsychological evaluations were broadly equivalent, and no studies contraindicated use of teleNP in culturally diverse populations. Conclusions: This review provides preliminary support, particularly in terms of teleNP feasibility, with culturally diverse individuals. Current research is hampered by low inclusion of culturally diverse individuals and limited studies, and while support is nascent, these findings should be balanced with promotion of healthcare equity/access.

Construct validity and extended normative data for older adults for the Brief Visuospatial Memory Test, Revised

PURPOSE

This study examined the construct validity of a visual memory test (Brief Visuospatial Memory Test, Revised [BVMT-R]) in a sample of older adults and provided normative data for adults aged 80+ years.

METHOD

The sample included 109 community-dwelling individuals (mean [M] age = 74.9 years, M education = 15.0 years, 62.4% female, and 97.2% European American).

PROCEDURES

Measures administered included the BVMT-R, California Verbal Learning Test, 2nd edition, and subtests of the Delis-Kaplan Executive Function System and Neuropsychological Assessment Battery.

RESULTS

The BVMT-R correlated highly with another measure of memory and less so with unrelated measures (e.g., verbal fluency). Age and education were significantly correlated with BVMT-R Total and Delayed Recall scores, with education as the strongest predictor. No significant differences were found for sex. Normative data were provided for adults aged 80 to 88 years (n = 29).

CONCLUSIONS

Adequate evidence was found for convergent validity and only partial support for discriminant validity. Normative data should continue to be stratified by age and also by formal education level.

Depressive symptoms and cognitive impairment predict all-cause mortality in long-term care residents

This study investigated whether symptoms of depression and cognitive dysfunction predicted all-cause mortality in long-term care (LTC) residents at 12 months after admission. Participants were 171 adults with a mean age of 77 in an urban LTC setting (51% African American and 49% European American). The Geriatric Depression Scale and the Dementia Rating Scale, Second Edition (DRS-2), were administered upon admission, and demographic variables and the Charlson Comorbidity Index were also recorded. Cox regression analyses found that increased depressive symptoms, lower performance on the DRS-2, and European American ethnicity were significant predictors of all-cause mortality. The overall results suggest that the combination of cognitive dysfunction and depressive symptoms can increase the chances of 12-month, all-cause mortality in LTC settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Malingering or expected deficits? A case of herpes simplex encephalitis

This study describes a patient with herpes simplex encephalitis. Brain MRI showed the expected finding of medial temporal damage. Neuropsychological assessment results were consistent with the location of damage, with profound memory impairment and mildly impaired naming, but normal visuospatial and executive skills. The patient also showed a typical testing pattern of insufficient effort and possible malingering, which was concerning as she was seeking disability compensation. In spite of this, we chose to place greatest weight on the finding of deficits consistent with the type, location, and severity of brain damage, considering this to be true cognitive impairment.

Naming test of the Neuropsychological Assessment Battery: convergent and discriminant validity

This study investigated the convergent and discriminant validity of the naming subtest of the Neuropsychological Assessment Battery (NAB), a measure of word-finding. Seventy community-dwelling adults age 60 and above completed the NAB naming test (Forms 1 and 2), the Boston Naming Test (BNT), and other measures of verbal and visual memory, visuoperceptual skills, processing speed, and abstraction. The NAB naming test correlated highly with the BNT and with established measures of memory. The BNT correlated more strongly with education and with sex. The BNT correlated more strongly with a measure of visuoperceptual skills than the NAB naming test did, suggesting that visuoperception is more involved in the BNT. Divergent validity of the NAB naming was demonstrated by a lack of correlations with less-related measures. Findings suggest that the NAB naming test possesses convergent and divergent validity as a measure of word-finding.

D-KEFS Tower Test performance in patients with lateral prefrontal cortex lesions: the importance of error monitoring

This study investigated performance on the Delis-Kaplan Executive Function System (D-KEFS) Tower Test in a sample of 12 patients with focal lesions in the lateral prefrontal cortex (PFC) and 12 control participants. PFC patients performed worse overall, spent more time on each move, and committed significantly more rule violations. The rule violation measure demonstrated 83% sensitivity and 100% specificity in the detection of lesions. Findings highlight the importance of error monitoring in the assessment of executive functioning. These preliminary results suggest that the lateral PFC may be critical for self-monitoring/inhibition and speed of processing in planning tasks.