Assessing Cognitive Function in Older Adults Using a Videoconference Approach

Abstract

BackgroundThe use of communication technologies is an emerging trend in healthcare and research. Despite efficient, reliable and accurate neuropsychological batteries to evaluate cognitive performance in-person, more diverse and less expensive and time consuming solutions are needed. Here we conducted a pilot study to determine the applicability of a videoconference (VC, Skype®) approach to assess cognitive function in older adults, using The Telephone Interview for Cognitive Status-Modified – Portuguese version (TICSM-PT).MethodsAfter inclusion and exclusion criteria, 69 individuals (mean age = 74.90 ± 9.46 years), selected from registries of local health centers and assisted-living facilities, were assessed on cognitive performance using videoconference, telephone and in-person approaches.FindingsThe videoconference administration method yielded comparable results to the traditional application. Correlation analyses showed high associations between the testing modalities: TICSM-PT VC and TICSM-PT telephone (r = 0.885), TICSM-PT VC and MMSE face-to-face (r = 0.801). Using the previously validated threshold for cognitive impairment on the TICSM-PT telephone, TICSM-PT VC administration presented a sensitivity of 87.8% and a specificity of 84.6%.InterpretationFindings indicate for the range of settings where videoconference approaches can be used, and for their applicability and acceptability, providing an alternative to current cognitive assessment methods. Continued validation studies and adaptation of neuropsychological instruments is warranted.

A narrative review of the evidence regarding the use of telemedicine to deliver video‐interpreting during dementia assessments for older people

“…Technological feasibility mostly related to the audio‐visual quality of the TM session. Audio‐visual quality was deemed “inadequate” 22% of the time in one study (Shores et al, ) and “poor” among 11.5% of participants in another study (Castanho et al, ). In the study of Schulz et al (), which used video‐interpreting, audio echo and picture quality affected TM sessions in 15% of patients and 22% of clinicians (Schulz et al, ).…”

“…Agreement is a measure of how similar results are between repeated measures, while reliability is defined as how well individual patients are distinguishable from each despite measurement errors (de Vet, Terwee, Knol, & Bouter, ). Eleven papers were found that measured agreement and reliability of neurocognitive assessments administered by TM compared with either FTF or telephone methods (Castanho et al, ; Cullum et al, ; Cullum et al, ; Galusha‐Glasscock et al, ; Grosch et al, ; Loh et al, ; Loh, Donaldson, Flicker, Maher, & Goldswain, ; Martin‐Khan et al, ; McEachern, Kirk, Morgan, Crossley, & Henry, ; Wadsworth et al, ; Wong, Martin‐Khan, Rowland, Varghese, & Gray, ). The most common neurocognitive assessments administered in these studies include MMSE (Castanho et al, ; Cullum et al, ; Cullum et al, ; Galusha‐Glasscock et al, ; Grosch et al, ; Loh et al, ; Loh et al, ; Martin‐Khan et al, ; McEachern et al, ; Wadsworth et al, ), Geriatric Depression Scale (GDS) (Loh et al, ; Loh et al, ), and RUDAS (Martin‐Khan et al, ; Wong et al, ).…”

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

“…exploring issues of usability and acceptability). 45,[99][100][101][102][103][104][105][106][107][108][109][110][111][112][113] Many focus specifically on the clinical use of Skype, 91,[114][115][116][117][118][119][120][121][122][123] either on its own or in combination with other technologies [e.g. WhatsApp (WhatsApp Inc., Mountain View, CA, USA) messaging 124 or FaceTime 125,126 ].…”

Diagnosis of cognitive decline and dementia in rural areas — A scoping review

“…One study showed a moderate difference between FTF and telehealth scores . The Portuguese study showed as well high correlations and strong associations between the 3 approaches (VC, FTF, and telephone‐based testing). The studies using a single approach (VC/VTC assessments) show that patients, caregivers as well as physicians report high satisfaction with this application.…”

“…Most of the studies included in this category (see Table ) originate from the USA ( n = 10) . Four included studies are from Australia, 3 from Canada, and one study has been conducted in Portugal …”