ABSTRACT
Today, in rural isolated areas or so-called 'medical deserts', access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, telemedicine platforms are gradually more employed for remote medical assessment. Only a few are tailored to comprehensive teleneuropsychological assessment of older adults. Hence, our study focuses on evaluating the feasibility of performing a remote neuropsychological assessment of older adults suffering from a cognitive complaint. 50 participants (aged 55 and older) were recruited at the local hospital of Digne-les-Bains, France. A brief neuropsychological assessment including a short clinical interview and several validated neuropsychological tests was administered in two conditions, once by Teleneuropsychology (TNP) and once by Face-to-Face (FTF) in a crossover design. Acceptability and user experience was assessed through questionnaires. Results show high agreement in most tests between the FTF and TNP conditions. The TNP was overall well accepted by the participants. However, differences in test performances were observed, which urges the need to validate TNP tests with broader samples with normative data.
ABSTRACT
BACKGROUND: Given the current COVID-19 pandemic situation, now more than ever, remote solutions for assessing and monitoring individuals with cognitive impairment are urgently needed. Older adults in particular, living in isolated rural areas or so-called 'medical deserts', are facing major difficulties in getting access to diagnosis and care. Telemedical approaches to assessments are promising and seem well accepted, reducing the burden of bringing patients to specialized clinics. However, many older adults are not yet adequately equipped to allow for proper implementation of this technology. A potential solution could be a mobile unit in the form of a van, equipped with the telemedical system which comes to the patients' home. The aim of this proof-of-concept study is to evaluate the feasibility and reliability of such mobile unit settings for remote cognitive testing. Methods and analysis: eight participants (aged between 69 and 86 years old) from the city of Digne-Les-Bains volunteered for this study. A basic neuropsychological assessment, including a short clinical interview, is administered in two conditions, by telemedicine in a mobile clinic (equipped van) at a participants' home and face to face in a specialized clinic. The administration procedure order is randomized, and the results are compared with each other. Acceptability and user experience are assessed among participants and clinicians in a qualitative and quantitative manner. Measurements of stress indicators were collected for comparison. RESULTS: The analysis revealed no significant differences in test results between the two administration procedures. Participants were, overall, very satisfied with the mobile clinic experience and found the use of the telemedical system relatively easy. CONCLUSION: A mobile unit equipped with a telemedical service could represent a solution for remote cognitive testing overcoming barriers in rural areas to access specialized diagnosis and care.