| Poster | Poster Session 04 Program Schedule
02/15/2024
12:00 pm - 01:15 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology
Final Abstract #88
Pain in the Context of Virtual Neuropsychological Assessment of Older Adults
Karlee Patrick, Kent State University, Kent, United States
John Gunstad, Kent State University, Kent, United States
Mary Beth Spitznagel, Kent State University, Kent, United States
Category: Teleneuropsychology/ Technology
Keyword 1: neuropsychological assessment
Keyword 2: chronic pain
Keyword 3: cognitive functioning
Objective:
Pain and cognitive impairment are prevalent in older adults, often co-occurring and conferring detrimental consequences. Neuropsychological evaluation is commonly employed in older adults with suspected cognitive impairment; however, prior work suggests pain may negatively impact cognitive test performance. Identification of pain in the context of neuropsychological evaluation is important, but pain based on self-report is often under-detected in this population. Alternative methods, such as video-based automatic coding of facial biomarkers of pain, might facilitate pain identification and enhance interpretation of neuropsychological evaluation results.
Participants and Methods:
The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain (Open DBMv2.0 software). Participants completed a brief neuropsychological assessment via Microsoft Teams (tests included semantic and phonemic fluency, Craft Story immediate and delayed recall, Cognitive Estimation Task, NAB Judgment, Montreal Cognitive Assessment [MoCA], Digit Span, Oral Trail Making Test A and B and self-report measures (i.e., chronic pain, psychological symptoms, and demographics). Assessment of acute pain (self-report and automatic coding) was completed at the beginning and end of the session. Pearson correlations bootstrapped with 5,000 samples were used to examine associations among pain measures and neuropsychological test results. Neuropsychological tests that correlated significantly with pain measures were entered as dependent variables in separate linear regressions, controlling for demographic variables and psychological symptoms.
Results:
Self-reported pain was negatively associated with poorer performance on Oral Trail Making Test B (both acute [r = -0.25, p < .01] and chronic pain [r = -0.26, p < .01]) and the MoCA (acute pain only [r = -.23, p < .05]). However, self-reported acute and chronic pain did not correlate significantly with other neuropsychological tests. Though automatic coding of pain was significantly associated with performance on neuropsychological tests (Craft Story delayed verbatim recall [r = -0.23, p < .05] and Craft Story delayed paraphrase recall [r = -0.23, p < .05]), it did not predict self-report of pain or performance on neuropsychological measures after controlling for demographic factors and psychological symptoms.
Conclusions:
Despite past work suggesting that pain impacts cognitive assessment, the current study found limited evidence of an association between either self-reported or automatically coded pain biomarkers and neuropsychological test performance. However, the significant correlations that are present warrant further exploration of relationships between pain and neuropsychological testing in this context to ensure that pain is not associated with test performance in other samples (e.g., individuals with higher levels of pain). Additionally, it is notable that all correlations between automatic coding of pain and neuropsychological test performance were in the expected negative direction, suggesting that automatic coding of pain may yet be useful for pain detection in this context. Future work should explore the utility of video-based automatic coding in samples with greater severity of pain and/or more significant cognitive impairment.
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