INS NYC 2024 Program

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 #110 Teleneuropsychology in Memory Clinics: Preliminary Evidence for Reliability, Validity, and Satisfaction of Direct-to-Home Evaluations Yer Thor, University of Wisconsin, Madison, United States Kristin Basche, University of Wisconsin, Madison, United States Amanda Peterson, University of Wisconsin, Madison, United States Hannah Rosario, University of Wisconsin, Madison, United States Victoria Williams, University of Wisconsin, Madison, United States Nathaniel Chin, University of Wisconsin, Madison, United States Lindsay Clark, University of Wisconsin, Madison, United States Category: Teleneuropsychology/ Technology Keyword 1: dementia - Alzheimer's disease Keyword 2: teleneuropsychology Keyword 3: cognitive screening Objective: Remote cognitive assessments became more widespread during the COVID-19 pandemic. Direct-to-home teleneuropsychological evaluations may increase accessibility to memory specialists and earlier diagnosis and treatment of Alzheimer’s disease and related disorders. The objective of this pilot study is to (1) investigate the reliability and validity of direct-to-home televideo memory clinic evaluations and (2) evaluate acceptability and satisfaction with direct-to-home testing. Participants and Methods: Patients recruited from a geriatric memory clinic with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia (n=39, mean age=75.5±4.6, 51.3% males, 97.4% white, 71.8% with a Bachelor’s degree) were enrolled. Participants completed direct-to-home cognitive testing using similar or identical tests as the memory clinic battery via televideo using a participant-owned computer or tablet approximately 8.5 weeks following their clinic visit. Reliability was assessed by comparing performances from direct-to-home and in-clinic evaluations using intraclass correlation coefficients (ICC). Validity of distinguishing cognitive groups was assessed using repeated measures ANOVAs including main effects of visit (direct-to-home, in-clinic), cognitive group (SCD, MCI, dementia), and visit x cognitive group interactions. Participants completed a questionnaire regarding satisfaction with direct-to-home testing. Results: Measures of attention (Trails A ICC=0.521, RBANS Attention ICC=0.837), memory (RBANS Immediate ICC=0.793, RBANS Delayed ICC=0.855), language (Category Fluency ICC=0.747, RBANS Language ICC=0.711), global performance (RBANS Global ICC=0.852), and mood screeners (GAS ICC=0.667, GDS ICC=0.765) demonstrated moderate to excellent reliability across the direct-to-home and in-clinic visits. Measures of executive functioning and visuospatial/construction abilities (Trails B/Oral Trails B ICC=0.338, RBANS Visuospatial ICC=0.326, Clock Draw ICC=0.579) ranged from poor to moderate reliability. Cognitive screening instruments (MMSE/TICS ICC=0.336) exhibited poor reliability. Results from repeated measures ANOVAs indicated non-significant visit x group interactions for most measures, indicating that test performance variation across cognitive groups was similar across clinic and televideo visits. One measure of attention (F(2,1)=6.315; p=0.003) was the exception, demonstrating typical group differences in clinic (Trails A) but similar performances across groups on the televideo exams (Oral Trails A). As expected, a main effect of cognitive group was observed for most tests. Similar to the ICC results, a main effect of visit type was observed for the cognitive screening instruments (MMSE/TICS F(2,1)=22.534; p<0.001) and RBANS Visuospatial (F(2,1)=7.857; p=0.007). Lastly, most participants were satisfied with direct-to-home testing (94.9%), would recommend it to others (76.9%), and would choose it over driving more than one hour for an in-person exam (87.1%). Conclusions: Most individuals with cognitive impairment were satisfied with direct-to-home testing. Preliminary comparisons of direct-to-home and in-clinic assessments suggest good reliability and validity for learning/memory, language, mood, and some measures of attention. Some measures of visuospatial/construction and executive functioning abilities may be less reliable or valid when administered over televideo. However, this may be due to inter-rater scoring differences or the specific alternate executive functioning task used. Overall, these results suggest direct-to-home cognitive testing via televideo may be an acceptable, reliable, and valid option for assessing memory concerns in a geriatric memory clinic population.

Poster

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 #110

Teleneuropsychology in Memory Clinics: Preliminary Evidence for Reliability, Validity, and Satisfaction of Direct-to-Home Evaluations

Yer Thor, University of Wisconsin, Madison, United States
Kristin Basche, University of Wisconsin, Madison, United States
Amanda Peterson, University of Wisconsin, Madison, United States
Hannah Rosario, University of Wisconsin, Madison, United States
Victoria Williams, University of Wisconsin, Madison, United States
Nathaniel Chin, University of Wisconsin, Madison, United States
Lindsay Clark, University of Wisconsin, Madison, United States

Category: Teleneuropsychology/ Technology

Keyword 1: dementia - Alzheimer's disease
Keyword 2: teleneuropsychology
Keyword 3: cognitive screening

Objective:

Remote cognitive assessments became more widespread during the COVID-19 pandemic. Direct-to-home teleneuropsychological evaluations may increase accessibility to memory specialists and earlier diagnosis and treatment of Alzheimer’s disease and related disorders. The objective of this pilot study is to (1) investigate the reliability and validity of direct-to-home televideo memory clinic evaluations and (2) evaluate acceptability and satisfaction with direct-to-home testing.

Participants and Methods:

Patients recruited from a geriatric memory clinic with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia (n=39, mean age=75.5±4.6, 51.3% males, 97.4% white, 71.8% with a Bachelor’s degree) were enrolled. Participants completed direct-to-home cognitive testing using similar or identical tests as the memory clinic battery via televideo using a participant-owned computer or tablet approximately 8.5 weeks following their clinic visit. Reliability was assessed by comparing performances from direct-to-home and in-clinic evaluations using intraclass correlation coefficients (ICC). Validity of distinguishing cognitive groups was assessed using repeated measures ANOVAs including main effects of visit (direct-to-home, in-clinic), cognitive group (SCD, MCI, dementia), and visit x cognitive group interactions. Participants completed a questionnaire regarding satisfaction with direct-to-home testing.

Results:

Measures of attention (Trails A ICC=0.521, RBANS Attention ICC=0.837), memory (RBANS Immediate ICC=0.793, RBANS Delayed ICC=0.855), language (Category Fluency ICC=0.747, RBANS Language ICC=0.711), global performance (RBANS Global ICC=0.852), and mood screeners (GAS ICC=0.667, GDS ICC=0.765) demonstrated moderate to excellent reliability across the direct-to-home and in-clinic visits. Measures of executive functioning and visuospatial/construction abilities (Trails B/Oral Trails B ICC=0.338, RBANS Visuospatial ICC=0.326, Clock Draw ICC=0.579) ranged from poor to moderate reliability. Cognitive screening instruments (MMSE/TICS ICC=0.336) exhibited poor reliability. Results from repeated measures ANOVAs indicated non-significant visit x group interactions for most measures, indicating that test performance variation across cognitive groups was similar across clinic and televideo visits. One measure of attention (F(2,1)=6.315; p=0.003) was the exception, demonstrating typical group differences in clinic (Trails A) but similar performances across groups on the televideo exams (Oral Trails A). As expected, a main effect of cognitive group was observed for most tests. Similar to the ICC results, a main effect of visit type was observed for the cognitive screening instruments (MMSE/TICS F(2,1)=22.534; p<0.001) and RBANS Visuospatial (F(2,1)=7.857; p=0.007). Lastly, most participants were satisfied with direct-to-home testing (94.9%), would recommend it to others (76.9%), and would choose it over driving more than one hour for an in-person exam (87.1%).

Conclusions:

Most individuals with cognitive impairment were satisfied with direct-to-home testing. Preliminary comparisons of direct-to-home and in-clinic assessments suggest good reliability and validity for learning/memory, language, mood, and some measures of attention. Some measures of visuospatial/construction and executive functioning abilities may be less reliable or valid when administered over televideo. However, this may be due to inter-rater scoring differences or the specific alternate executive functioning task used. Overall, these results suggest direct-to-home cognitive testing via televideo may be an acceptable, reliable, and valid option for assessing memory concerns in a geriatric memory clinic population.