Author: Gabriel Qi
Considering the relevancy to COVID-19, I am introducing two articles about telemedicine
involving neuropsychological testing for the April 2020 issue of the ANA
Listserv Research Digest. The two articles describe two different approaches to
teleneuropsychology, and I hope they can be of some help if any of you are considering
transitioning to a telehealth model.
The first article is a review of the assessment of dementia through videoconferencing (VC;
Castanho, Sousa, & Santos, 2017). The authors reviewed several studies where VC was
used to assess cognitive aging. The tools involved include the Mini-Mental State
Examination (MMSE), Standardized MMSE, Clock Drawing test, Short Blessed test,
Rowland Universal Dementia Assessment Scale (RUDAS), Digit Span, Hopkins Verbal
Leaning test – Revised (HVLT-R), tests of verbal fluency, and RBANS. Essentially, no
significant differences were found in scores on these tests between the VC and face-to face (FTF) approaches. Please refer to this review for the specific studies involving the
abovementioned tests.
The second article describes telemedicine in the VA setting, which may or may not be
useful in the current situation. The model comprised of dementia subspecialists in a
major metropolitan medical center and patients in three outlying VA Community Based
Outpatient Clinics (CBOCs) located 180, 150, and 100 miles away (Harrell et al., 2014).
Telehealth clinical technicians (TCTs) at the CBOCs provided assistance in accompanying
patients to the evaluation room, coordinating teleconferencing, preparing stimuli in
accordance with an ordered folder system, and transmitting stimuli via fax to the
clinician following test completion. The battery involved is very comprehensive and
routinely used, which can be found in the appendix of the article. Given the special
setup of the model, it may not be readily usable in response to the COVID-19 pandemic
but may spark some of your creativity as the community brainstorm for solutions.
Food for thought this month:
What are some teleneuropsychology setup and/or guidelines that could work in
response to the COVID-19 pandemic?
Here are the links to access the articles this month:
1. https://content.iospress.com/articles/journal-of-alzheimers-diseasereports/adr170007
2. https://content.iospress.com/articles/journal-of-alzheimers-diseasereports/adr170007
References:
• Castanho, T. C., Sousa, N., & Santos, N. C. (2017). When new technology is an
answer for old problems: the use of videoconferencing in cognitive aging
assessment. Journal of Alzheimer’s disease reports, 1, 15-21. doi:10.3233/ADR170007
• Harrell, K. M., Wilkins, S. S., Connor, M. K., & Chodosh, J. (2014). Telemedicine
and the evaluation of cognitive impairment: the additive value of
neuropsychological assessment. Journal of the American Medical Directors
Association, 15, 600-606. doi:10.1016/j.jamda.2014.04.015