Wadsworth Hannah E, Dhima Kaltra, Womack Kyle B, Hart John, Weiner Myron F, Hynan Linda S, Cullum C Munro
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Arch Clin Neuropsychol. 2018 Dec 1;33(8):1040-1045. doi: 10.1093/arclin/acx140.
The feasibility and reliability of neuropsychological assessment at a distance have been demonstrated, but the validity of this testing medium has not been adequately demonstrated. The purpose of this study was to determine the ability of video teleconferencing administration of neuropsychological measures (teleneuropsychology) in discriminating cognitively impaired from non-impaired groups of older adults. It was predicted that measures administered via video teleconference would distinguish groups and that the magnitude of differences between impaired and non-impaired groups would be similar to group differences achieved in traditional administration.
The sample consisted of 197 older subjects, separated into two groups, with and without cognitive impairment. The cognitive impairment group included 78 individuals with clinical diagnoses of mild cognitive impairment or Alzheimer's disease. All participants completed counterbalanced neuropsychological testing using alternate test forms in both a teleneuropsychology and a traditional face-to-face (FTF) administration condition. Tests were selected based upon their common use in dementia evaluations, brevity, and assessment of multiple cognitive domains. Results from FTF and teleneuropsychology test conditions were compared using individual repeated measures ANCOVA, controlling for age, education, gender, and depression scores.
All ANCOVA models revealed significant main effects of group and a non-significant interaction between group and administration condition. All ANCOVA models revealed non-significant main effects for administration condition, except category fluency.
Results derived from teleneuropsychologically administered tests can distinguish between cognitively impaired and non-impaired individuals similar to traditional FTF assessment. This adds to the growing teleneuropsychology literature by supporting the validity of remote assessments in aging populations.
远距离神经心理学评估的可行性和可靠性已得到证实，但这种测试方式的有效性尚未得到充分证明。本研究的目的是确定通过视频电话会议进行神经心理学测量（远程神经心理学）在区分老年人认知障碍组和非障碍组方面的能力。预计通过视频电话会议进行的测量能够区分不同组，并且障碍组和非障碍组之间的差异程度将与传统方式下获得的组间差异相似。
样本包括197名老年受试者，分为两组，即有认知障碍组和无认知障碍组。认知障碍组包括78名临床诊断为轻度认知障碍或阿尔茨海默病的个体。所有参与者在远程神经心理学和传统面对面（FTF）施测条件下，使用交替测试形式完成了平衡的神经心理学测试。根据测试在痴呆评估中的常用性、简短性以及对多个认知领域的评估来选择测试。使用个体重复测量协方差分析比较FTF和远程神经心理学测试条件下的结果，控制年龄、教育程度、性别和抑郁得分。
所有协方差分析模型均显示出组的显著主效应以及组与施测条件之间的非显著交互作用。除类别流畅性外，所有协方差分析模型均显示施测条件的主效应不显著。
远程神经心理学施测的测试结果能够区分认知障碍个体和非障碍个体，与传统的面对面评估相似。这通过支持老年人群体中远程评估的有效性，为不断增长的远程神经心理学文献增添了内容。
