School of Graduate Psychology, Pacific University, Hillsboro, Oregon, USA.
School of Graduate Psychology, Pacific University, Hillsboro, Oregon, USA,
Dement Geriatr Cogn Disord. 2020;49(5):456-470. doi: 10.1159/000511945. Epub 2020 Dec 8.
Distance or remote cognitive assessments, administered via phone or computer platforms, have emerged as possible alternatives to traditional assessments performed during office visits. Distance refers to any nontraditional assessment feature, not only or necessarily location. We conducted a systematic review to examine the psychometric soundness of these approaches.
We searched PubMed, PsycINFO, AgeLine, and Academic Search Premier for articles published between January 2008 and June 2020. Studies were included if participants were over the age of 50, a structured assessment of cognitive function in older adults was evaluated, the assessment method was deemed distant, and validity and/or reliability data were reported. Assessment distance was defined as having any of the following features: use of an electronic test interface, nonroutine test location (e.g., home), test self-administered, and test unsupervised. Distance was categorized as low, intermediate, or high.
RESULTS/DISCUSSION: Twenty-six studies met inclusion criteria. Sample sizes ranged from n = 8 to 8,627, and the mean age ranged from 57 to 83. Assessments included screens, brief or full batteries, and were performed via videoconferencing, phone, smartphone, or tablet/computer. Ten studies reported on low distance, 11 on intermediate distance, and 5 studies for high distance assessments. Invalid performance data were observed with older age and cognitive impairment. Convergent validity data were reported consistently and suggested a decline with increasing distance: r = 0.52-0.80 for low, 0.49-0.75 for intermediate, and 0.41-0.53 for high distance. Diagnostic validity estimates presented a similar pattern. Reliability data were reported too inconsistently to allow evaluation.
The validity of cognitive assessments with older adults appears supported at lower but not higher distance. Less is known about the reliability of such assessments. Future research should delineate the person and procedure boundaries for valid and reliable test results.
通过电话或计算机平台进行的远程认知评估已成为传统门诊评估的替代方法。“远程”是指任何非传统评估特征，不仅限于或不一定是地理位置。我们进行了系统评价，以检查这些方法的心理测量学稳健性。
我们在 2008 年 1 月至 2020 年 6 月期间在 PubMed、PsycINFO、AgeLine 和 Academic Search Premier 上搜索了文章。如果参与者年龄在 50 岁以上、对老年人进行了结构化认知功能评估、评估方法被认为是远程的并且报告了有效性和/或可靠性数据，则纳入研究。评估距离的定义为具有以下任何特征：使用电子测试界面、非常规测试地点（例如，家庭）、自我测试和无人监督测试。距离分为低、中、高。
结果/讨论：26 项研究符合纳入标准。样本量从 n = 8 到 8627 不等，平均年龄从 57 岁到 83 岁不等。评估包括屏幕、简短或完整的电池，通过视频会议、电话、智能手机或平板电脑/计算机进行。有 10 项研究报告了低距离，11 项研究报告了中距离，5 项研究报告了高距离评估。观察到年龄较大和认知障碍与无效表现数据相关。一致性报告了收敛有效性数据，并表明距离增加时会出现下降：低距离为 r = 0.52-0.80，中距离为 r = 0.49-0.75，高距离为 r = 0.41-0.53。诊断有效性估计呈现出类似的模式。可靠性数据报告不一致，无法进行评估。
在较低但不在较高距离下，对老年人认知评估的有效性似乎得到了支持。关于此类评估的可靠性知之甚少。未来的研究应该阐明有效和可靠测试结果的人与程序界限。
