Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy.
Camillo Golgi Geriatric Institute, Abbiategrasso, Milan, Italy.
Aging Clin Exp Res. 2023 Mar;35(3):699-710. doi: 10.1007/s40520-023-02343-9. Epub 2023 Jan 30.
The SARS-CoV-2 pandemic forced to rethink teleneuropsychology, since neuropsychological assessments started to be performed by phone or videoconference, with personal devices and without direct assistance from the clinician, a practice called "Direct-To-Home NeuroPsychology" (DTH-NP).
The present study, employing a counterbalanced cross-over design, was aimed at evaluating (1) the feasibility and (2) the acceptability of DTH-NP in Italian older adults without previously diagnosed neurocognitive disorder, (3) the comparability between remote and face-to-face administration of selected neuropsychological tests.
Fifty-eight community-dwelling older adults (65-85 years) were randomly assigned to one of two groups performing a complete neuropsychological assessment remotely (via phone call and videoconference) and face-to-face, in a counterbalance order, 8 weeks apart. The study recruitment rate was calculated, and the number of uncompleted tests and acceptability questionnaire responses were compared between the two administration modalities. Comparability was defined as good reliability of DTH-NP (intraclass correlation coefficient) and agreement between remote and face-to-face scores (Bland-Altman plots).
Recruitment rate was 81%, with a preference for telephonic contact (79%). The acceptability analysis did not reveal any issues related to the DTH-NP assessment, even if most participants would rather repeat it face-to-face. Tests assessing short-term memory, language, and reasoning showed good comparability.
Our results point out to a good recruitment rate in a DTH-NP study in an Italian population of older adults (mean age = 80), satisfying acceptability of DTH-NP and remote-face-to-face comparability of certain verbally mediated tests. Further studies including larger samples in videoconference modality, and outpatients, could better clarify its strengths and limits.
SARS-CoV-2 大流行迫使人们重新思考远程神经心理学，因为神经心理评估开始通过电话或视频会议、使用个人设备且没有临床医生的直接协助来进行，这种做法被称为“直接到家庭神经心理学”（DTH-NP）。
本研究采用交叉平衡设计，旨在评估（1）在没有先前诊断为神经认知障碍的意大利老年人群中，DTH-NP 的可行性和（2）可接受性，（3）远程和面对面进行特定神经心理学测试的可比较性。
58 名居住在社区的老年人（65-85 岁）被随机分配到两组之一，在 8 周的间隔内，以平衡的方式远程（通过电话和视频会议）和面对面完成完整的神经心理评估。计算了研究的招募率，并比较了两种管理模式下未完成的测试数量和可接受性问卷的回复。可比性定义为 DTH-NP 的良好可靠性（组内相关系数）和远程与面对面分数之间的一致性（Bland-Altman 图）。
招募率为 81%，电话联系的偏好率为 79%。可接受性分析没有发现与 DTH-NP 评估相关的任何问题，尽管大多数参与者更愿意面对面重复该评估。评估短期记忆、语言和推理的测试显示出良好的可比性。
我们的结果表明，在意大利老年人群（平均年龄 80 岁）的 DTH-NP 研究中，具有较高的招募率，DTH-NP 的可接受性和某些口头介导测试的远程-面对面的可比性令人满意。包括更大的视频会议模式样本和门诊患者的进一步研究，可以更好地阐明其优势和局限性。
