Validity of Teleneuropsychology for Older Adults in Response to COVID-19: A Systematic and Critical Review
Clinical Neuropsychologist
Marra, D. E., Hamlet, K. M., et al. (2020).
Clinical Neuropsychologist, 34(7-8), 1411-1452.
This systematic review, building on another review (Brearly, et al. 2017), investigates the validity of conducting cognitive screening and assessment via telepractice in older adults. The following summary highlights conclusions about screening and assessment tools within the scope of speech-language pathology.
Not stated
<p>This systematic review expands upon the following article, which is available elsewhere in the Evidence Maps:</p>
<ul>
<li>Brearly, T. W., Shura, R. D., et al. (2017). Neuropsychological Test Administration by Videoconference: A Systematic Review and Meta-Analysis. <em>Neuropsychology Review, 27</em>(2), 174-186.</li>
</ul>
January 1, 2016 to March 21, 2020
Counterbalanced cross-over design studies
19 total studies: 9 from Brearly, et al. 2017, plus an additional 10 from the updated search
For screening cognition in older adults via telepractice, three tools demonstrated validity for administration via telepractice similar to in-person administration.
<ul>
<li>The Mini Mental State Exam (MMSE) demonstrated excellent reliability across nine studies (ICC ranged from 0.42 to 0.92) and longitudinal validity across modalities and time-points in another study.</li>
<li>The Montreal Cognitive Assessment (MoCA) demonstrated strong reliability across four studies (ICC ranged from 0.59 to 0.93).</li>
<li>The Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) demonstrated excellent reliability (ICC = 0.86) in one study and longitudinal validity across modalities and time-points in another study.</li>
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One small study investigating the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) found sub-test reliability ranging from fair to excellent (ICC = 0.59 to 0.90). The authors note that because the Coding sub-test of the RBANS involves providing the patient with a record form, administration of the entire battery via telepractice may not be feasible.
For screening or assessing cognition in adults via telepractice, sufficient evidence demonstrates that personal or laptop computers can be successfully utilized for telepractice service provision. Currently, insufficient evidence is available on whether smartphones can be used for telepractice. Emerging evidence on cloud-based communication services indicates that these technologies may be appropriate when sufficiently fast and reliable internet is available.
For assessing cognition in older adults via telepractice, several tools were investigated for their validity when administered via telepractice. The reported validity of these measures were as follows:
<ul>
<li>Digit Span Forwards, Digit Span Backwards, and Digit Span Total demonstrated good to moderate evidence of validity across six studies. The studies included individuals from culturally and linguistically diverse populations within their samples.</li>
<li>The Brief Test of Attention (BTA) demonstrated limited evidence of validity in one study.</li>
<li>The Oral Trails A demonstrated some evidence of validity in one study.</li>
<li>The Boston Naming Test (BNT) demonstrated good validity across four studies.</li>
<li>The Ponton-Satz Spanish Naming Test demonstrated some evidence of validity in one study.</li>
<li>Letter fluency demonstrated strong evidence of validity across seven studies.</li>
<li>Category fluency demonstrated moderate evidence of validity across five studies. The authors note that multiple trials may be required.</li>
<li>The Token Test, Picture Description, and Aural Comprehension of Words and Phrases demonstrated insufficient evidence of validity in one study.</li>
<li>The Hopkins Verbal Learning Test - Revised (HVLT-R) demonstrated strong evidence of validity across five studies.</li>
<li>The Brief Visuospatial Memory Test - Revised (BVMT-R) demonstrated some evidence of validity in one study.</li>
<li>The Clock Drawing Test demonstrated moderate evidence of validity and variability in results across eight studies.</li>
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