Tele-neuropsychological multidomain assessment in Italian people with cognitive disorders: Reliability and user satisfaction

Abstract

Background: Tele-neuropsychology has already been employed in neurocognitive disorders, however, in Italy, the evidence of its psychometric quality and satisfaction is still limited.

Objective: This study aimed to: (1) evaluate the reliability of a standardized battery of neuropsychological screening and domain-specific tests delivered at home via videoconference to a sample of Italian people with cognitive disorders, compared with traditional face-to-face administration; (2) assess the feasibility and satisfaction about remote administration.

Methods: This crossover study enrolled patients with subjective cognitive disorder, mild neurocognitive disorder, or dementia. All participants performed a brief neuropsychological screening assessment in face-to-face or remote mode. People with milder cognitive disorders (Mini-Mental State Examination ≥ 20) also performed an extended neuropsychological battery. After 15 days, each participant repeated the same assessment in the opposite mode. Finally, participants completed a satisfaction questionnaire.

Results: 114 participants were initially enrolled in the study and 100 individuals performed both face-to-face and remote assessments (14 dropouts). All neuropsychological tests showed agreement between the two modes of administration, except for the Digit Span Forward (p = 0.009) and oral-Symbol Digit Modalities Test (p < 0.001). According to Lin's concordance correlation coefficient (LCCCs), tests also showed good or excellent reliability (LCCCs between 0.609 and 0.964); only the Digit Span Backward and the Stroop test showed moderate reliability (LCCCs =0.514-0.441, respectively). Among 100 participants, 65 patients answered the satisfaction questionnaire, declaring high satisfaction for the remote evaluation.

Conclusions: Tele-neuropsychology seems to work with in-home assessments among Italian patients with cognitive disorders and seems to be acceptable to them.

Trial registration: ClinicalTrials.gov, Identifier: NCT06078332 (October 17, 2023).

Keywords: Alzheimer's disease; cognitive impairment; dementia; neuropsychological assessment; tele-neuropsychology; telemedicine; videoconferencing.