Tele-Neuropsychological assessments in Alzheimer's disease: a comparison of ''face to face'' versus Video-Conferencing

Telemedicine consists in the use of telecommunication technologies to provide healthcare services, overcoming geographic, temporal, social, and cultural barriers. Today telemedicine is a developed field which includes about 50 different subspecialties: neuropsychology is one of them. Allowing the objective evaluation of the cognitive state of individuals, neuropsychology is a discipline of wide application; it also contributes significantly to an early diagnosis of subjects suspected to develop cognitive impairments due to Alzheimer disease or other degenerative dementias. Subjects at risk, and subjects who have already develop the illness, would particularly benefit of a telehealth intervention, which allows to overcome the barriers of space and time, and to provide an evaluation, as well as the therapy monitoring. These aspects would be particularly important for subjects who live far from health institutions , as those of rural areas. Obviously, we need to be sure that the results of the Tele-Neuropsychological assessment are comparable to those obtained via the classic '' face to face '' administration. This is the purpose of this research. We aimed in fact to compare the performances obtained in the two conditions at the MMSE test and the ADAS Cog test. To this purpose, we submitted a group of subjects affected by mild to moderate Alzheimer disease with associated vascular damages, to MMSE and the ADAS COG test, and performed a statistical analysis of data through a two sided Student ''t'' test. We found that the administration modality had no significant impact on the results. In fact, no significant difference was found neither in the MMSE, or in the ADAS_Cog scores administered by telehealth versus ''face to face''. While the results obtained at the MMSE confirm some previous data, this is, at our knowledge, the first study done on the ADAS_Cog, a test. Even if the conditions we employed in this research are not entirely superposable to those of patients staying at home (we evaluated the feasibility of teleheath by locating the patient and his caregiver in another room of the memory clinic ), we are confident that telehealth methodology, by video-conferencing, is as much reliable as the face to face modality. The small number of the subjects evaluated represents an obvious limitation of this study and suggests further studies involving larger number of subjects. However, our preliminary results give support to the idea that by tehealth the screening and the follow-up of the cognitive impairments age associated is feasible and valid.