Suspected Atypical Alzheimer's Disease (AD), Suspected Typical Alzheimer's Disease (AD)
Conditions
Brief summary
The overarching goal of this study is to a) assess the feasibility and preliminary validity of home-based delivery of TeleNP to patients with suspected Alzheimer's Disease (AD), referred for cognitive assessments in a Neurology Clinic; and b) elucidate whether TeleNP is equivalent to face-to-face evaluation (FF) for diagnostic adjudication of atypical versus typical AD.
Interventions
BEHAVIORALFace-to-face evaluation (FF)
The intervention is the assessment modality. The control condition is face-to-face evaluation (FF).
BEHAVIORALTeleNP evaluation
The intervention is the assessment modality. The intervention condition is TeleNP evaluation.
Sponsors
National Institute on Aging (NIA)
University of Colorado, Denver
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
60 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Individuals age 60 to 90 years who are undergoing evaluation for possible AD and whose severity ranges from MCI to mild dementia. * Individuals must carry a diagnosis of either suspected typical AD or atypical AD, based on the referring neurologist's diagnosis.
Exclusion criteria
* Individuals with moderate to severe levels of dementia and individuals with active delirium (per neurologist's determination). * Individuals who are legally blind or deaf, due to the auditory and visual components of the study. * Individuals with a brain tumor and individuals who have a confirmed nonAD neurological diagnosis (e.g, Multiple Sclerosis; FTD). * Individuals who are being evaluated outside of the UCH Memory Disorders Clinic. * Individuals who report active (i.e., within the last 6 months) substance use of illicit drugs such as cocaine or methamphetamines, or who carry a diagnosis of a major psychiatric disorder (e.g., schizophrenia; bipolar disorder). Note that care partners (3rd arm) did not undergo the intervention and there were no additional eligibility requirements for them except that they were involved in the patient's care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7 | Raw scores for measures of Memory, Executive Functions, Language, and Spatial Abilities will be compared across both conditions. CVLT= California Verbal Learning Test- 2nd edition; Delayed recall measures Memory, total words recalled after 20-minutes (range: 0-16). Higher=better. RBANS = Repeatable Battery for the Assessment of Neuropsychological Status; Delayed recall (Memory) - total elements recalled (range: 0-20). Higher=better. Figure Copy (Spatial)- total copied (range: 0-20). BNT=Boston Naming Test (Language) -total correct (range: 0-15). Higher=better. Category Fluency (Language) - total correct) (range: 0- no limit). Higher=better. JoLO=Judgment of Line Orientation (Spatial) -total correct (range: 0-15). Higher=better |
| Agreement of Neuropsychologist Diagnosis Across Testing Modalities as Measured by Neuropsychologist-Determined Diagnosis | After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7 | Neuropsychologist-determined diagnosis (i.e., typical AD, atypical/complex AD, not AD) will be compared across both conditions whether TeleNP alters assessment of patient diagnosis. |
| Agreement of Neuropsychologist Appraisal of Severity Across Testing Modalities as Measured by Neuropsychologist-Determined Severity | After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7 | Neuropsychologist-determined severity (i.e., subjective cognitive concerns; MCI; mild dementia) will be compared across both conditions whether TeleNP alters assessment of patient severity. |
| Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7 | The 4-item Acceptability and Feasibility of Intervention Measures Scale is used for rating all participants and care partners' perspective on the acceptability and feasibility of the Face-to-face evaluation (FF) and TeleNP evaluation as assessed using a 5-point Likert scale at Week 1 or Weeks 5-7, depending on randomization. Scores range from Completely disagree (1) to Completely agree (5). |
| Acceptability and Feasibility of Intervention Measures as Measured by 19-item UTAUT Questionnaire Adapted to TeleNP | After the exposure to the TeleNP evaluation (up to Week 7) | The UTAUT questionnaire adapted to TeleNP is used for rating all participants' perspective on the acceptability and feasibility of TeleNP evaluation as assessed using a 5-point Likert scale at Week 1 or Weeks 5-7, depending on randomization. Scores range from Strongly disagree (1) to Strongly agree (5). Performance expectancy refers to the degree to which an individual believes that using a technology will help them improve their performance. Effort expectancy is the degree of ease associated with using the technology. Behavioral intention reflects an individual's plan to use the technology. |
| Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures) | After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7 | Raw scores for measures of Executive Functions will be compared across both conditions. DKEFS= Delis-Kaplan Executive Function Systems; Color-Word Inhibition (Executive Functions) -total time (range: 0-180). Higher=worse Oral Trail Making Test B (Executive Functions) total time (range: 0-300). Higher=worse |
Countries
United States
Participant flow
Recruitment details
Intervention (Patients): Eligible participants were adults ≥age 60 years and \<90 years whose severity was MCI or mild dementia. Behavioral neurologists referred patients based on: a) the patient was undergoing initial diagnostic evaluation, b) the neurologist intended to place a referral for a neuropsychological evaluation, and c) Alzheimer's Disease was on the differential diagnostic workup. Non-intervention (Care Partners): There were no eligibility requirements for the care partner
Pre-assignment details
Intervention Arms (Patients): Upon consenting for the study, randomization was conducted using a computerized process through REDCap based on block randomization with blocks of sizes 32, 24, 16, and two of 8 based on modality (FF vs TeleNP) order, test form type (standard vs alternate; used for a subset of tests), and assigned to one of two board certified neuropsychologists. Non-Intervention Arm (Care Partner): Care partners were not assigned to an intervention, no pre-assignment details
Participants by arm
| Arm | Count |
|---|---|
| Face-to-face Evaluation (FF), Teleneuropsychology Evaluation (TeleNP) Study participants underwent both modalities (FF; TeleNP), conducted 4-6 weeks apart (allowing for maximum of 90 days). Order of modality, either FF followed by TeleNP or vice versa, was randomized at baseline using a computerized process through REDCap. | 32 |
| Teleneuropsychology Evaluation (TeleNP), Face-to-face Evaluation (FF) Study participants underwent both modalities (TeleNP; FF), conducted 4-6 weeks apart (allowing for maximum of 90 days). Order of modality, either TeleNP followed by FF or vice versa, was randomized at baseline using a computerized process through REDCap. | 31 |
| Care Partner Care Partners did not undergo the intervention. They filled out acceptability surveys, which were an outcome measure | 50 |
| Total | 113 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 1 | 0 | 0 |
| Overall Study | Withdrawal by Subject | 2 | 0 | 0 |
Baseline characteristics
| Characteristic | Care Partner | Total | Face-to-face Evaluation (FF), Teleneuropsychology Evaluation (TeleNP) | Teleneuropsychology Evaluation (TeleNP), Face-to-face Evaluation (FF) |
|---|---|---|---|---|
| Age, Continuous Care Partners | 63.8 Years STANDARD_DEVIATION 12.6 | 63.8 Years STANDARD_DEVIATION 12.6 | — | — |
| Age, Continuous Patients | — | 73.38 Years STANDARD_DEVIATION 6.29 | 73.03 Years STANDARD_DEVIATION 6.49 | 73.74 Years STANDARD_DEVIATION 6.16 |
| Diagnosis (By Referring Neurologist): Atypical AD, Typical AD Atypical AD | 0 Participants | 22 Participants | 12 Participants | 10 Participants |
| Diagnosis (By Referring Neurologist): Atypical AD, Typical AD Typical AD | 0 Participants | 41 Participants | 20 Participants | 21 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 4 Participants | 2 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 48 Participants | 109 Participants | 30 Participants | 31 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 4 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 2 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 47 Participants | 106 Participants | 30 Participants | 29 Participants |
| Severity Level: MCI, Mild Dementia MCI | 0 Participants | 46 Participants | 24 Participants | 22 Participants |
| Severity Level: MCI, Mild Dementia Mild Dementia | 0 Participants | 17 Participants | 8 Participants | 9 Participants |
| Sex: Female, Male Female | 33 Participants | 68 Participants | 15 Participants | 20 Participants |
| Sex: Female, Male Male | 17 Participants | 45 Participants | 17 Participants | 11 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 63 | 0 / 63 |
| other Total, other adverse events | 0 / 63 | 0 / 63 |
| serious Total, serious adverse events | 0 / 63 | 0 / 63 |
Outcome results
Primary
Acceptability and Feasibility of Intervention Measures as Measured by 19-item UTAUT Questionnaire Adapted to TeleNP
The UTAUT questionnaire adapted to TeleNP is used for rating all participants' perspective on the acceptability and feasibility of TeleNP evaluation as assessed using a 5-point Likert scale at Week 1 or Weeks 5-7, depending on randomization. Scores range from Strongly disagree (1) to Strongly agree (5). Performance expectancy refers to the degree to which an individual believes that using a technology will help them improve their performance. Effort expectancy is the degree of ease associated with using the technology. Behavioral intention reflects an individual's plan to use the technology.
Time frame: After the exposure to the TeleNP evaluation (up to Week 7)
Population: For the patients (i.e., the primary participants), 3 participants signed a consent but did not complete baseline. N=63.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 19-item UTAUT Questionnaire Adapted to TeleNP | Performance Expectancy Domain | 4.0 Score (Higher=more acceptable, range 1-5 |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 19-item UTAUT Questionnaire Adapted to TeleNP | Effort Expectancy Domain | 4.0 Score (Higher=more acceptable, range 1-5 |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 19-item UTAUT Questionnaire Adapted to TeleNP | Behavioral Intention Domain | 4.0 Score (Higher=more acceptable, range 1-5 |
Primary
Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale
The 4-item Acceptability and Feasibility of Intervention Measures Scale is used for rating all participants and care partners' perspective on the acceptability and feasibility of the Face-to-face evaluation (FF) and TeleNP evaluation as assessed using a 5-point Likert scale at Week 1 or Weeks 5-7, depending on randomization. Scores range from Completely disagree (1) to Completely agree (5).
Time frame: After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7
Population: For the patients (i.e., the primary participants), 3 participants signed a consent but did not complete baseline. N=63.~For the care partners, it was not a requirement that the patient's have a care partner. Results are provided for the care partners who were available and consented (n=50).
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Acceptability of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Intervention Appropriateness Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Feasibility of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Acceptability of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Intervention Appropriateness Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Teleneuropsychology (TeleNP) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Feasibility of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Intervention Appropriateness Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Acceptability of Intervention Measure. Range 1-5; Higher=More Acceptable | 3.95 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Acceptability of Intervention Measure. Range 1-5; Higher=More Acceptable | 3.9 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Intervention Appropriateness Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | FF (Face-to-Face). Feasibility of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
| Face-to-Face (FF) | Acceptability and Feasibility of Intervention Measures as Measured by 4-item Acceptability and Feasibility of Intervention Measures Scale | TeleNP. Feasibility of Intervention Measure. Range 1-5; Higher=More Acceptable | 4.0 Score on a Scale |
Primary
Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items
Raw scores for measures of Memory, Executive Functions, Language, and Spatial Abilities will be compared across both conditions. CVLT= California Verbal Learning Test- 2nd edition; Delayed recall measures Memory, total words recalled after 20-minutes (range: 0-16). Higher=better. RBANS = Repeatable Battery for the Assessment of Neuropsychological Status; Delayed recall (Memory) - total elements recalled (range: 0-20). Higher=better. Figure Copy (Spatial)- total copied (range: 0-20). BNT=Boston Naming Test (Language) -total correct (range: 0-15). Higher=better. Category Fluency (Language) - total correct) (range: 0- no limit). Higher=better. JoLO=Judgment of Line Orientation (Spatial) -total correct (range: 0-15). Higher=better
Time frame: After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7
Population: Three participants who underwent the intervention signed a consent but did not complete baseline. Care Partners did not undergo the intervention and thus are not included in these outcomes.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | CVLT Delayed Recall (Memory). Total Score, Higher=better score. | 4.31 score on a scale | Standard Deviation 4.3 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | Category Fluency Total (Language), Total Score, Higher=better score. | 13.19 score on a scale | Standard Deviation 5.5 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | RBANS Figure Copy (Spatial), Total Score, Higher=better score. | 17.08 score on a scale | Standard Deviation 2.5 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | JoLO 15-item Total (Spatial), Total Score, Higher=better score. | 10.60 score on a scale | Standard Deviation 3.4 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | RBANS Figure Delayed Recall (Memory). Total Score, Higher=better score. | 8.21 score on a scale | Standard Deviation 5.2 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | BNT-15 item Total (Language), Total Score, Higher=better score. | 12.40 score on a scale | Standard Deviation 3.2 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | RBANS Figure Copy (Spatial), Total Score, Higher=better score. | 17.21 score on a scale | Standard Deviation 2.6 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | CVLT Delayed Recall (Memory). Total Score, Higher=better score. | 4.40 score on a scale | Standard Deviation 4.2 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | BNT-15 item Total (Language), Total Score, Higher=better score. | 12.52 score on a scale | Standard Deviation 3.2 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | Category Fluency Total (Language), Total Score, Higher=better score. | 12.83 score on a scale | Standard Deviation 5.8 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | JoLO 15-item Total (Spatial), Total Score, Higher=better score. | 11.10 score on a scale | Standard Deviation 3 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores, Measures With Total Correct Items | RBANS Figure Delayed Recall (Memory). Total Score, Higher=better score. | 8.60 score on a scale | Standard Deviation 4.9 |
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Memory: CVLT shown below.95% CI: [0.5, 0.78]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Memory: RBANS shown below.95% CI: [0.71, 0.84]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Memory: BNT-15 shown below.95% CI: [0.76, 0.9]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Lang8age: Category Fluency shown below.95% CI: [0.63, 0.85]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Spatial: JoLO 15-item Total95% CI: [0.45, 0.75]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Spatial: RBANS Figure Copy shown below.95% CI: [0.38, 0.72]
Primary
Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures)
Raw scores for measures of Executive Functions will be compared across both conditions. DKEFS= Delis-Kaplan Executive Function Systems; Color-Word Inhibition (Executive Functions) -total time (range: 0-180). Higher=worse Oral Trail Making Test B (Executive Functions) total time (range: 0-300). Higher=worse
Time frame: After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7
Population: Three participants signed a consent but did not complete baseline
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures) | DKEFS Color-Word Inhibition Total Time | 104.84 seconds | Standard Deviation 44.1 |
| Teleneuropsychology (TeleNP) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures) | Oral Trail Making Test, Total Time | 88.54 seconds | Standard Deviation 87.1 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures) | DKEFS Color-Word Inhibition Total Time | 96.29 seconds | Standard Deviation 38.1 |
| Face-to-Face (FF) | Agreement of Cognitive Test Results Across Testing Modalities as Measured by Neuropsychological Test Mean Scores (Timed Measures) | Oral Trail Making Test, Total Time | 79.59 seconds | Standard Deviation 83.3 |
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Executive Functions: DKEFS Color Word Inhibition shown below.95% CI: [0.71, 0.89]
Comparison: Unadjusted intraclass correlation coefficient (ICC) estimates and their 95% confidence intervals were calculated for each outcome measure to assess the reliability of measures across condition type based on a single-rating, absolute-agreement, two-way random-effects model.~Results for Executive Functions:Oral Trail Making Test B shown below.95% CI: [0.81, 0.93]
Primary
Agreement of Neuropsychologist Appraisal of Severity Across Testing Modalities as Measured by Neuropsychologist-Determined Severity
Neuropsychologist-determined severity (i.e., subjective cognitive concerns; MCI; mild dementia) will be compared across both conditions whether TeleNP alters assessment of patient severity.
Time frame: After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7
Population: Three participants signed a consent but did not complete baseline. Neuropsychologist (n=2 neuropsychologists)-determine diagnostic agreement for all participants (n=63) will be determined between the modalities.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Teleneuropsychology (TeleNP) | Agreement of Neuropsychologist Appraisal of Severity Across Testing Modalities as Measured by Neuropsychologist-Determined Severity | 0.89 Cohen's Kappa |
Comparison: We constructed 3x3 tables for the diagnostic considerations by core battery and severity impression by condition. Agreement between each question and impression category was determined using Cohen's kappa (unweighted). Kappa values were interpreted using the agreement categories as follows: 0-.20 as None, .21-.39 as Minimal, .40-.5995% CI: [0.79, 0.99]
Primary
Agreement of Neuropsychologist Diagnosis Across Testing Modalities as Measured by Neuropsychologist-Determined Diagnosis
Neuropsychologist-determined diagnosis (i.e., typical AD, atypical/complex AD, not AD) will be compared across both conditions whether TeleNP alters assessment of patient diagnosis.
Time frame: After the exposure to each health delivery conditions, Face-to-face evaluation (FF) and TeleNP evaluation, at Week 1 and Weeks 5-7
Population: Three participants signed a consent but did not complete baseline. Neuropsychologist (n=2 neuropsychologists)-determine diagnostic agreement for all participants (n=63) will be determined between the modalities.
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Teleneuropsychology (TeleNP) | Agreement of Neuropsychologist Diagnosis Across Testing Modalities as Measured by Neuropsychologist-Determined Diagnosis | 0.74 Cohen's Kappa |
Comparison: We constructed 3x3 tables for the diagnostic considerations by core battery and syndrome impression by condition. Agreement between each question and impression category was determined using Cohen's kappa (unweighted). Kappa values were interpreted using the agreement categories as follows: 0-.20 as None, .21-.39 as Minimal, .40-.5995% CI: [0.6, 0.88]