Validity of teleneuropsychology for older adults in response to COVID-19: A systematic and critical review

Abstract

Objective: Due to the recent COVID-19 pandemic, the field of neuropsychology must rapidly evolve to incorporate assessments delivered via telehealth, or teleneuropsychology (TNP). Given the increasing demand to deliver services electronically due to public health concerns, it is important to review available TNP validity studies. This systematic review builds upon the work of Brearly and colleagues’ (2017) meta-analysis and provides an updated review of the literature, with special emphasis on test-level validity data.

Method: Using similar methodology as Brearly and colleagues (2017) three internet databases (PubMed, EBSCOhost, PsycINFO) were searched for relevant articles published since 2016. Studies with older adults (aged 65+) who underwent face-to-face and TNP assessments in a counterbalanced cross-over design were included. After review, 10 articles were retained. Combined with nine articles from Brearly’s analysis, a total of 19 studies were included in the systematic review.

Results: Retained studies included samples from 5 different countries, various ethnic/cultural backgrounds, and diverse diagnostic populations. Test-level analysis suggests there are cognitive screeners (MMSE, MoCA), language tests (BNT, Letter Fluency), attention/working memory tasks (Digit Span Total), and memory tests (HVLT-R) with strong support for TNP validity. Other measures are promising but lack sufficient support at this time. Few TNP studies have done in-home assessments and most studies rely on a PC or laptop.

Conclusions: Overall, there appears to be good support for TNP assessments in older adults. Challenges to TNP in the current climate are discussed. Finally, a provisional outline of viable TNP procedures used in our clinic is provided.

Keywords:

• Telehealth
• teleneuropsychology
• systematic review
• validity study

Acknowledgments

A special thank you to Andrea Mejia, Nicole Evangelista, and the rest of the faculty members in the department of Clinical and Health Psychology at the University of Florida for their assistance with this project.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Notes

1 Full search term from PubMed: ((((tele OR remote OR video OR cyber))) AND cognitive) AND (testing OR assessment OR evaluation) AND (“2016/01/01”[PDat] : “2020/03/21”[PDat]) AND aged[MeSH

2 Data from Tables 2–8 were made available to the public on the Inter Organizational Practice Committee website prior to manuscript publication in service to other practitioners (https://iopc.squarespace.com/teleneuropsychology-research).

3 Hildebrand and colleagues (2004) also administered the Rey Auditory Verbal Learning Test as part of their validity study. However, in personal correspondence with Brearly and colleagues (2017), the authors identified potential problems with the RAVLT data and was excluded from Brearly’s quantitative analysis (Brearly et al., 2017, p. 179). Therefore, the RAVLT was not included in this systematic review.