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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Fereshtehnejad SM, Lökk J. Challenges of Teleneurology in the Care of Complex Neurodegenerative Disorders: The Case of Parkinson's Disease with Possible Solutions. Healthcare (Basel) 2023; 11:3187. [PMID: 38132077 PMCID: PMC10742857 DOI: 10.3390/healthcare11243187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
Teleneurology is a specialist field within the realm of telemedicine, which is dedicated to delivering neurological care and consultations through virtual encounters. Teleneurology has been successfully used in acute care (e.g., stroke) and outpatient evaluation for chronic neurological conditions such as epilepsy and headaches. However, for some neurologic entities like Parkinson's disease, in which an in-depth physical examination by palpating muscles and performing neurologic maneuvers is the mainstay of monitoring the effects of medication, the yield and feasibility of a virtual encounter are low. Therefore, in this prospective review, we discuss two promising teleneurology approaches and propose adjustments to enhance the value of virtual encounters by improving the validity of neurological examination: 'hybrid teleneurology', which involves revising the workflow of virtual encounters; and 'artificial intelligence (AI)-assisted teleneurology', namely the use of biosensors and wearables and data processing using AI.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Edmond J. Safra Program in Parkinsonߣs Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON M5T 2S8, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, 171 77 Stockholm, Sweden;
| | - Johan Lökk
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, 171 77 Stockholm, Sweden;
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3
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Baik JS, Min JH, Ko SH, Yun MS, Lee B, Kang NY, Kim B, Lee H, Shin YI. Effects of Home-Based Computerized Cognitive Training in Community-Dwelling Adults With Mild Cognitive Impairment. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 12:97-105. [PMID: 38088994 PMCID: PMC10712670 DOI: 10.1109/jtehm.2023.3317189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/03/2023] [Accepted: 09/12/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVE There is a growing importance for the home-based (HB) support services, and computerized cognitive training (CCT) has been reported as an effective intervention for cognitive impairment. However, there is still a need for further verification of the effect of HB-CCT. This study aimed to determine the effectiveness of HB-CCT on the cognitive function of community-dwelling adults with mild cognitive impairment (MCI) as well as safety in its use. METHODS Fifty community-dwelling adults with MCI were included, of which 25 each were randomized to either HB-CCT or control groups. Evaluations of comprehensive cognition, memory, attention, language, executive function, and depression were performed before and after the intervention, including three times a week for eight weeks in the intervention group and eight weeks apart with no intervention in the control group. RESULTS In baseline and post-evaluation comparisons, the HB-CCT group showed significant improvements, while the control group did not show significant changes. Statistically significant variations were noted between the HB-CCT and control groups in all post-intervention evaluations relative to baseline. Additionally, no side effects were observed. CONCLUSION Beneficial effects on cognition and depression were noted in the intervention group compared with the control group, suggesting that HB-CCT may be a positive tool for cognitive improvement in adults with MCI.
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Affiliation(s)
- Ji Soo Baik
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Ji Hong Min
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
- Department of Rehabilitation MedicineThe Graduate School of MedicinePusan National UniversityYangsan50612Republic of Korea
| | - Mi Sook Yun
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan HospitalYangsan50612Republic of Korea
| | - Byunghoon Lee
- Department of Rehabilitation MedicinePusan National University HospitalBusan46241Republic of Korea
| | - Nae Yoon Kang
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
| | | | | | - Yong-Il Shin
- Department of Rehabilitation MedicinePusan National University Yangsan HospitalYangsan50612Republic of Korea
- Department of Rehabilitation MedicineThe Graduate School of MedicinePusan National UniversityYangsan50612Republic of Korea
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4
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Vinze S, Chodosh J, Lee M, Wright J, Borson S. The national public health response to Alzheimer's disease and related dementias: Origins, evolution, and recommendations to improve early detection. Alzheimers Dement 2023; 19:4276-4286. [PMID: 37435983 DOI: 10.1002/alz.13376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/12/2023] [Accepted: 06/04/2023] [Indexed: 07/13/2023]
Abstract
Longstanding gaps in the detection of Alzheimer's disease and related dementias (ADRD) and biopsychosocial care call for public health action to improve population health. We aim to broaden the understanding of the iterative role state plans have played over the last 20 years in prioritizing improvements in the detection of ADRD, primary care capacity, and equity for disproportionately affected populations. Informed by national ADRD priorities, state plans convene stakeholders to identify local needs, gaps, and barriers and set the stage for development of a national public health infrastructure that can align clinical practice reform with population health goals. We propose policy and practice actions that would accelerate the collaboration between public health, community organizations, and health systems to improve ADRD detection-the point of entry into care pathways that could ultimately improve outcomes on a national scale. HIGHLIGHTS: We systematically reviewed the evolution of state/territory plans for Alzheimer's disease and related dementias (ADRD). Plan goals improved over time but lacked implementation capacity. Landmark federal legislation (2018) enabled funding for action and accountability. The Centers for Disease Control and Prevention (CDC) funds three Public Health Centers of Excellence and many local initiatives. Four new policy steps would promote sustainable ADRD population health improvement.
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Affiliation(s)
- Sanjna Vinze
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Joshua Chodosh
- Grossman School of Medicine, Departments of Medicine and Population Health, and VA Harbor Healthcare System, New York, New York, USA
| | - Matthew Lee
- Department of Population Health, Grossman School of Medicine, New York, New York, USA
| | - Jacob Wright
- Dementia Care Research and Consulting, Santa Ana, California, USA
| | - Soo Borson
- Keck USC School of Medicine, Department of Family Medicine, Alhambra, California, USA
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Canyazo CM, Keller G, Helou B, Arruabarrena M, Corvalán N, Carello A, Harris P, Feldman M, Fernández R, Calandri IL, Martin ME, Allegri RF, Crivelli L. Effectiveness of cognitive rehabilitation on mild cognitive impairment using teleneuropsychology. Dement Neuropsychol 2023; 17:e20220079. [PMID: 37533595 PMCID: PMC10392881 DOI: 10.1590/1980-5764-dn-2022-0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/18/2023] [Accepted: 03/05/2023] [Indexed: 08/04/2023] Open
Abstract
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods A sample of 60 patients with mild cognitive impairment according to Petersen's criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on each outcome of interest over time (pre/post-intervention). Results A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions Our study suggests that CTR is an effective intervention.
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Affiliation(s)
- Carlos Martínez Canyazo
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Hospital Fleni, Servicio de Neuroinmunología, Buenos Aires, Argentina
| | - Greta Keller
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Belen Helou
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | | | - Nicolas Corvalán
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Agostina Carello
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Paula Harris
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Monica Feldman
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
| | - Rodrigo Fernández
- Universidad de Buenos Aires, Instituto de Psicología, Biología Molecular y Neurociencias, CONICET, Buenos Aires, Argentina
| | | | | | - Ricardo Francisco Allegri
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Universidad de la Costa, Departamento de Ciencias de la Salud, Barranquilla, Colombia
- Instituto de Neurociencias, Fleni-CONICET, Buenos Aires, Argentina
| | - Lucía Crivelli
- Hospital Fleni, Departamento de Neurología Cognitiva, Buenos Aires, Argentina
- Instituto de Neurociencias, Fleni-CONICET, Buenos Aires, Argentina
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Novais T, Qassemi S, Cestac P, McCambridge C, Villars H, Zueras A, Decaudin B, Dambrine M, Huvent-Grelle D, Roche J, Schoenenburg S, Federico D, Nier AC, Krolak-Salmon P, Mouchoux C. Impact of pharmaceutical care integrated at a psychosocial intervention to reduce caregiver's burden in Alzheimer's disease or related dementias: Negative results at 18 months and difficulties to conduct PHARMAID RCT. Contemp Clin Trials Commun 2023; 33:101146. [PMID: 37397433 PMCID: PMC10313878 DOI: 10.1016/j.conctc.2023.101146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/13/2023] [Accepted: 04/21/2023] [Indexed: 07/04/2023] Open
Abstract
Background Psychosocial interventions for caregivers of patients with Alzheimer disease and relative dementias (ADRD) reported a caregiver burden improvement. Multicomponent intervention integrating pharmaceutical care has not yet been evaluated while ADRD patients and their caregivers are exposed to high risk of drug-related problems. The PHARMAID study aimed to assess the impact of personalized pharmaceutical care integrated to a psychosocial program on the burden of ADRD caregivers at 18 months. Methods The PHARMAID RCT was conducted between September 2016 and June 2020 [ClinicalTrials.gov: NCT02802371]. PHARMAID study planned to enroll 240 dyads, i.e. ADRD patients and caregivers, whose inclusion criteria were: outpatient with mild or major neurocognitive disorders due to ADRD, living at home, receiving support from a family caregiver. Three parallel groups compared a control group with two interventional groups: psychosocial intervention and integrated pharmaceutical care at a psychosocial intervention. The main outcome was the caregiver burden assessed by the Zarit Burden Index (ZBI, score range 0-88) at 18 months. Results Overall, 77 dyads were included (32% of the expected sample size). At 18 months, the mean ZBI scores were 36.7 ± 16.8 in the control group, 30.3 ± 16.3 for the group with psychosocial intervention, and 28.8 ± 14.1 in group with integrated pharmaceutical care at psychosocial intervention. No significant difference was demonstrated between the three groups (p = 0.326). Conclusions The findings suggest that PHARMAID program had no significant impact on caregiver burden at 18 months. Several limitations have been highlighted and discussed by the authors in order to formulate recommendations for further research.
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Affiliation(s)
- Teddy Novais
- Department of Pharmacy, Charpennes Hospital, Hospices Civils de Lyon, F-69100, Villeurbanne, France
- Lyon Institute for Aging, Hospices Civils de Lyon, F-69000, Lyon, France
- Research on Healthcare Performance (RESHAPE), INSERM U1290, University Lyon1, F-69000, Lyon, France
| | - Soraya Qassemi
- REIPO Team, La Grave Hospital, Toulouse University Hospital, F-31000, Toulouse, France
| | - Philippe Cestac
- Department of Pharmacy, Toulouse University Hospital, F-31000, Toulouse, France
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse, F-31000, Toulouse, France
| | - Cécile McCambridge
- Department of Pharmacy, Toulouse University Hospital, F-31000, Toulouse, France
| | - Hélène Villars
- Centre for Epidemiology and Population Health Research (CERPOP), UMR 1027, INSERM, University of Toulouse, F-31000, Toulouse, France
- Geriatric Department, Toulouse University Hospital, F-31000, Toulouse, France
| | - Audrey Zueras
- Geriatric Department, Toulouse University Hospital, F-31000, Toulouse, France
| | - Bertrand Decaudin
- ULR 7365-GRITA-Groupe de Recherche sur Les Formes Injectables et Les Technologies Associées, University Lille, F-59000, Lille, France
- Pharmacie Institute, CHU Lille, F-59000, Lille, France
| | | | | | - Jean Roche
- Department of Geriatric Psychiatry, CHU Lille, F-59000, Lille, France
| | | | - Denis Federico
- Lyon Institute for Aging, Hospices Civils de Lyon, F-69000, Lyon, France
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, F-69100, Villeurbanne, France
| | - Anne-Cécile Nier
- Lyon Institute for Aging, Hospices Civils de Lyon, F-69000, Lyon, France
| | - Pierre Krolak-Salmon
- Lyon Institute for Aging, Hospices Civils de Lyon, F-69000, Lyon, France
- Clinical and Research Memory Centre of Lyon (CMRR), Charpennes Hospital, University Hospital of Lyon, F-69100, Villeurbanne, France
- Clinical Research Centre (CRC) - VCF (Aging – Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, F-69000, Lyon, France
- Neuroscience Research Centre of Lyon (CRNL), F-69000, Lyon, France
| | - Christelle Mouchoux
- Department of Pharmacy, Charpennes Hospital, Hospices Civils de Lyon, F-69100, Villeurbanne, France
- Lyon Institute for Aging, Hospices Civils de Lyon, F-69000, Lyon, France
- Clinical Research Centre (CRC) - VCF (Aging – Brain - Frailty), Charpennes Hospital, University Hospital of Lyon, Villeurbanne, F-69000, Lyon, France
- Neuroscience Research Centre of Lyon (CRNL), F-69000, Lyon, France
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Muili AO, Mustapha MJ, Offor MC, Oladipo HJ. Emerging roles of telemedicine in dementia treatment and care. Dement Neuropsychol 2023; 17:e20220066. [PMID: 37261258 PMCID: PMC10229090 DOI: 10.1590/1980-5764-dn-2022-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/20/2022] [Accepted: 01/20/2023] [Indexed: 06/02/2023] Open
Abstract
Dementia is a neurological disorder that affects memory, thinking, orientation, and other important functions of the brain; telemedicine is a part of the healthcare delivery system involving diagnosis and consultation over telecommunications devices such as mobile phones and computers. In this review, we assessed the impact, accessibility, and possible improvements in telemedicine in dementia treatment. Regarding the use of telemedicine in the treatment, we evaluated its impact on the management of the disease (i.e., diagnosis and follow-up). We also evaluated studies on the current improvements and accessibility of telemedicine in dementia treatment. The review findings showed that it is effective in diagnosing patients, monitoring their progress during treatment, and providing caregiver support. However, studies have revealed a lack of accessibility and improvement in telemedicine among the elderly, particularly in West African countries. Finally, lasting solutions were provided to address the problems in the review permanently.
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Ardelean A, Redolat R. Supporting Behavioral and Psychological Challenges in Alzheimer Using Technology: A Systematic Review. ACTIVITIES, ADAPTATION & AGING 2023. [DOI: 10.1080/01924788.2023.2172900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- A. Ardelean
- Department of Psychobiology, Faculty of Psychology and Logopedy, Universitat de València, Valencia, Spain
| | - R. Redolat
- Department of Psychobiology, Faculty of Psychology and Logopedy, Universitat de València, Valencia, Spain
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Peri K, Balmer D, Cheung G. The experiences of carers in supporting a person living with dementia to participate in virtual cognitive stimulation therapy during the COVID-19 pandemic. Aging Ment Health 2023; 27:372-379. [PMID: 35403508 DOI: 10.1080/13607863.2022.2053834] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Cognitive stimulation therapy (CST) is an evidence-based group intervention for people with dementia. In response to the COVID-19 pandemic, many existing CST groups moved virtually and this required carers of people living with dementia to assist with setting up the appropriate technology. This study aimed to explore the roles and experiences of carers in accessing virtual CST (vCST). METHODS This qualitative study used semi-structured individual interviews, via telephone or videoconference, to explore the roles and experiences of carers. Interviews were recorded, transcribed verbatim and thematically analysed. RESULTS Twelve family carers (age: 51-75 years) reported a range of experiences, from novice to expert knowledge in terms of accessing digital devices (mainly laptops and iPads) and connecting to Zoom. Accessing vCST provided carers an immediate application of new knowledge. Carers reported positive responses to vCST that provided their family member living with dementia with social contact and cognitive stimulation during lockdown. CONCLUSION Accessing vCST required carers to have an existing adequate level of technological competence in order to learn and use the Zoom platform. Adult learning principles can be used to improve carers' digital literacy required for vCST and other telehealth initiatives.
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Affiliation(s)
- Kathryn Peri
- School of Nursing, The University of Auckland, New Zealand
| | - Deborah Balmer
- School of Nursing, The University of Auckland, New Zealand
| | - Gary Cheung
- Department of Psychological Medicine, School of Medicine, The University of Auckland, New Zealand
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Oyeyemi DM, Omer ZB, Brown B, Freimund J, Gummerson C, Rink A, Gallant N, Marottoli RA. Developing an animated COVID-19 e-curriculum for adults with dementia and caregivers: Challenges and solutions. PATIENT EDUCATION AND COUNSELING 2023; 106:180-187. [PMID: 36371243 PMCID: PMC9597565 DOI: 10.1016/j.pec.2022.10.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 10/14/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Effective education and support for adults with dementia and their caregivers around pandemic issues is critical for protecting them. Animation-based learning has shown promise in patient education. We collaborated with educators and support staff at Alzheimer's Association Connecticut (AACT) to conduct a mixed-methods study and develop an animated e-curriculum addressing pandemic related challenges. METHODS We conducted focus groups and surveys with dementia and caregiver educators and support staff at AACT for the initial needs assessment and the later e-curriculum evaluation. An interdisciplinary team of educators followed a step-wise process to transform the needs assessment results into an animation based e-curriculum. RESULTS Participants identified the following pandemic challenges: 1) social isolation, 2) caregiver fatigue, 3) safety, and 4) difficulty navigating the healthcare system. The overall quality and usefulness of the e-curriculum was "very good" or "excellent". CONCLUSIONS An animated e-curriculum addressing pandemic related issues relevant to adults with dementia and caregivers had positive reviews and was associated with improvement in self-reported ability to perform curriculum objectives among community dementia educators. PRACTICE IMPLICATIONS The pandemic challenges identified may facilitate the development of further resources. Additionally, this project may serve as a guide for clinicians interested in incorporating animation into education efforts.
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Affiliation(s)
- Deborah M Oyeyemi
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Zehra B Omer
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA; Department of Geriatrics & Extended Care, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
| | - Bryan Brown
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Jennifer Freimund
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Christine Gummerson
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Andrea Rink
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Noelle Gallant
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Richard A Marottoli
- Department of Internal Medicine, Section of Geriatrics, Yale University School of Medicine, New Haven, CT, USA; Department of Geriatrics & Extended Care, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
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11
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Virtanen L, Kaihlanen AM, Kainiemi E, Saukkonen P, Heponiemi T. Patterns of acceptance and use of digital health services among the persistent frequent attenders of outpatient care: A qualitatively driven multimethod analysis. Digit Health 2023; 9:20552076231178422. [PMID: 37256014 PMCID: PMC10226178 DOI: 10.1177/20552076231178422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
Objective Utilising digital health services in the treatment of patients who frequently attend outpatient care could be beneficial for patients' health and the sustainability of health systems but carries the risk of digital exclusion. This study aimed to explore the patterns of acceptance and use of digital health services among frequent attenders (FAs), which may help in the assessment of patients' digital suitability. Methods Persistent FAs (N = 30) were recruited by random sampling from one Finnish municipality. The semistructured interviews were conducted in February-May 2021. We analysed the data with qualitative content analysis using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Additionally, we quantified the data for two-step cluster analyses to create separate cluster models that grouped FAs based on acceptance and use of (a) digital services for self-management of health and (b) telemedicine services. Results Based on digital self-management, FAs were defined as Self-Managers, Supported Self-Managers, and Non-Self-Managers. Based on telemedicine use, they were grouped into Telemedicine Users, Doubtful Telemedicine Users, and Telemedicine Refusers. The clusters described different opportunities, awareness, and interest in using digital health services. Referral from professionals seemed to promote digital service use. For some, digital services were not accessible. Conclusions Our findings emphasise the importance of assessing the suitability of FAs to digital health services, as their readiness to use may vary. Professionals should recommend digital services that support individual health to suitable patients. More accessible digital services could promote digital suitability despite functional limitations.
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Affiliation(s)
- Lotta Virtanen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Anu-Marja Kaihlanen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Emma Kainiemi
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Petra Saukkonen
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
| | - Tarja Heponiemi
- Welfare State Research and Reform Unit, Finnish Institute for Health and
Welfare (THL), Helsinki, Finland
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12
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Gürsoy MD, Tığrak TK, Köse A. Telepractice with Preschool Children: Speech-Language Pathologists' Perspectives in Turkey. Int J Telerehabil 2022; 14:e6465. [PMID: 38026561 PMCID: PMC10681051 DOI: 10.5195/ijt.2022.6465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
The purpose of this research was to investigate speech-language pathologists' (SLPs) perspectives, attitudes, and experiences of using telepractice for preschoolers in Turkey. A mixed-method online survey was used with SLPs who implemented telepractice with preschool children. Frequency distribution and theme analysis were used to examine the data. Therapy was the most offered online service (98%). Further, 67% of SLPs worked with speech sound disorders. More than half of SLPs felt confident offering telepractice to preschoolers. Most respondents thought that telepractice was an appropriate and easily accessible approach for preschool children, with the applicability of telepractice connected to a child's type of problem. The SLPs were motivated by the numerous advantages of telepractice. However, their opinions were divided when telepractice was compared to in-person treatment. The SLPs in Turkey must be better educated about telepractice, and clinical standards established. The findings point to areas of telepractice that might be improved for preschoolers, especially in Turkey.
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Affiliation(s)
- Merve Dilbaz Gürsoy
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Tuğçe Karahan Tığrak
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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13
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Requena-Komuro MC, Jiang J, Dobson L, Benhamou E, Russell L, Bond RL, Brotherhood EV, Greaves C, Barker S, Rohrer JD, Crutch SJ, Warren JD, Hardy CJ. Remote versus face-to-face neuropsychological testing for dementia research: a comparative study in people with Alzheimer's disease, frontotemporal dementia and healthy older individuals. BMJ Open 2022; 12:e064576. [PMID: 36428012 PMCID: PMC9702828 DOI: 10.1136/bmjopen-2022-064576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/20/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES We explored whether adapting neuropsychological tests for online administration during the COVID-19 pandemic was feasible for dementia research. DESIGN We used a longitudinal design for healthy controls, who completed face-to-face assessments 3-4 years before remote assessments. For patients, we used a cross-sectional design, contrasting a prospective remote cohort with a retrospective face-to-face cohort matched for age/education/severity. SETTING Remote assessments were conducted using video-conferencing/online testing platforms, with participants using a personal computer/tablet at home. Face-to-face assessments were conducted in testing rooms at our research centre. PARTICIPANTS The remote cohort comprised 25 patients (n=8 Alzheimer's disease (AD); n=3 behavioural variant frontotemporal dementia (bvFTD); n=4 semantic dementia (SD); n=5 progressive non-fluent aphasia (PNFA); n=5 logopenic aphasia (LPA)). The face-to-face patient cohort comprised 64 patients (n=25 AD; n=12 bvFTD; n=9 SD; n=12 PNFA; n=6 LPA). Ten controls who previously participated in face-to-face research also took part remotely. OUTCOME MEASURES The outcome measures comprised the strength of evidence under a Bayesian framework for differences in performances between testing environments on general neuropsychological and neurolinguistic measures. RESULTS There was substantial evidence suggesting no difference across environments in both the healthy control and combined patient cohorts (including measures of working memory, single-word comprehension, arithmetic and naming; Bayes Factors (BF)01 >3), in the healthy control group alone (including measures of letter/category fluency, semantic knowledge and bisyllabic word repetition; all BF01 >3), and in the combined patient cohort alone (including measures of working memory, episodic memory, short-term verbal memory, visual perception, non-word reading, sentence comprehension and bisyllabic/trisyllabic word repetition; all BF01 >3). In the control cohort alone, there was substantial evidence in support of a difference across environments for tests of visual perception (BF01=0.0404) and monosyllabic word repetition (BF01=0.0487). CONCLUSIONS Our findings suggest that remote delivery of neuropsychological tests for dementia research is feasible.
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Affiliation(s)
- Maï-Carmen Requena-Komuro
- Dementia Research Centre, University College London, London, UK
- Kidney Cancer Program, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Jessica Jiang
- Dementia Research Centre, University College London, London, UK
| | - Lucianne Dobson
- Dementia Research Centre, University College London, London, UK
| | - Elia Benhamou
- Dementia Research Centre, University College London, London, UK
- Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
| | - Lucy Russell
- Dementia Research Centre, University College London, London, UK
| | - Rebecca L Bond
- Dementia Research Centre, University College London, London, UK
| | | | | | - Suzie Barker
- Dementia Research Centre, University College London, London, UK
| | | | | | - Jason D Warren
- Dementia Research Centre, University College London, London, UK
| | - Chris Jd Hardy
- Dementia Research Centre, University College London, London, UK
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14
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Nkodo JA, Gana W, Debacq C, Aidoud A, Poupin P, Camus V, Fougère B. The Role of Telemedicine in the Management of the Behavioral and Psychological Symptoms of Dementia: A Systematic Review. Am J Geriatr Psychiatry 2022; 30:1135-1150. [PMID: 35241355 DOI: 10.1016/j.jagp.2022.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023]
Abstract
The first-line management of behavioral and psychological symptoms of dementia (BPSD) is based on nonpharmacologic interventions such as the provision of guidance and medical support to caregivers. However, accessibility to specialized care and medical resources is often scarce. The ongoing COVID-19 pandemic has compromised the delivery of outpatient care (notably in order to minimize the risk of disease transmission), thus making it essential to provide other means of accessing care for these patient populations. The use of telemedicine (TM) may be a means of increasing access to specialist care for patients with disabilities and poor access to health services, such as those with BPSD. The aim of this study is to provide a review of the literature on the use of TM for treatment and follow-up of patients with BPSD and their caregivers. We searched the PUBMED, EMBASE and CINAHL for articles published between January 1st, 2000, and December 31st, 2020, on the applicability of TM support for people with BPSD and their caregivers. We included open-label studies, qualitative studies, and randomized controlled trials . We did not include studies on the use of TM during the COVID-19 pandemic. A total of 22 publications were included and reviewed. TM was found to 1) be acceptable and feasible for both patients and caregivers, 2) decrease the frequency and intensity of BPSD, and 3) improve the caregiver's perceived wellbeing and mental health. Videoconferencing was effective for patient-centered interventions in nursing homes. Telephone-based interventions were more relevant when they were targeted at caregivers. The published studies are lacking in scope and high-quality studies are now needed to confirm these findings and assess TM's cost-effectiveness and ability to improve the management of patients with BPSD. In view of the ongoing COVID-19 pandemic, remote solutions for assessing and monitoring individuals with BPSD are urgently needed - particularly those living in rural areas and so-called "medical deserts."
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Affiliation(s)
- Jacques-Alexis Nkodo
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France.
| | - Wassim Gana
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Camille Debacq
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Amal Aidoud
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Pierre Poupin
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France
| | - Vincent Camus
- Service de Psychiatrie Universitaire (JAN, VC), CHRU Tours, Tours, France; UMR INSERM U1253 & Université de Tours (VC), Tours, France
| | - Bertrand Fougère
- Division of Geriatric Medicine (JAN, WG, CD, AA, PP, BF), CHRU de Tours, Tours, France; Education, Ethics, Health (EA 7505) (BF), Tours University, Tours, France
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15
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Scheerbaum P, Book S, Jank M, Hanslian E, DellO'ro M, Schneider J, Scheuermann JS, Bösl S, Jeitler M, Kessler C, Graessel E. Computerised cognitive training tools and online nutritional group counselling for people with mild cognitive impairment: study protocol of a completely digital, randomised, controlled trial. BMJ Open 2022; 12:e060473. [PMID: 35777882 PMCID: PMC9252202 DOI: 10.1136/bmjopen-2021-060473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION People with mild cognitive impairment (MCI) are at increased risk of decreasing cognitive functioning. Computerised cognitive training (CCT) and nutrition have been shown to improve the cognitive capacities of people with MCI. For each variable, we developed two kinds of interventions specialised for people with MCI (CCT: 'individualised' CCT; nutrition: a whole-food, plant-based diet). Additionally, there are two kinds of active control measures (CCT: 'basic' CCT; nutrition: a healthy diet following the current guidelines of the German Nutrition Society). The aim of this study is to investigate the effects of the two interventions on cognition in people with MCI in a 2×2 randomised controlled trial with German participants. METHODS AND ANALYSIS Participants will be community-dwelling individuals with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination. With N=200, effects with an effect size of f≥0.24 (comparable to Cohen's d≥0.48) can be detected. Screening, baseline, t6 and t12 testing will be conducted via a videoconferencing assessment, telephone, and online survey. Participants will be randomly allocated to one of four groups and will receive a combination of CCT and online nutritional counselling. The CCT can be carried out independently at home on a computer, laptop, or tablet. Nutrition counselling includes 12 online group sessions every fortnight for 1.5 hours. The treatment phase is 6 months with follow-ups after six and 12 months after baseline. ETHICS AND DISSEMINATION All procedures were approved by the Friedrich-Alexander-Universität Erlangen-Nürnberg Ethics Committee (Ref. 21-318-1-B). Written informed consent will be obtained from all participants. Results will be published in peer-reviewed scientific journals, conference presentations. TRIAL REGISTRATION NUMBER ISRCTN10560738.
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Affiliation(s)
- Petra Scheerbaum
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephanie Book
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jank
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Genesis Mediware GmbH, Hersbruck, Germany
| | - Etienne Hanslian
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Melanie DellO'ro
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia Schneider
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Julia-Sophia Scheuermann
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sophia Bösl
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Christian Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charite University Hospital, Berlin, Germany
| | - Elmar Graessel
- Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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16
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Zhang Y, Leuk JSP, Teo WP. Domains, feasibility, effectiveness, cost, and acceptability of telehealth in aging care: a scoping review of systematic reviews (Preprint). JMIR Aging 2022; 6:e40460. [PMID: 37071459 PMCID: PMC10155091 DOI: 10.2196/40460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/02/2022] [Accepted: 01/29/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Aging is becoming a major global challenge. Compared with younger adults, the older population has greater health needs but faces inadequate access to appropriate, affordable, and high-quality health care. Telehealth can remove geographic and time boundaries, as well as enabling socially isolated and physically homebound people to access a wider range of care options. The impacts of different telehealth interventions in terms of their effectiveness, cost, and acceptability in aging care are still unclear. OBJECTIVE This scoping review of systematic reviews aimed to provide an overview of the domains of telehealth implemented in aging care; synthesize evidence of telehealth's feasibility, effectiveness, cost benefits, and acceptability in the context of aging care; identify gaps in the literature; and determine the priorities for future research. METHODS Guided by the methodological framework of the Joanna Briggs Institute, we reviewed systematic reviews concerning all types of telehealth interventions involving direct communication between older users and health care providers. In total, 5 major electronic databases, PubMed, Embase (Ovid), Cochrane Library, CINAHL, and PsycINFO (EBSCO), were searched on September 16, 2021, and an updated search was performed on April 28, 2022, across the same databases as well as the first 10 pages of the Google search. RESULTS A total of 29 systematic reviews, including 1 post hoc subanalysis of a previously published large Cochrane systematic review with meta-analysis, were included. Telehealth has been adopted in various domains in aging care, such as cardiovascular diseases, mental health, cognitive impairment, prefrailty and frailty, chronic diseases, and oral health, and it seems to be a promising, feasible, effective, cost-effective, and acceptable alternative to usual care in selected domains. However, it should be noted that the generalizability of the results might be limited, and further studies with larger sample sizes, more rigorous designs, adequate reporting, and more consistently defined outcomes and methodologies are needed. The factors affecting telehealth use among older adults have been categorized into individual, interpersonal, technological, system, and policy levels, which could help direct collaborative efforts toward improving the security, accessibility, and affordability of telehealth as well as better prepare the older population for digital inclusion. CONCLUSIONS Although telehealth remains in its infancy and there is a lack of high-quality studies to rigorously prove the feasibility, effectiveness, cost benefit, and acceptability of telehealth, mounting evidence has indicated that it could play a promising complementary role in the care of the aging population.
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Affiliation(s)
- Yichi Zhang
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Ageing Research Institute for Society and Education, Interdisciplinary Graduate Programme, Nanyang Technological University, Singapore, Singapore
| | - Jessie Siew-Pin Leuk
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Wei-Peng Teo
- Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
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17
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Tsiakiri A, Koutzmpi V, Megagianni S, Toumaian M, Geronikola N, Despoti A, Kanellopoulou S, Arampatzi X, Margioti E, Davila A, Zoi P, Kalligerou F, Liozidou A, Tsapanou A, Sakka P. Remote neuropsychological evaluation of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 35595233 DOI: 10.1080/23279095.2022.2074850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
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Affiliation(s)
- A Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
- Hellenic Neuropsychological Society, Athens, Greece
| | - V Koutzmpi
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - S Megagianni
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - M Toumaian
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis," Athens, Greece
| | - N Geronikola
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Despoti
- Hellenic Neuropsychological Society, Athens, Greece
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - X Arampatzi
- Athens Alzheimer's Association, Athens, Greece
| | - E Margioti
- Athens Alzheimer's Association, Athens, Greece
| | - A Davila
- Athens Alzheimer's Association, Athens, Greece
| | - P Zoi
- Athens Alzheimer's Association, Athens, Greece
| | - F Kalligerou
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Liozidou
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, The Scientific College of Greece. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens
| | - A Tsapanou
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, USA
| | - P Sakka
- Athens Alzheimer's Association, Athens, Greece
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18
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Philippe TJ, Sikder N, Jackson A, Koblanski ME, Liow E, Pilarinos A, Vasarhelyi K. Digital Health Interventions for Delivery of Mental Health Care: Systematic and Comprehensive Meta-Review. JMIR Ment Health 2022; 9:e35159. [PMID: 35551058 PMCID: PMC9109782 DOI: 10.2196/35159] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has shifted mental health care delivery to digital platforms, videoconferencing, and other mobile communications. However, existing reviews of digital health interventions are narrow in scope and focus on a limited number of mental health conditions. OBJECTIVE To address this gap, we conducted a comprehensive systematic meta-review of the literature to assess the state of digital health interventions for the treatment of mental health conditions. METHODS We searched MEDLINE for secondary literature published between 2010 and 2021 on the use, efficacy, and appropriateness of digital health interventions for the delivery of mental health care. RESULTS Of the 3022 records identified, 466 proceeded to full-text review and 304 met the criteria for inclusion in this study. A majority (52%) of research involved the treatment of substance use disorders, 29% focused on mood, anxiety, and traumatic stress disorders, and >5% for each remaining mental health conditions. Synchronous and asynchronous communication, computerized therapy, and cognitive training appear to be effective but require further examination in understudied mental health conditions. Similarly, virtual reality, mobile apps, social media platforms, and web-based forums are novel technologies that have the potential to improve mental health but require higher quality evidence. CONCLUSIONS Digital health interventions offer promise in the treatment of mental health conditions. In the context of the COVID-19 pandemic, digital health interventions provide a safer alternative to face-to-face treatment. However, further research on the applications of digital interventions in understudied mental health conditions is needed. Additionally, evidence is needed on the effectiveness and appropriateness of digital health tools for patients who are marginalized and may lack access to digital health interventions.
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Affiliation(s)
- Tristan J Philippe
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | - Anna Jackson
- School of Social Work, The University of British Columbia, Vancouver, BC, Canada
| | - Maya E Koblanski
- Department of Cellular & Physiological Sciences, The University of British Columbia, Vancouver, BC, Canada.,Department of Psychology, The University of British Columbia, Vancouver, BC, Canada
| | - Eric Liow
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Andreas Pilarinos
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Krisztina Vasarhelyi
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
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19
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Book S, Jank M, Pendergrass A, Graessel E. Individualised computerised cognitive training for community-dwelling people with mild cognitive impairment: study protocol of a completely virtual, randomised, controlled trial. Trials 2022; 23:371. [PMID: 35513855 PMCID: PMC9069424 DOI: 10.1186/s13063-022-06152-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 03/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background People with mild cognitive impairment (MCI) are at increased risk of converting to dementia. Cognitive training can improve the cognitive abilities of people with MCI. Computerised cognitive training (CCT) offers several advantages over traditional paper-and-pencil cognitive training and has the potential to be more individualised by matching task difficulty with individual performance. Recent systematic reviews have reported promising effects of CCT on improving the cognitive capacities of people with MCI. However, the quality of existing studies has been limited, and it is still unclear whether CCT can influence the progression to dementia. We developed an ‘individualised’ CCT (MAKSCog) specialised for people with MCI that automatically matches task difficulty with individual performance and an active control training (‘basic’ CCT). The aims of the present study are (a) to evaluate MAKSCog and (b) to investigate whether it can be applied to maintain the cognitive abilities of people with MCI. Methods The present study investigates the effects of CCT on cognition in a randomised controlled intervention study in Germany. Participants are community-dwelling people with a psychometric diagnosis of MCI based on the Montreal Cognitive Assessment (MoCA) and Mini-Mental Status Test (MMSE). Screening and baseline testing are conducted via a videoconferencing assessment and telephone. Participants are randomly allocated. The treatment phase is 6 months with an open phase in which participants can freely decide to continue to use the CCTs. Additionally, both CCTs contain a monthly computerised cognitive assessment that measures different cognitive abilities: information processing speed, memory span, short term memory, and logical reasoning. Discussion This is the first study to investigate the effect of MAKSCog, an individualised CCT, specifically developed for people with different subtypes of MCI. A methodological strength is the double-blind, randomised, controlled design and the use of basic CCT as an active control group. The study is conducted entirely virtually with valid telehealth assessments for cognitive function. Methodological limitations might include a restriction to participants who feel comfortable with the use of technology and who own a computer, laptop, or tablet. Trial registration ISRCTN ISRCTN14437015. Prospectively registered on 27 February 2020.
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Affiliation(s)
- Stephanie Book
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Michael Jank
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Anna Pendergrass
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Elmar Graessel
- Centre for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
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20
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Khan S, Llinas EJ, Danoff SK, Llinas RH, Marsh EB. The telemedicine experience: using principles of clinical excellence to identify disparities and optimize care. Medicine (Baltimore) 2022; 101:e29017. [PMID: 35451400 PMCID: PMC8913094 DOI: 10.1097/md.0000000000029017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/17/2022] [Indexed: 01/04/2023] Open
Abstract
The use of telemedicine has increased significantly during the Corona virus disease 2019 pandemic. This manuscript serves to identify the underlying principles of clinical excellence in telemedicine and to determine whether effective care practices can be generalized as a one-size-fits-all model or must instead be tailored to individual patient populations.A survey assessing care quality and patient satisfaction for patients using telemedicine was created and administered via email to 2 urban cohorts of varying demographics and socioeconomic backgrounds: a population of patients with prior stroke and cerebrovascular disease, and a cohort of patients followed for interstitial lung disease. Results were compared across groups to determine the generalizability of effective practices across populations.Individuals taking part in telemedicine were more likely to be White, more affluent, and woman, regardless of clinical diagnosis compared with a similar cohort of patients seen in-person the year prior. A lower-than-expected number of patients who were Black and of lower socioeconomic status followed up virtually, indicating potential barriers to access. Overall, patients who participated in televisits were satisfied with the experience and felt that the care met their medical needs; however, those who were older were more likely to experience technical difficulties and prefer in-person visits, while those with less education were less likely to feel that their questions were addressed in an understandable way.When thoughtfully designed, telemedicine practices can be an effective model for patient care, though implementation must consider population characteristics including age, education, and socioeconomic status, and strategies such as ease of access versus optimization of communication strategies should be tailored to meet individual patient needs.
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Affiliation(s)
- Sheena Khan
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Edward J. Llinas
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Sonye K. Danoff
- Division of Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Rafael H. Llinas
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD
| | - Elisabeth B. Marsh
- Department of Neurology, The Johns Hopkins School of Medicine, Baltimore, MD
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21
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Hernandez HHC, Ong PL, Anthony P, Ang SL, Salim NBM, Yew PYS, Ali NB, Lim JP, Lim WS, Chew J. Cognitive assessment by telemedicine: reliability and agreement between face-to-face and remote videoconference-based cognitive tests in older adults attending a memory clinic. Ann Geriatr Med Res 2022; 26:42-48. [PMID: 35236016 PMCID: PMC8984169 DOI: 10.4235/agmr.22.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/26/2022] [Indexed: 11/04/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has spurred the rapid adoption of telemedicine. However, the reproducibility of face-to-face (F2F) versus remote videoconference-based cognitive testing remains to be established. We assessed the reliability and agreement between F2F and remote administrations of the Abbreviated Mental Test (AMT), modified version of the Chinese Mini-Mental State Examination (mCMMSE), and Chinese Frontal Assessment Battery (CFAB) in older adults attending a memory clinic. Methods The participants underwent F2F followed by remote videoconference-based assessment by the same assessor within 3 weeks. Reliability was evaluated using intraclass correlation coefficients (ICC; two-way mixed, absolute agreement), the mean difference between remote and F2F-based assessments using paired-sample t-tests, and agreement using Bland-Altman plots. Results Fifty-six subjects (mean age, 76±5.4 years; 74% mild; 19% moderate dementia) completed the AMT and mCMMSE, of which 30 completed the CFAB. Good reliability was noted based on the ICC values—AMT: ICC=0.80, 95% confidence interval [CI] 0.68–0.88; mCMMSE: ICC=0.80, 95% CI 0.63–0.88; CFAB: ICC=0.82, 95% CI 0.66–0.91. However, remote AMT and mCMMSE scores were higher compared to F2F—mean difference (i.e., remote minus F2F): AMT 0.3±1.1, p=0.03; mCMMSE 1.3±2.9, p=0.001. Significant differences were observed in the orientation and recall items of the mCMMSE and the similarities and conflicting instructions of CFAB. Bland–Altman plots indicated wide 95% limits of agreement (AMT -1.9 to 2.6; mCMMSE -4.3 to 6.9; CFAB -3.0 to 3.8), exceeding the a priori-defined levels of error. Conclusion While the remote and F2F cognitive assessments demonstrated good overall reliability, the test scores were higher when performed remotely compared to F2F. The discrepancies in agreement warrant attention to patient selection and environment optimization for the successful adaptation of telemedicine for cognitive assessment.
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Affiliation(s)
| | - Poh Ling Ong
- Dementia Care, Nursing Specialty, Tan Tock Seng Hospital, Singapore
| | | | - Siew Ling Ang
- Dementia Care, Nursing Specialty, Tan Tock Seng Hospital, Singapore
| | | | | | | | - Jun Pei Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Justin Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.,Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
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22
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Abstract
Purpose of Review This review discusses the complex relationship between COVID-19 and dementia and how the pandemic has affected the management of patients with dementia. This population resulted particularly susceptible to SARS-CoV-2 infection and its effects and also to the negative effects of the measures taken worldwide to control the spread of the virus. Recent Findings Patients with dementia were at increased risk for COVID-19 compared to patients without dementia, and diagnosis of dementia represents an independent risk factor for hospitalization in COVID-19 patients. Mortality due to SARS-CoV2 infection in subjects with dementia is 2–5 times higher than in the general population. Cognitive impairment and delirium have been described in COVID-19 survivors. SARS-COV2 pandemic exacerbates the vulnerability of dementia patients and their caregivers, due to the morbidity and mortality from COVID-19, the indirect effects of the pandemic on the social supports, and the effects on healthcare system on which they depend. Summary The COVID-19 pandemic requires people with dementia to move from traditional models of health care to innovative models for home care, to support caregivers’ burden, and to improve long term care.
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23
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Alhuwail D, Abd-Alrazaq A, Al-Jafar E, Househ M. Telehealth for the geriatric population: uses, opportunities, and challenges. SMART HOME TECHNOLOGIES AND SERVICES FOR GERIATRIC REHABILITATION 2022:107-122. [DOI: 10.1016/b978-0-323-85173-2.00008-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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24
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Schneider LS, Qiu Y, Thomas RG, Evans C, Jacobs DM, Jin S, Kaye JA, LaCroix AZ, Messer K, Salmon DP, Sano M, Schafer K, Feldman HH. Impact of potential modifications to Alzheimer's disease clinical trials in response to disruption by COVID-19: a simulation study. Alzheimers Res Ther 2021; 13:201. [PMID: 34930444 PMCID: PMC8686345 DOI: 10.1186/s13195-021-00938-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The COVID-19 pandemic disrupted Alzheimer disease randomized clinical trials (RCTs), forcing investigators to make changes in the conduct of such trials while endeavoring to maintain their validity. Changing ongoing RCTs carries risks for biases and threats to validity. To understand the impact of exigent modifications due to COVID-19, we examined several scenarios in symptomatic and disease modification trials that could be made. METHODS We identified both symptomatic and disease modification Alzheimer disease RCTs as exemplars of those that would be affected by the pandemic and considered the types of changes that sponsors could make to each. We modeled three scenarios for each of the types of trials using existing datasets, adjusting enrollment, follow-ups, and dropouts to examine the potential effects COVID-19-related changes. Simulations were performed that accounted for completion and dropout patterns using linear mixed effects models, modeling time as continuous and categorical. The statistical power of the scenarios was determined. RESULTS Truncating both symptomatic and disease modification trials led to underpowered trials. By contrast, adapting the trials by extending the treatment period, temporarily stopping treatment, delaying outcomes assessments, and performing remote assessment allowed for increased statistical power nearly to the level originally planned. DISCUSSION These analyses support the idea that disrupted trials under common scenarios are better continued and extended even in the face of dropouts, treatment disruptions, missing outcomes, and other exigencies and that adaptations can be made that maintain the trials' validity. We suggest some adaptive methods to do this noting that some changes become under-powered to detect the original effect sizes and expected outcomes. These analyses provide insight to better plan trials that are resilient to unexpected changes to the medical, social, and political milieu.
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Affiliation(s)
- Lon S Schneider
- Keck School of Medicine of the University of Southern California, Los Angeles, USA.
| | - Yuqi Qiu
- University of California, San Diego, USA
| | | | | | | | - Shelia Jin
- University of California, San Diego, USA
| | | | | | | | | | - Mary Sano
- Icahn School of Medicine at Mount Sinai, New York, USA
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25
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Powell KR, Alexander GL. Consequences of Rapid Telehealth Expansion in Nursing Homes: Promise and Pitfalls. Appl Clin Inform 2021; 12:933-943. [PMID: 34614517 DOI: 10.1055/s-0041-1735974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Expectations regarding use and potential benefits of telehealth (TH) in nursing homes (NHs) are high; however, unplanned and unexpected consequences can occur as a result of major policy and technological changes. OBJECTIVES The goal of this study was to elicit stakeholder perspectives of consequences of rapid TH expansion in NHs. METHODS Using a qualitative descriptive design, we drew a sample based on findings from a national study examining trends in NH information and technology (IT) maturity, including TH use. We used maximum variation sampling to purposively select participants who (1) participated in our IT maturity survey for two consecutive years, (2) completed year 1 of the IT maturity survey prior to TH expansion (before March 6, 2020) and year 2 after TH expansion (after March 6, 2020), (3) represented a broad range of facility characteristics, and (4) were identified as an end user of TH or responsible for TH implementation. Using six questions from the IT maturity survey, we created a total TH score for each facility and selected participants representing a range of scores. RESULTS Interviews were conducted with (n = 21) NH administrators and clinicians from 16 facilities. We found similarities and differences in perceptions of TH expansion according to facility TH score, NH location, and participant role. Desirable consequences included four subthemes as follows: (1) benefits of avoiding travel for the NH resident, (2) TH saving organizational resources, (3) improved access to care, and (4) enhanced communication. Undesirable consequences include the following five subthemes: (1) preference for in-person encounters, (2) worsening social isolation, (3) difficulty for residents with cognitive impairment, (4) workflow and tech usability challenges, and (5) increased burden on NH staff/infrastructure. Participants from rural NHs perceived lack of training, poor video/sound quality, and internet/connectivity issues to be potential pitfalls. CONCLUSION Clinicians and NH administrators should consider leveraging the desirable consequences of rapid TH expansion and implement mitigation strategies to address the undesirable/unanticipated consequences.
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Affiliation(s)
- Kimberly R Powell
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, United States
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26
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Keng BMH, Gan WH, Tam YC, Oh CC. Personal protective equipment-related occupational dermatoses during COVID-19 among health care workers: A worldwide systematic review. JAAD Int 2021; 5:85-95. [PMID: 34485949 PMCID: PMC8407949 DOI: 10.1016/j.jdin.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Occupational dermatoses caused by personal protective equipment (PPE) in the ongoing COVID-19 pandemic are emerging occupational health challenges that must be promptly and effectively addressed to ease burden on our health care workers. Objective A systematic review was conducted to determine common PPE-related dermatoses, affected body sites, and implicated occupational contactants. We further proposed solutions to mitigate this problem. Methods Online databases were searched for articles on PPE-related dermatoses in health care workers during the COVID-19 pandemic written in English and published from January 1, 2020, to January 30, 2021. Results Sixteen studies, including a total of 3958 participants, were included. The most common dermatoses were xerosis, pressure-related erythema, and contact dermatitis, mainly affecting the face and hands. The most widely implicated contactants were increased frequency of hand hygiene, gloves, N95 masks, and goggles. Proposed solutions were categorized as individual self-care, protection of the workforce, and long-term preventive measures. Conclusion Through measures such as regular basic skin care education, early access to specialty clinics via telemedicine, and designing of better-fit PPE, the challenges posed by PPE-related occupational dermatoses can be significantly reduced.
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Affiliation(s)
| | - Wee Hoe Gan
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yew Chong Tam
- Education Resource Centre, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Duke-NUS Medical School, Singapore, Singapore.,Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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27
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Teshale SM, Ruiz S, Iyengar V. Monitoring Cognitive Health Status in Homebound Older Adults: Insights from a Nationwide Request for Information. J Aging Soc Policy 2021; 34:894-902. [PMID: 34382898 DOI: 10.1080/08959420.2021.1962172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The COVID-19 pandemic has fueled growing concerns about the long-term impacts on outcomes in older adults including social isolation and declines in cognitive health. Prior to the pandemic, the Administration for Community Living (ACL) released a nationwide request for information to understand how community-based organizations monitor changes in cognitive status for homebound older adults. This Perspective describes strategies reported by community-based organizations to monitor cognitive status in homebound older adults and notes the potential for technology to mitigate the risk of social isolation and delays in observing cognitive decline, considerations that are especially relevant during COVID-19 amid social distancing requirements.
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Affiliation(s)
| | - Sarah Ruiz
- U.S. Department of Health and Human Services, National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, Washington, District of Columbia, USA
| | - Vijeth Iyengar
- U.S. Department of Health and Human Services, Administration on Aging, Administration for Community Living, Washington, District of Columbia, USA
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28
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Painter J, Turner J, Procter PM. Understanding and Accommodating Patient and Staff Choice When Implementing Video Consultations in Mental Health Services. Comput Inform Nurs 2021; 39:578-583. [PMID: 34238832 PMCID: PMC8505136 DOI: 10.1097/cin.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
During the COVID-19 pandemic, some mental healthcare in the United Kingdom has moved online, with more likely to follow. The current evidence base for video consultations is modest; hence, this study seeks to aid decision-makers by reporting on one large National Health Service mental health trust's video-consultation pilot project. Patients' choices/preferences were gathered via online forms; and staff's views, through a focus group. The typical patient was female, 26 years old, living in a deprived locality. Consultations typically lasted 37 minutes, saving patients 0-30 minutes of travel and £0-£3.00. Satisfaction was high, and the software was intuitive. Audio quality varied, but patients felt able to disclose "as if in person," were willing to use video consultation again, and found them more preferable than home visits and clinic attendance. Staff could foresee benefits but were concerned for their therapeutic relationships and were avoidant without familiarization, training, clinical coaching, and managerial reassurances especially regarding high-risk patients/situations. They argued video consultation would not suit all patients and should be used according to individual need. We found COVID-19 is necessitating staff to adopt video consultation and that patients are satisfied. However, unless staff's concerns are resolved, enabling them to use their full repertoire of interpersonal skills, therapeutic relationships will trump efficiency and video consultations may not remain their treatment modality of choice.
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29
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Gillani N, Arslan T. Intelligent Sensing Technologies for the Diagnosis, Monitoring and Therapy of Alzheimer's Disease: A Systematic Review. SENSORS 2021; 21:s21124249. [PMID: 34205793 PMCID: PMC8234801 DOI: 10.3390/s21124249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/16/2022]
Abstract
Alzheimer’s disease is a lifelong progressive neurological disorder. It is associated with high disease management and caregiver costs. Intelligent sensing systems have the capability to provide context-aware adaptive feedback. These can assist Alzheimer’s patients with, continuous monitoring, functional support and timely therapeutic interventions for whom these are of paramount importance. This review aims to present a summary of such systems reported in the extant literature for the management of Alzheimer’s disease. Four databases were searched, and 253 English language articles were identified published between the years 2015 to 2020. Through a series of filtering mechanisms, 20 articles were found suitable to be included in this review. This study gives an overview of the depth and breadth of the efficacy as well as the limitations of these intelligent systems proposed for Alzheimer’s. Results indicate two broad categories of intelligent technologies, distributed systems and self-contained devices. Distributed systems base their outcomes mostly on long-term monitoring activity patterns of individuals whereas handheld devices give quick assessments through touch, vision and voice. The review concludes by discussing the potential of these intelligent technologies for clinical practice while highlighting future considerations for improvements in the design of these solutions for Alzheimer’s disease.
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30
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Quail Z, Bolton L, Massey K. Digital delivery of non-pharmacological intervention programmes for people living with dementia during the COVID-19 pandemic. BMJ Case Rep 2021; 14:e242550. [PMID: 34140328 PMCID: PMC8212172 DOI: 10.1136/bcr-2021-242550] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2021] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic significantly impeded face-to-face health and social care delivery for people living with dementia and their carers. Interruption of meaningful activity engagement along with increased social isolation is known to be associated with loss of skills, increased loneliness, physical deterioration and decline in cognition and mood in people with dementia. To ensure continuity of care for people living with dementia, for whom multimodal, non-pharmacological intervention programmes were being provided, there was an urgent need to adopt a remote delivery model. Guidance on digitally delivered assessment and care specific to non-pharmacological interventions for dementia is lacking. Adoption of technology-enabled care for people with dementia requires overcoming barriers to technology use, adaptation of therapeutic guidelines, adaptation of communication methods and carer support. Despite these challenges, therapists successfully transitioned from in-person to digital delivery of therapeutic interventions with associated benefits of continued meaningful activity engagement discussed.
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Affiliation(s)
- Zara Quail
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
| | - Laura Bolton
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
| | - Karina Massey
- Care Visions Healthy Ageing, Care Visions Limited, Stirling, UK
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31
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Cheung G, Peri K. Challenges to dementia care during COVID-19: Innovations in remote delivery of group Cognitive Stimulation Therapy. Aging Ment Health 2021; 25:977-979. [PMID: 32631103 DOI: 10.1080/13607863.2020.1789945] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Gary Cheung
- Department of Psychological Medicine, School of Medicine University of Auckland, Auckland, New Zealand
| | - Kathryn Peri
- School of Nursing, The University of Auckland, Auckland, New Zealand
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32
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Kalita J, Pandey PC, Shukla R, Misra UK. Feasibility and usefulness of tele-follow-up in the patients with tuberculous meningitis. Trans R Soc Trop Med Hyg 2021; 115:1153-1159. [PMID: 34036372 PMCID: PMC8194613 DOI: 10.1093/trstmh/trab069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/06/2021] [Accepted: 04/16/2021] [Indexed: 11/18/2022] Open
Abstract
Background Tuberculous meningitis (TBM) is the most severe form of tuberculosis and these patients need close follow-up because of a high frequency of complications. The coronavirus disease 2019 pandemic and lockdown resulted in an interruption in physical follow-up. In this situation, tele-follow-up may be helpful. We report the feasibility and usefulness of a telephonic follow-up in patients with TBM. Methods Patients with TBM managed by us from January 2017 to March 2020 were included from the TBM registry. Their presenting symptoms, and clinical and investigation findings were noted. We contacted these patients telephonically and their clinical status was obtained using a questionnaire. Based on the telephonic information, outcomes were categorized as death, poor or good. Patients with the new medical problems were advised as to relevant investigations and the reports were obtained through WhatsApp for prescribing treatment. Results The telephone numbers of 103 of 144 (71.5%) patients were viable. Twenty-seven (26.2%) patients died, 15 (19.7%) had a poor outcome and 61 (80.2%) had a good outcome. Twenty-five (32.9%) patients had new medical problems: 18 TBM related and 7 TBM unrelated. The medical problems of 23 patients could be managed telephonically and only 3 (4%) patients needed a physical visit. Sixty-five (85.5%) patients happily answered the questionnaire and willing responders needed a treatment modification more frequently than the reluctant responders (p=0.008). Patients on active antitubercular treatment needed treatment modification more frequently (80% vs 21.3%). Conclusions Tele-follow-up is feasible in 96% of TBM patients and is beneficial, cost effective and overcomes the barrier of distance.
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Affiliation(s)
- Jayantee Kalita
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh 226014, India
| | - Prakash C Pandey
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh 226014, India
| | - Ruchi Shukla
- Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh 226014, India
| | - Usha K Misra
- Department of Neurology, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, Uttar Pradesh 226007, India
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33
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Jacobs DM, Peavy GM, Banks SJ, Gigliotti C, Little EA, Salmon DP. A survey of smartphone and interactive video technology use by participants in Alzheimer's disease research: Implications for remote cognitive assessment. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12188. [PMID: 34027018 PMCID: PMC8132053 DOI: 10.1002/dad2.12188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/17/2021] [Accepted: 03/30/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Participants from a longitudinal cohort study were surveyed to evaluate the practical feasibility of remote cognitive assessment. METHODS All active participants/informants at the University of California San Diego Alzheimer's Disease Research Center were invited to complete a nine-question survey assessing technology access/use and willingness to do cognitive testing remotely. RESULTS Three hundred sixty-nine of 450 potential participants/informants (82%) completed the survey. Overall, internet access (88%), device ownership (77%), and willingness to do cognitive testing remotely (72%) were high. Device access was higher among those with normal cognition (85%) or cognitive impairment (85%) than those with dementia (52%), as was willingness to do remote cognitive testing (84%, 74%, 39%, respectively). Latinos were less likely than non-Latinos to have internet or device access but were comparable in willingness to do remote testing. DISCUSSION Remote cognitive assessment using interactive video technology is a practicable option for nondemented participants in longitudinal studies; however, additional resources will be required to ensure representative participation of Latinos.
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Affiliation(s)
- Diane M. Jacobs
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
| | - Guerry M. Peavy
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
| | - Christina Gigliotti
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
| | - Emily A. Little
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
| | - David P. Salmon
- Department of NeurosciencesUniversity of California San DiegoLa JollaCaliforniaUSA
- Shiley‐Marcos Alzheimer's Disease Research CenterLa JollaCaliforniaUSA
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34
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Zucca M, Isella V, Lorenzo RD, Marra C, Cagnin A, Cupidi C, Bonanni L, Laganà V, Rubino E, Vanacore N, Agosta F, Caffarra P, Sambati R, Quaranta D, Guglielmi V, Appollonio IM, Logroscino G, Filippi M, Tedeschi G, Ferrarese C, Rainero I, Bruni AC. Being the Family Caregiver of a Patient With Dementia During the Coronavirus Disease 2019 Lockdown. Front Aging Neurosci 2021; 13:653533. [PMID: 33967740 PMCID: PMC8098661 DOI: 10.3389/fnagi.2021.653533] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
Background: Family caregivers of patients with dementia are at high risk of stress and burden, and quarantine due to the coronavirus disease 2019 (COVID-19) pandemic may have increased the risk of psychological disturbances in this population. The current study was carried out during the national lockdown declared in March 2020 by the Italian government as a containment measure of the first wave of the coronavirus pandemic and is the first nationwide survey on the impact of COVID-19 lockdown on the mental health of dementia informal caregivers. Methods: Eighty-seven dementia centers evenly distributed on the Italian territory enrolled 4,710 caregiver-patient pairs. Caregivers underwent a telephone interview assessing classical symptoms of caregiver stress and concern for the consequences of COVID-19 infection on patient's health. We calculated prevalence of symptoms and regressed them on various potential stress risk factors: caregivers' sociodemographic characteristics and lifestyle, patients' clinical features, and lockdown-related elements, like discontinuity in medical care. Results: Approximately 90% of caregivers reported at least one symptom of stress, and nearly 30% reported four or more symptoms. The most prevalent symptoms were concern for consequences of COVID-19 on patient's health (75%) and anxiety (46%). The main risk factors for stress were identified as a conflicting relationship with the patient and discontinuity in assistance, but caregiver's female sex, younger age, lower education, and cohabitation with the patient also had an impact. Availability of help from institutions or private individuals showed a protective effect against sense of abandonment but a detrimental effect on concern about the risk for the patient to contract COVID-19. The only protective factor was mild dementia severity, which was associated with a lower risk of feeling isolated and abandoned; type of dementia, on the other hand, did not affect stress risk. Conclusion: Our results demonstrate the large prevalence of stress in family caregivers of patients with dementia during the COVID-19 pandemic and have identified both caregivers and situations at a higher risk of stress, which should be taken into account in the planning of interventions in support of quarantined families and patients.
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Affiliation(s)
- Milena Zucca
- Department of Neuroscience, Aging Brain and Memory Clinic, University of Torino, Turin, Italy
| | - Valeria Isella
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | | | - Camillo Marra
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Chiara Cupidi
- CDCD Ospedale del Delta, AUSL Ferrara, Ferrara, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Valentina Laganà
- Department of Primary Care, Regional Neurogenetic Centre, Catanzaro, Italy
| | - Elisa Rubino
- Department of Neuroscience and Mental Health, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Federica Agosta
- Neurology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | | | - Renato Sambati
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Bari, Italy.,Department of Basic Medicine Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Davide Quaranta
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | - Valeria Guglielmi
- Memory Clinic, Fondazione Policlinico Agostino Gemelli, IRCCS Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ildebrando M Appollonio
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Giancarlo Logroscino
- Department of Clinical Research in Neurology, Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro, Bari, Italy.,Department of Basic Medicine Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Massimo Filippi
- Neurology Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Ferrarese
- Department of Medicine and Surgery and Milan Center for Neuroscience (NeuroMi), University of Milano-Bicocca, Milan, Italy
| | - Innocenzo Rainero
- Department of Neuroscience, Aging Brain and Memory Clinic, University of Torino, Turin, Italy
| | - Amalia C Bruni
- Department of Primary Care, Regional Neurogenetic Centre, Catanzaro, Italy
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Design of an Interactive Two-Way Telemedicine Service System for Smart Home Care for the Elderly. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6632865. [PMID: 33936578 PMCID: PMC8060097 DOI: 10.1155/2021/6632865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/25/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022]
Abstract
In this paper, we deeply analyse and study the interactive telemedicine service system for elderly care in smart homes and design a data summarization method for large concurrent scenarios. The method first parses and reconstructs the data received by the system initially and then stores the reconstructed valid data into the local database, which realizes the fast data summarization under the heavy concurrency scenario. Secondly, a multiformat data adaptation method is designed for the problem that the data to be provided and processed are in various formats. The method uses a unified data format and adaptation process constraints to achieve centralized management of heterogeneous data from multiple sources, which provide a unified data support service for the system and upper-layer applications. Again, to deal with the application problem of highly correlated data, the data-sharing system provides data for each functional component of the telemedicine platform according to business requirements based on standardized data structure and unified storage management. This enables the barrier-free flow of multisource highly correlated data. When the consultation is in progress, the doctor can communicate with the patient with video and audio devices and, at the same time, can access the patient's historical medical records and the medical records uploaded by the patient; after the consultation is completed, the consultation doctor needs to fill in the consultation record. The consultation assistance module can statistically analyse the workload of doctors and other information according to the background data, and the telemedicine system will play an increasingly important role in the medical and health care business.
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Geddes MR, O'Connell ME, Fisk JD, Gauthier S, Camicioli R, Ismail Z. Remote cognitive and behavioral assessment: Report of the Alzheimer Society of Canada Task Force on dementia care best practices for COVID-19. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12111. [PMID: 32999916 PMCID: PMC7507991 DOI: 10.1002/dad2.12111] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Despite the urgent need for remote neurobehavioral assessment of individuals with cognitive impairment, guidance is lacking. Our goal is to provide a multi-dimensional framework for remotely assessing cognitive, functional, behavioral, and physical aspects of people with cognitive impairment, along with ethical and technical considerations. METHODS Literature review on remote cognitive assessment and multidisciplinary expert opinion from behavioral neurologists, neuropsychiatrists, neuropsychologists, and geriatricians was integrated under the auspices of the Alzheimer Society of Canada Task Force on Dementia Care Best Practices for COVID-19. Telephone and video approaches to assessments were considered. RESULTS Remote assessment is shown to be acceptable to patients and caregivers. Informed consent, informant history, and attention to privacy and autonomy are paramount. A range of screening and domain-specific instruments are available for telephone or video assessment of cognition, function, and behavior. Some neuropsychological tests administered by videoconferencing show good agreement with in-person assessment but still lack validation and norms. Aspects of the remote dementia-focused neurological examination can be performed reliably. DISCUSSION Despite challenges, current literature and practice support implementation of telemedicine assessments for patients with cognitive impairment. Convergence of data across the clinical interview, reliable and brief remote cognitive tests, and remote neurological exam increase confidence in clinical interpretation and diagnosis.
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Affiliation(s)
- Maiya R. Geddes
- Department of Neurology and NeurosurgeryMontreal Neurological InstituteMcGill UniversityMontrealCanada
- McGill Center for Studies in AgingMcGill UniversityVerdunCanada
- Departments of Psychiatry and NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonUSA
| | - Megan E. O'Connell
- Department of PsychologyUniversity of SaskatchewanSaskatoonCanada
- Canadian Center for Health & Safety in AgricultureMedicineUniversity of SaskatchewanSaskatoonCanada
| | - John D. Fisk
- Department of PsychiatryDalhousie UniversityHalifaxCanada
- Department of Psychology and NeuroscienceDalhousie UniversityHalifaxCanada
- Department of MedicineDalhousie UniversityHalifaxCanada
| | - Serge Gauthier
- McGill Center for Studies in AgingMcGill UniversityVerdunCanada
| | - Richard Camicioli
- Neuroscience and Mental Health Institute and Department of MedicineDivision of NeurologyUniversity of AlbertaEdmontonCanada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health SciencesCumming School of MedicineUniversity of CalgaryCalgaryAlbertaCanada
- Hotchkiss Brain InstituteO'Brien Institute for Public HealthUniversity of CalgaryCalgaryAlbertaCanada
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37
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Mok VCT, Pendlebury S, Wong A, Alladi S, Au L, Bath PM, Biessels GJ, Chen C, Cordonnier C, Dichgans M, Dominguez J, Gorelick PB, Kim S, Kwok T, Greenberg SM, Jia J, Kalaria R, Kivipelto M, Naegandran K, Lam LCW, Lam BYK, Lee ATC, Markus HS, O'Brien J, Pai MC, Pantoni L, Sachdev P, Skoog I, Smith EE, Srikanth V, Suh GH, Wardlaw J, Ko H, Black SE, Scheltens P. Tackling challenges in care of Alzheimer's disease and other dementias amid the COVID-19 pandemic, now and in the future. Alzheimers Dement 2020; 16:1571-1581. [PMID: 32789951 PMCID: PMC7436526 DOI: 10.1002/alz.12143] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 01/08/2023]
Abstract
We have provided an overview on the profound impact of COVID‐19 upon older people with Alzheimer's disease and other dementias and the challenges encountered in our management of dementia in different health‐care settings, including hospital, out‐patient, care homes, and the community during the COVID‐19 pandemic. We have also proposed a conceptual framework and practical suggestions for health‐care providers in tackling these challenges, which can also apply to the care of older people in general, with or without other neurological diseases, such as stroke or parkinsonism. We believe this review will provide strategic directions and set standards for health‐care leaders in dementia, including governmental bodies around the world in coordinating emergency response plans for protecting and caring for older people with dementia amid the COIVD‐19 outbreak, which is likely to continue at varying severity in different regions around the world in the medium term.
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Affiliation(s)
- Vincent C T Mok
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China.,Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sarah Pendlebury
- NIHR Oxford Biomedical Research Centre, The Joint Research Office, Oxford, UK.,Departments of Acute General Medicine and Geratology, John Radcliffe Hospital, Oxford, UK.,Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Adrian Wong
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China.,Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Lisa Au
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China.,Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Philip M Bath
- Stroke Trials Unit, Division of Clinical Neuroscience, School of Medicine, The University of Nottingham, Nottingham, UK
| | - Geert Jan Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Christopher Chen
- Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charlotte Cordonnier
- Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Jacqueline Dominguez
- Memory Center, International Institute for Neurosciences, St. Luke's Medical Center, Manila, Philippines
| | - Philip B Gorelick
- The Ken & Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Division of Cerebrovascular Disease and Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Timothy Kwok
- Division of Geriatrics, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Steven M Greenberg
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jianping Jia
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Rajesh Kalaria
- Translational and Clinical Research Institute, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK
| | - Miia Kivipelto
- Karolinska Institutet, Dept NVS, Division of Clinical Geriatrics, Center for Alzheimer Research and Karolinska University Hospital, Theme Aging, Stockholm, Sweden.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Ageing and Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
| | | | - Linda C W Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China
| | - Bonnie Yin Ka Lam
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China.,Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Leonardo Pantoni
- Stroke and Dementia Lab, "Luigi Sacco" Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Perminder Sachdev
- Neuropsychiatric Institute, School of Psychiatry, The University of New South Wales, Sydney, Australia
| | - Ingmar Skoog
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Eric E Smith
- Division of Neurology, Department of Clinical Neurosciences and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Velandai Srikanth
- Department of Geriatric Medicine Peninsula Health, Peninsula Clinical School, Monash University, Clayton, Victoria, Australia
| | - Guk-Hee Suh
- Department of Psychiatry, Hallym University College of Medicine, Seoul, South Korea
| | - Joanna Wardlaw
- Centre for Clinical Brain Sciences, Edinburgh Imaging and UK Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ho Ko
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Shatin, Hong Kong SAR, China.,Gerald Choa Neuroscience Centre, Margaret K. L. Cheung Research Centre for Management of Parkinsonism, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sandra E Black
- Department of Medicine (Neurology), Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Philip Scheltens
- Alzheimer Center Amsterdam, University Medical Centers, Amsterdam, the Netherlands
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Marra DE, Hamlet KM, Bauer RM, Bowers D. Validity of teleneuropsychology for older adults in response to COVID-19: A systematic and critical review. Clin Neuropsychol 2020; 34:1411-1452. [DOI: 10.1080/13854046.2020.1769192] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- David E. Marra
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Kristin M. Hamlet
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Russell M. Bauer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
- Brain Rehabilitation Research Center, Malcolm Randall VAMC, Gainesville, FL, USA
| | - Dawn Bowers
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Neurology, University of Florida, Gainesville, FL, USA
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