Feasibility of remote assessment of language and cognition in healthy subjects with heterogeneous educational levels

Abstract

AbstractBackgroundThe COVID‐19 pandemic is accelerating the use of telemedicine in the management of chronic neurological diseases. However, studies on the feasibility of assessing language and cognition are still scarce, especially in developing countries in which education is very heterogeneous. This pilot study evaluated the feasibility of using telemedicine for linguistic‐cognitive assessment, by comparing the performance of healthy adults in face‐to‐face and online assessments in a Brazilian sample. We also verified the influence of age and education on the two assessment forms.MethodThe sample consisted of 15 cognitively healthy subjects, aged between 57‐70 years (M = 63.2; SD = 4.6) and between 8‐22 years of education (M = 14.7; SD = 4.3). The Western Aphasia Battery‐Revised (WAB‐R) (Kertesz, 2007; Neves et al., 2014) was used for language assessment, with subtests for spontaneous speech, auditory verbal comprehension, repetition, naming, reading, and writing. The Addenbrooke’s Cognitive Examination‐revised version (ACE‐R) (Mioshi et al., 2006; Carvalho e Caramelli, 2007) was used for a brief cognitive screening and is composed of five subscales assessing attention and orientation, memory, fluency, language, and visuospatial skills. Subjects were randomly evaluated both face‐to face and online, with an interval of 1‐6 months.ResultNo differences were found in both WAB‐R and ACE‐R scores obtained in a face‐to‐face versus online environment. However, performance was associated with different sociodemographic variables in the two different evaluation contexts. In face‐to‐face assessment, there was a positive correlation between education and writing subtests (Spearman r = 0.878; p = 0.004). In the remote form of evaluation, there was a negative correlation between age and auditory verbal comprehension (Spearman r = ‐0.722; p = 0.043), and a positive correlation between education and spontaneous speech (Spearman r = 0.871; p = 0.004), auditory verbal comprehension (Spearman r = 0,768; p = 0,025), writing (Spearman r = 0.727; p = 0.040) and Aphasia Coefficient score (Spearman r = 0.736; p = 0.037).ConclusionThe absence of statistical difference between the two forms of evaluation demonstrated the viability of remote assessment of language and cognition in healthy subjects, despite the more significant influence of education in this evaluation form. Further studies will be conduct to verify the feasibility of remote assessment in individuals with mild cognitive impairment and dementia.