82 Face-to-face versus Telehealth Assessment Differences among Cognitively Healthy Older Adults and those with MCI

Abstract

Objective:

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is a well validated and reliable clinical assessment tool that can be used for characterizing cognitive function in older adults. The RBANS has been shown to reliably discriminate between Alzheimer’s disease (AD), mild cognitive impairment (MCI), and cognitively healthy (CH) individuals. While the RBANS has traditionally been administered in a face to face setting, administration is also feasible via telehealth. Due to the COVID-19 pandemic, cognitive assessments were unexpectedly moved to telehealth formats. Given this, the current study assessed whether differences emerged between face to face and telehealth RBANS scores in both individuals who were CH and had MCI.

Participants and Methods:

A total of 61 individuals (N_CH = 27, N_MCI = 34) completed baseline and 1-year follow-up visits in the current study. The sample was predominantly female (N = 43, 70.5%), identified as white (N = 57, 93.4%), and were well educated (M_Years = 15.93). Participants completed the RBANS form B at an in-person baseline visit and form C at a one year follow-up visit. Higher RBANS scores indicate overall better cognitive performance. As expected, CH individuals performed better than those with MCI on immediate memory, language, attention, delayed memory, and total score. There were no significant differences found for the visuospatial index. Repeated measures ANOVAs were conducted to assess whether differences in RBANS performance existed based on test administration method.

Results:

Group differences between testing formats were observed in CH individuals on immediate memory [F(1,37) =9.10, p < .01)], language [F(1, 37)=9.41=p < .01)], and total score [F(1,37)=6.56, p < .05], with higher performance in those who completed the followup session in-person.There were no differences in baseline performance on any RBANS index between those who received an in person versus telehealth format (p’s > .05). No differences were observed in the MCI group. There were no significant differences observed between the CH and MCI group on demographic factors.

Conclusions:

Results from the current study suggest that CH counterparts experienced a greater degree of difference in scores between testing formats, whereas individuals with MCI did not. The lack of difference in MCI individuals may be due to less room for variability over time for this group given already low scores. These results suggest that while telehealth has been shown to be a viable option for RBANS administration in some samples, further work needs to be conducted regarding the equivalence of in-person vs. telehealth formats. This study is not without limitations. The small MCI group was segmented into in-person and telehealth groups, further reducing power to detect statistically significant results. The sample was also homogenous with highly educated, Caucasian women. Future research should aim to assess a larger, more diverse sample to identify whether RBANS is a reliable measure alone for assessing cognitive change over time via telehealth for MCI.