Development of a telemedicine protocol for the diagnosis of Alzheimer's disease

Abstract

We developed a telemedicine protocol for diagnosis of Alzheimer's Disease (AD). Assessments by video-conferencing (remote) were compared with face to face (direct) assessments. Eight physicians performed direct assessments and two physicians conducted remote assessments. There was alternate allocation of direct or remote initial assessment. The participants were 20 subjects over 65 years living in a rural area and referred by general practitioners (GPs) because of cognitive impairment. Each assessment included a Standardised Mini Mental State Examination, Geriatric Depression Scale, Katz assessment of Activities of Daily Living, Instrumental ADL assessment, and the Informant Questionnaire for Cognitive Decline in the Elderly. Laboratory results and radiological imaging were available from referring GPs. There was good agreement for diagnosing Alzheimer's disease between telemedicine and direct assessment, kappa = 0.8 (P<0.0001). However, because of the small sample size, the presence of systematic bias could not be completely excluded. We conclude that it is possible to diagnose AD at a distance using telemedicine, but this requires validation with a larger study.

Telemedicine and telecare for older patients—A systematic review

“…In some studies it was reported that patients dropped out because they refused the technical installation and use of telemedical devices. One study including patients with Alzheimer's disease, emphasized the importance of the cooperation of caregiving relatives [71]. These "marginal notes" indicate possible problems of some patients in handling the telemedicine intervention.…”

A Multidisciplinary Model of Dementia Care in an Underserved Retirement Community, Made Possible by Telemedicine

“…Comparative studies have found agreement between face-to-face (FTF) and telemedicine assessments using the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Katz assessment of Activities of Daily Living, Instrumental ADL assessment, and Informant Questionnaire for Cognitive Decline in the Elderly (30, 31). Mild cognitive impairment (MCI) and AD can be diagnosed by telemedicine as studies have found that the accuracy of diagnosis via telemedicine was not inferior to FTF assessment (32, 33).…”

Remote Assessment of Cognitive Function in Juvenile Neuronal Ceroid Lipofuscinosis (Batten disease)

“…Among adults, remote assessment has been established as reliable and valid for cognitive evaluation of minor cognitive impairment, memory disorders and dementia 19-21 . Remote cognitive assessment of adult-onset dementias by telephone or videoconferencing has been demonstrated to be as accurate as in-person evaluation and correlates well with standard cognitive assessments such as the Mini-Mental Status Exam.…”