Telemedicine and the Mini-Mental State Examination: Assessment from a Distance

Abstract

The objective of this study was to determine the reliability of the Mini-Mental State Examination (MMSE) administration via telehealth with a focus on the auditory and visual test components. Reliability was assessed through use of an in-person collaborator and by assessment of faxed test copies. The MMSE was administered via telehealth with the assistance of a face-to-face collaborator. Patient responses were recorded by both the remote and in-person nurse and compared item by item; total scores for each subject were also compared. Visual items were assessed through a blinded separate scoring of a faxed copy. Percent agreement per item and total score were calculated and correlations between scores were determined by Pearson correlation coefficients. Mean score differences and associated 95% confidence intervals were calculated. Eighty percent of individual items demonstrated remote to in-person agreement of >95% and all items were >85.5% in agreement. Pearson correlation coefficients demonstrated high correlations (>0.86) between 80% of the items examined. Mean differences in scored test items were not significantly different from zero. This study demonstrates the utility of using telehealth for cognitive assessment by MMSE. It supports the use of telehealth to improve healthcare access among patients for whom distance, cost, and mobility are potential barriers to attending face-to-face clinical visits. Continued validation and reliability testing is warranted to ensure that all healthcare provided via telehealth maintains an equal quality level to that of in-person care.

Assessing Cognitive Function in Older Adults Using a Videoconference Approach

“…Demographic ageing is a worldwide phenomenon that presents new socio-economic and health challenges, with an increasing need for proficient healthcare services to meet the needs of older adults. Most relevant, ageing is accompanied by cognitive decline; ( Ciemins et al, 2009 ) thus, an efficient assessment process to determine cognitive status in aged individuals is of uttermost need. However, a comprehensive neuropsychological testing is a lengthy ordeal that goes well beyond several hours of physical presence in a healthcare institution.…”

Effectiveness and feasibility of telepsychiatry in resource constrained environments? A systematic review of the evidence

“…2 There appears to be widespread implementation of telepsychiatry across countries [3][4] , across different treatment modalities 5 and across different service settings [6][7][8][9] from Child and Adolescent services (CAMHS) [10][11][12][13][14][15][16][17] to Geriatric services. [18][19][20][21] Telepsychiatry has been used for assessment and diagnosis, ongoing management, medication review, development of clinical care plans, psychotherapy, neuropsychological testing, forensic evaluations and certain psychiatric emergencies. [22][23] For the purpose of this paper telepsychiatry is defined as the use of live interactive audio-video communication, also known as videoconferencing, to provide psychiatric clinical services from a distance.…”

Diagnosis of cognitive decline and dementia in rural areas — A scoping review

“…Another study assessed the reliability of the MMSE administration (baseline and annual assessments) via telehealth with a focus on the auditory and visual test components. Reliability was assessed through the use of an in‐person collaborator and by faxed test copies.…”

“…In another 5 studies, telemedicine consultations were not directly compared with in-person examinations. In an American study, 31 In another American study, 35 Another study 37 assessed the reliability of the MMSE administration (baseline and annual assessments) via telehealth with a focus on the auditory and visual test components. Reliability was assessed through the use of an in-person collaborator and by faxed test copies.…”