A team of clinicians led by a physician-scientist, Dr. Maiya Geddes, at The Neuro has found remote assessment of cognition in cognitively impaired adults has advantages for patients.
Dementia increases the risk of contracting COVID-19 among people 65 and older. It also increases their risk of dying or becoming seriously ill from the disease. Yet individuals with dementia need access to diagnostic assessment and care, and this is typically done in person, putting them at risk of contracting the virus. The lack of access to specialty care may mean delayed or missed diagnoses, poor symptom management, missed opportunities for lifestyle and other behavioural interventions and increased risks to caregivers. Remote assessment and care may provide opportunities to overcome these challenges.
Delivering care during pandemic while keeping patients safe
In March, the Alzheimer Society of Canada convened a national COVID-19 and Dementia workgroup of behavioural medical specialists to study remote dementia assessments as a way to deliver care to patients while keeping them safe during the pandemic. Dr. Geddes, a behavioural neurologist at The Neuro and doctor at the McGill University Research Centre for Studies in Aging, leads this national workgroup.
The team has found that remote cognitive assessment is promising and they highlight ethical and technical considerations when conducting telemedicine assessments for dementia. Patients and caregivers also need access to encrypted platforms that are simple and easy to use. The team have identified avenues for future development including cognitive assessments that are valid across cultures, language and educational backgrounds.
Improving access to healthcare
The study found patients and their caregivers generally accept remote assessments since they are more convenient, especially for patients who live far from neurological care. Dr. Geddes says remote assessment could improve healthcare access for immobile or geographically isolated patients, even when the pandemic in over.
“We need to do a better job of protecting these individuals and giving them access to care. Hopefully one of the positive side-effects of the pandemic will be that it will increase care options for vulnerable older adults.”
Overall, this study provides best practices for specialized clinicians when assessing cognition remotely, and provides guidance for further research. They published their best practice guidance on dementia and COVID-19 on Sept. 22, 2020 in the journal Alzheimer’s & Dementia: DADM.
In the video below, Dr. Maiya Geddes discusses remote assessment of cognition in cognitively impaired adults