A Reliability of the Tele-Neuropsychological Assessment Using the Computerized Montreal Cognitive Assessment in Community-Dwelling Older Adults

Abstract

Background: The Montreal Cognitive Assessment (MoCA) has been widely used to discriminate individuals with mild cognitive impairment (MCI). As a tele-neuropsychological service has become important due to Coronavirus Disease-19 (COVID-19), computerized neuropsychological assessments delivered by telehealth have recently been developed. However, to date, their reliability is unclear yet. Thus, this study was to investigate the reliability of the tele-neuropsychological assessment using the computerized MoCA (c-MoCA). Method: Thirty-four community-dwelling older adults (age: 65-86 years, 17 females) participated in this study. While the primary assessor scored the participant's performance by telehealth, the secondary assessor independently scored the performance by directly observing face-to-face. To establish the inter-rater reliability of the c-MoCA by telehealth, the absolute agreement and the intra class correlation coefficient (ICC) were analyzed. Results: The inter-rater reliability of the c-MoCA by telehealth was high (ICC = 0.923; absolute agreement = 0.924, p's < 0.001). In addition, there was no significant difference in the c-MoCA score between primary and secondary assessors. Conclusion: This study demonstrated that the c-MoCA delivered as a tele neuropsychological assessment was reliable. This finding suggests that the c-MoCA could be used as a tele-neuropsychological service in older adults who have a low accessibility to medical settings. Copyright (C) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.