Remote Testing in Abbiategrasso (RTA)
Condition: Cognitive Assessment
Study type: Observational

Summary: 
      The remote cognitive assessment has the advantage of reaching people despite the restrictions
      due to the pandemic, so it is of fundamental importance both in the treatment of dementia and
      the research context. The scientific literature on the feasibility, acceptability and
      validity of remote neuropsychological assessment provides promising indications. However, the
      limitations related to access and familiarity with technologies in elderly populations, and
      to methodological aspects (e.g. the not-controlled environment, the validity of the remote
      assessment compared to the in-person assessment) remain to be clarified. For the present
      observational feasibility study, 58 older adults (65-85 years), randomly extracted among 93
      eligible participants, will be recruited among donors of our Brain Bank. Participants will
      undergo both face-to-face and remote testing (via phone calls or videoconferencing) sessions
      in a counterbalanced cross-over design. The study will target (1) the recruitment rate in a
      study on remote testing, (2) the acceptability of remote cognitive tests and the procedures
      for delivering remote testing, (3) the comparability between remote and face-to-face
      performances on neuropsychological tests.
    

Detailed description: 
      In February and March 2021, the 237 donors of our Brain Bank, aged between 65 and 98 and
      living at home, were interviewed by telephone. The purpose of the survey was to collect
      information on how they were experiencing the isolation linked to the pandemic in the last
      year, on health conditions and sleep, daily habits (nutrition, movement, leisure), use of the
      Internet and social networks as a way to maintain contact with one's family-friend network
      and experiences of loneliness (Rolandi et al, 2020). In this context, the willingness to
      participate in a study on remote cognitive assessment by phone, personal computer or tablet
      was explored.

      The sample size was calculated to estimate differences between testing conditions, i.e.
      face-to-face and remote testing (telephone or videoconference). A sample size of 52 is
      required to detect an effect size of 0.40 at 0.80% of power, in a paired-sample test with a
      normal distribution. We planned an increase in sample size of 6 participants, because the
      expected drop-out rate is 10% due to possible acute clinical conditions interfering with the
      participation in the study, or death.

      For the present observational feasibility study, 58 older adults (65-85 years), randomly
      extracted among 93 eligible participants, will be recruited among donors of the Brain Bank
      who previously have expressed the willingness to adhere to the study. Participants will
      undergo both face-to-face and remote testing sessions in a counterbalanced cross-over design.
      Each individual will undergo a comprehensive neuropsychological assessment consisting of a
      set of cognitive tests (memory, attention, etc) administered remotely via telephone calls or
      videoconferencing and face-to-face. Participants will be randomly allocated to one of the two
      conditions (remote first or face-to-face first). Each participant will take part to the
      second evaluation (remote or face-to-face) 8 weeks later. To reduce learning effect bias and
      intra-rate variability, this procedure will be counterbalanced so that half of the
      participants first experience the face-to-face interaction and the other half will initially
      receive the videoconference administration.
    

Observational model: Case-Crossover
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        In February and March 2021, the 237 donors of the Abbiategrasso Brain Bank, aged between 65
        and 98 and living at home, were interviewed by telephone. The purpose of the survey was to
        collect information on how they were experiencing the isolation linked to the pandemic in
        the last year (Rolandi et al, 2020). In this context, the willingness to participate in a
        study on remote cognitive assessment by phone, personal computer or tablet was explored.
        For the present observational feasibility study, 58 older adults (65-85 years), randomly
        extracted among 93 eligible participants, will be recruited among donors of the
        Abbiategrasso Brain Bank who previously have expressed the willingness to adhere to the
        study.
      
Keywords: remote neuropsychological assessment; feasibility study; counterbalanced cross-over design