Background: A significant clinical need exists for a broad range of health care professionals to be able to objectively screen for the presence of MS-related cognitive dysfunction in the telehealth medical setting. The tele-MoCA appears to be an inadequate screening instrument for MSrelated cognitive dysfunction in isolation as this particular instrument does not assess the cognitive domains typically impacted by MS.
Objectives: To this end, we developed a brief, objective telehealth screening battery specifically designed to screen for the presence of MS-related cognitive dysfunction in the MS patient population remotely.
Methods: A brief cognitive screen was developed to be given via telehealth platform (Zoom). The screening was designed to be 30-minutes in length and to assess neurocognitive domains typically impacted by MS (i.e., attention, information processing speed, memory, and mental flexibility). In addition, a self-report mood inventory was included. The screen was administered by a trained technician in a neurologists office to 16 diverse patients currently undergoing treatment at the Neurology Center of Fairfax. Two different batteries were administered (one for patients under the age of 50 and the other for patients over the age of 50). In addition, all patients were administered the MoCA. Age-adjusted, normative cut-offs were used to evaluate patient performance on each measure. Scores were therefore divided into two classifications Within the normal range or below expectations on the measures.
Results: The present test findings support the use of an objective, brief cognitive screening battery for MS patients in a telehealth-based, generalized medical setting. It appears that the modified screening battery is more effective than the tele-MoCA in the detection of possible cognitive dysfunction in the MS patient population. Age: 21 to 62 (mean: 42 years; <50, n=10; >50, n=6)
Gender: 31% Male, 69% Female
Ethnicity: 56% White, 19% Black, 13% Hispanic, 12% Other
Education: 12 to 18 years
Time: 25-59 min (mean: 33.6 min.)
Device: Laptop (n =5), Phone (n=6), Desktop (n=3), and iPad (n=2)
Referred for full neuropsychology: Yes (n=4, 25%)
Conclusions: This Brief Telehealth Cognitive Screening allows a broad range of healthcare providers to objectively evaluate the presence of MS-related cognitive dysfunction with patients remotely. Importantly, the Brief Cognitive Screening requires minimal training to administer, and is not time consuming for the patient. This screening allows for common features of brevity, simplicity, reasonable sensitivity and specificity, and acceptability to patients and clinicians, and will likely be proven to be a strong tool in the arsenal of continuity of care moving forward.