How accurate are remote, virtual assessments at diagnosing d | Figure 1
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How accurate are remote, virtual assessments at diagnosing dementia?
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We aimed to assess whether memory and thinking tests carried out by telephone or video call can detect dementia.
We looked at various memory and thinking tests. Many tests have been developed over time and they differ in their content and application, but most are based on a modification of a traditional in‐person test.
Main results
The review included 31 studies, using 19 different memory tests, with a total of 3075 participants.
Only seven tests were relevant to our question regarding accuracy of remote testing. With the limited number of studies, estimates on the accuracy of these tests are imprecise. Our review suggests that remote tests could correctly identify people with dementia between 26% and 100% of the time, and could correctly rule out dementia 65% to 100% of the time.
The remaining 24 studies compared a remote test with the face‐to‐face equivalent. These studies suggested that remote test scores usually agreed with in‐person testing, but this was not perfect.
How reliable are the results?
In the studies, a clinical diagnosis of dementia was used as the reference (gold) standard. There were a number of issues in the design, conduct and reporting of the studies. Studies often did not include people with hearing or language impairments that may have complicated remote testing.
Most studies investigated older adults (over 65 years). The findings may not be representative of all older adults with dementia, as some studies only examined specific groups of people, for example, after stroke. The studies were usually performed in specialist centres by experts. So, we do not know how well these tests identify dementia in routine community practice.
The review highlights the lack of high‐quality research. There were many differences between the studies included such as the type of test used, participants included, the setting in which the study is carried out and language studied. This made comparisons between studies difficult. Our review suggests that remote assessments and in‐person assessments are not always equivalent. In situations where access to in‐person assessment is difficult, remote testing could be used as a useful first step. Ideally, followed up with an in‐person assessment before a diagnosis is made. Due to limited studies, we cannot recommend one particular remote test for the assessment of dementia.
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