![]() The lack of visual cues during telephone assessments might also be problematic. For cognitive assessments, some patients might write down the words they have been asked to recall, thereby invalidating that aspect of memory testing. Not all families can support audiovisual assessment telephone assessment remains far more common. Telephone audio quality might be poor and patients being assessed might have hearing impairments. There are barriers to remote assessment, as family physicians have experienced during the pandemic. This means that the patient will need to access the test by printing it at home or receiving a copy in the mail. The authors of the MoCA have developed instructions on how to administer it virtually. When video equipment is available and of good quality, it is possible to complete full versions of tests like the MoCA and the MMSE 12 while observing patient responses. If caregivers can be present, virtual assessment can assess for further functional loss and development of concerning symptoms. Once dementia is diagnosed, monitoring for functional loss and development of challenging behaviour or safety issues is crucial. Family members often try to help loved ones during office assessments, and monitoring this remotely might be difficult.Īs with conventional testing, physicians need to interpret the findings in the context of the patient’s vision, hearing, education level, and daily function (activities of daily living and instrumental activities of daily living). The patient should participate without assistance, unless requested by the assessor. Therefore, we would recommend that when assessing an individual with visual impairments to conduct the cognitive test by re-scoring it without the visual components, e.g., the MoCA Blind, to magnify the visual components, or to substitue the visual component when possible using auditory alternatives, e.g., the oral trail making task.The environment for virtual care should be quiet and private. However, it appears that older adults with actual visual impairments may have developed compensatory strategies to adapt to this loss in visual acuity as there were no significant differences in scores of older adults with and without visual impairments. The MoCA scores in older adults with normal vision (M=27.32, SD =2.41) and with visual impairment (M=26.68, SD =2.52), did not differ significantly (t36=−0.787, P=0.436, d=0.26, BF10 =0.4).Ĭonclusions: Our findings show that simulated reductions in visual acuity and contrast sensitivity lead to lower scores on measures of cognitive ability, specifically the MoCA. Results: Acuity of participants at 20/20 (M=0.06 LogMAR, SD =0.1), simulated 20/80 (M=0.63, SD =0.18) and simulated 20/200 (M=0.88, SD =0.19) showed that the participants experienced simulated acuity loss with the goggles. For comparison, we included MoCA data from a sample of older adults with normal vision (n=19, Mage =74, Acuity M=0.04 logMAR, SD=0.16) or visual impairment (n=19, Mage =79, Acuity M=0.35 logMAR, SD=0.3). ![]() Only participants that scored >26 (i.e., normal cognitive function) at 20/20 were included in the analysis. The MoCA was administered following the clinical protocols. Methods: Participants (n=19) completed one of the three version of the MoCA under three conditions (20/20, simulated 20/80, simulated 20/200). Therefore we simulated visual impairments, i.e., reduced visual acuity and contrast sensitivity, in young healthy adults to determine how this impacts their scores on a measure of cognitive ability, i.e., the MoCA. But it is not clear if lowers scores on cognitive assessments are due to the assessments relying on visual stimuli, or if individuals with visual impairments are actually more likely to have cognitive impairments. Scores on cognitive assessments are typically lower for individuals with visual impairments compared to individuals with normal/corrected to normal vision. ![]() ![]() Policy of Dealing with Allegations of Research Misconductīackground: Cognitive assessments, such as the Montreal Cognitive Assessment (MoCA), use components that assume intact sensory abilities, however, adults show concomitant decreases in visual acuity with increasing age. ![]() Policy of Screening for Plagiarism Process. ![]()
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