Comparison of in-person vs. remote administration of cognitive screening tools for people with ALS

Objective This study investigated whether cognitive screening tools used for people with amyotrophic lateral sclerosis (pwALS) are affected by the screen being administered face-to-face or remotely online.

It also investigated whether demographic variables predicted total cognitive screen scores.

Methods The cognitive component of the Edinburgh Cognitive and Behavioural ALS Screen (ECASc), the cognitive component of the ALS Cognitive Behavioural Screen (ALS-CBSc), and the Mini Addenbrooke’s Cognitive Examination (Mini-ACE) were administered to 41 pwALS and 41 controls face-to-face.

Versions of the cognitive screens designed to be administered remotely were administered to 57 pwALS and 44 controls via videoconferencing methods.

Backwards stepwise linear regressions were conducted to assess whether total scores on the ECASc, ALS-CBSc, and Mini-ACE scores were predicted by administration mode (face-to-face or remote) or demographic variables.

Results Mode of administration significantly affected scores on the ECASc and ALS-CBSc; remote administration was associated with better total scores.

Administration mode did not significantly affect Mini-ACE scores.

All cognitive screens were significantly affected by IQ scores; higher IQ scores predicted better screening tool scores.

Only ECASc scores were significantly affected by age, with older age predicting poorer scores.

Being female was associated with better Mini-ACE scores; sex did not predict ECASc and ALS-CBSc scores.

Conclusions Our results suggest that videoconferencing versions of the ECASc and ALS-CBSc may function differently to the original, face-to-face versions.

There are advantages to using remote versions of cognitive screening tools but clinicians and researchers who use them should consider that they may not yield equivalent scores.