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5 Cognitive Rehabilitation Using Teleneuropsychology. A Cohort Study in South America
- Carlos Martinez Canyazo, Rodrigo S Fernandez, Maria B Helou, Micaela Arruabarrena, Nicolas Corvalan, Agostina Carello, Paula Harris, Monica Feldman, Ismael Luis Calandri, Maria E Martin, Ricardo F Allegri, Lucia Crivelli
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 209
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Objective:
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation (CR) worldwide. However, the use of teleneuropsychology (TNP) to provide CR has contributed significantly to the continuity of treatment. The objective of this study was to measure the effects of CR via the TNP on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with Mild Cognitive Impairment (MCI).
Participants and Methods:A sample of 60 patients (60% female; age: 72.4±6.96) with MCI according to Petersen criteria was randomly divided into two groups: 30 cases (treatment group) and 30 controls (waiting list group). Subjects were matched for age, sex, and MMSE or MoCA.
The treatment group received ten weekly CR sessions of 45 minutes weekly. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different Linear Mixed Models were estimated to test treatment effect (CR vs. Controls) on each outcome of interest over Time (Pre/Post), controlling for Diagnosis, Age, Sex, and MMSE/MoCA performance.
Results:A significant Group (Control/Treatment) x Time (pre/post) interaction revealed that the treatment group at 10 weeks had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency(p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ Satisfaction p=0.004) and use of memory strategies (MMQ Strategy p=0.00), and a significant reduction of affective symptomatology: depression (GDS p=0.00), neuropsychiatric symptoms (NPIQ p=0.045), Forgetfulness (EDO-10 p=0.00), Stress (DAS Stress p=0.00).
Conclusions:This is the first study to test CR using teleNP in South America. Our results suggest that CR through teleNP is an effective intervention to improve performance on cognitive variables and reduce neuropsychiatric symptomatology compared to patients with MCI. These results have great significance in the context of the COVID-19 pandemic in South America, where teleNP is proving to be a valuable tool.
38 Craft Story 21, Argentine Baremization of a Memory test and Design of a Recognition Instance.
- Maria Agostina Carello, Nicolas Corvalän, Greta Keller, Micaela Maria Arruabarrena, Cecilia Palermo, Carlos Alberto Martinez Canyazo, Ismael Luis Calandri, Ricardo Francisco Allegri, Lucia Crivelli
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 718-719
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Objective:
Craft Story 21 is a practical, comprehensive, and freely available tool to assess logical memory in patients with memory impairment. Currently, the test does not have normative values in Spanish that adjust to our specific population. Furthermore, the original test does not have a recognition phase to increase the specificity of the memory profile by allowing a distinction between different amnesic profiles. Therefore, this study has two main aims: 1) the generation of normative data for the Craft Story 21 memory test, adjusting to the characteristics of our Spanish-speaking country according to sex, age, and educational level; and 2) the design and validation of the recognition phase of the test and the assessment of its psychometric properties.
Participants and Methods:The baremization sample comprised 81 healthy participants aged 41 to 91, assessed through the Uniform Data Set III (UDS III) battery of the National Alzheimer’s Coordinating Center (NACC). The design of the recognition phase included three steps: (1) construction of the scale and review by experts, (2) pilot study, and (3) analysis of its psychometric properties. In the latter, 190 participants were recruited and classified into two groups matched by age, sex, and educational level: Mild Cognitive Impairment (MCI n=96) according to Petersen’s (1999) criteria and healthy controls (HC n=94). In addition, the diagnostic accuracy of the test was studied by the ROC curve method, its concurrent validity by correlation with other memory tests (RAVLT), and its internal consistency with Cronbach’s alpha test.
Results:The Baremization sample was divided into 16 groups: 4 age groups (41-51, 51-61, 6171 and >72 years), two educational levels (6-12 years and >12 years), and sex (male and female). Performance was significantly different between age groups (p < 0.003**). No significant differences were found in Craft Story 21 performance between education (p > 0.09) or sex (p > 0.56) groups within the same age group. Normative values in terms of means and standard deviations are presented for each group. Regarding the design of the recognition phase, the groups did not show significant differences in age (p= 0.13), sex (p= 0.88), or schooling (p= 0.33). The overall score of Craft Story 21 test showed the ability to discriminate between healthy controls from patients with MCI (sensitivity = 81.6% and specificity = 72.4%). Its diagnostic accuracy by phase (immediate AUC= 0.86; delayed AUC= 0.86 and recognition AUC= 0.75) was superior than Rey Auditory and Verbal Learning Test (RAVLT): immediate (AUC= 0.79), delayed (AUC= 0.82) and recognition (AUC= 0.74). It presented evidence of concurrent validity with RAVLT in its immediate (r=0.56, p<0.001), delayed (r= 0.66, p<0.001) and recognition (r= 0.37, p<0.001) trails. The instrument also presented evidence of reliability (a= 0.82).
Conclusions:The Craft Story 21 test is a practical, brief and multicultural scale. Thus having appropriate scales for the specific population to be assessed to a more accurate and precise description of the memory profile. Additionally, the new Recognition phase of the test showed evidence of validity and reliability for assessing memory processes.