Abstract
Purpose :
The Montreal Cognitive Assessment Blind version (MoCA-B; administration without visual items) has good sensitivity and specificity in detecting individuals at risk for cognitive impairment. However, the experience of administering and receiving this screening tool remotely is not well understood. The objective was to explore the facilitators and barriers experienced by participants and administrators when the MoCA-B is conducted over the phone.
Methods :
Ten older adults (Mean age = 69, SD = 12, Range = 67-76) without a reported history of cognitive or visual impairment participated in this observational study. Questionnaires pertaining to telephone use and demographic information were presented alongside a telephone administration of the MoCA-B. Subsequently, a semi-structured interview was conducted and transcribed to facilitate analysis of participants' experience. Administrators took extensive field notes throughout the process as documentation of their experiences. Data were analyzed using thematic analysis separately for each perspective. Theme generation was informed by elements of feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited efficacy.
Results :
The remote administration of the MoCA-B was generally well received by participants and administrators. Test administration was facilitated by positive attitudes of all parties, clear test instructions, and simple questionnaire response options. Remote administration was convenient for participants and administrators by reducing travel time. Participants identified concerns with the long process of obtaining consent over the phone, loss of social contact, and potential threats to confidentiality. Administrators identified communication challenges, unpredictable technical difficulties, and age-related hearing impairment as major limitations.
Conclusions :
Telephone administration of the MoCA-B is an accessible format for cognitive screening with older adults and does not require functional vision. Its acceptability is increased when both participants and assessors have a positive experience. Future work should focus on developing clear guidelines for remote administration of the MoCA-B.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.