Comparing face-to-face and videoconference completion of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke

Journal article


Chapman, Jodie E., Cadilhac, Dominique A., Gardner, Betina, Ponsford, Jennie, Bhalla, Ruchi and Stolwyk, Renerus J.. (2021). Comparing face-to-face and videoconference completion of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke. Journal of Telemedicine and Telecare. 27(8), pp. 484-492. https://doi.org/10.1177/1357633X19890788
AuthorsChapman, Jodie E., Cadilhac, Dominique A., Gardner, Betina, Ponsford, Jennie, Bhalla, Ruchi and Stolwyk, Renerus J.
Abstract

Introduction
Videoconferencing may help address barriers associated with poor access to post-stroke cognitive screening. However, the equivalence of videoconference and face-to-face administrations of appropriate cognitive screening tools needs to be established. We compared face-to-face and videoconference administrations of the Montreal Cognitive Assessment (MoCA) in community-based survivors of stroke. We also evaluated whether participant characteristics (e.g. age) influenced equivalence.

Methods
We used a randomised crossover design (two-week interval). Participants were recruited through community advertising and use of a stroke-specific database. Both sessions were conducted by the same researcher in the same location. Videoconference sessions were conducted using Zoom. A repeated-measures t-test, intraclass correlation coefficient (ICC), Bland–Altman plot and multivariate regression modelling were used to establish equivalence.

Results
Forty-eight participants (26 men, Mage = 64.6 years, standard deviation (SD) = 10.1; Mtime since stroke = 5.2 years, SD = 4.0) completed the MoCA face-to-face and via videoconference on average 15.8 (SD = 9.7) days apart. Participants did not perform systematically better in a particular condition, and no participant variable predicted difference in MoCA performance. However, the ICC was low (0.615), and the Bland–Altman plot indicated wide limits of agreement, indicating variability between sessions.

Discussion
Our findings provide preliminary evidence to support the use of videoconference to administer the MoCA following stroke. However, further research into the test–retest reliability of scores derived from the MoCA is needed in this population. Administering the MoCA via videoconference holds potential to ensure that all stroke survivors undergo cognitive screening, in line with recommended clinical practice.

KeywordsMontreal Cognitive Assessment; MoCA; telehealth; videoconference; stroke; neurology; screening; rehabilitation
Year2021
JournalJournal of Telemedicine and Telecare
Journal citation27 (8), pp. 484-492
PublisherSage Publications Ltd.
ISSN1357-633X
Digital Object Identifier (DOI)https://doi.org/10.1177/1357633X19890788
Scopus EID2-s2.0-85077211662
Research or scholarlyResearch
Page range484-492
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online09 Dec 2019
Publication process dates
Deposited25 Oct 2021
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