Rea, Raffaele (2014) Tele-Neuropsychological assessments in Alzheimer's disease: a comparison of “face to face” versus Video-Conferencing. PhD thesis, SCHOOL OF ADVANCED STUDIES - Doctoral course in Environmental sciences and Public Health - PhD Programme in E-Health and telemedicine (XXVI cycle).
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Telemedicine consists in the use of telecommunication technologies to provide healthcare services, overcoming geographic, temporal, social, and cultural barriers. Today telemedicine is a developed field which includes about 50 different subspecialties: neuropsychology is one of them. Allowing the objective evaluation of the cognitive state of individuals, neuropsychology is a discipline of wide application; it also contributes significantly to an early diagnosis of subjects suspected to develop cognitive impairments due to Alzheimer disease or other degenerative dementias. Subjects at risk, and subjects who have already develop the illness, would particularly benefit of a telehealth intervention, which allows to overcome the barriers of space and time, and to provide an evaluation, as well as the therapy monitoring. These aspects would be particularly important for subjects who live far from health institutions , as those of rural areas. Obviously, we need to be sure that the results of the Tele-Neuropsychological assessment are comparable to those obtained via the classic “ face to face “ administration. This is the purpose of this research. We aimed in fact to compare the performances obtained in the two conditions at the MMSE test and the ADAS Cog test. To this purpose, we submitted a group of subjects affected by mild to moderate Alzheimer disease with associated vascular damages, to MMSE and the ADAS COG test, and performed a statistical analysis of data through a two sided Student “t” test. We found that the administration modality had no significant impact on the results. In fact, no significant difference was found neither in the MMSE, or in the ADAS_Cog scores administered by telehealth versus “face to face”. While the results obtained at the MMSE confirm some previous data, this is, at our knowledge, the first study done on the ADAS_Cog, a test. Even if the conditions we employed in this research are not entirely superposable to those of patients staying at home (we evaluated the feasibility of teleheath by locating the patient and his caregiver in another room of the memory clinic ), we are confident that telehealth methodology, by video-conferencing, is as much reliable as the face to face modality. The small number of the subjects evaluated represents an obvious limitation of this study and suggests further studies involving larger number of subjects. However, our preliminary results give support to the idea that by tehealth the screening and the follow-up of the cognitive impairments age associated is feasible and valid.
|Item Type:||Tesi (PhD)|
|Informazioni aggiuntive:||Tutor: Prof. Francesco Amenta. PUBLICATIONS MADE DURING THE PH.D. FROM 2011 TO 2014 : 1. Raffaele Rea, Anna Carotenuto, Angiola Maria Fasanaro, Enea Traini, and Francesco Amenta. “Apathy in Alzheimer’s Disease: Any Effective Treatment?”. The Scientific World Journal Volume 2014 (2014), Article ID 421385, 9 pages. 2. Rea Raffaele, Carotenuto Anna, Traini Enea, Fasanaro Angiola Maria, Manzo Valentino, Amenta Freancesco. “Apathy treatment in Alzheimer disease. Results of the ASCOMALVA Trial”. Journal of Alzheimer’s disease. In press. 3. Francesco Amenta, Anna Carotenuto, Angiola Maria Fasanaro, Raffaele Rea, Enea Traini. “The ASCOMALVA (Association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease) trial. Interim results after 2 years of treatment”. Journal of Alzheimer’s disease. In press. 4. Luisa Colucci, Massimiliano Bosco, Antonio Rosario Ziello , Raffaele Rea , Francesco Amenta, Angiola Maria Fasanaro “Effectiveness of nootropic drugs with a cholinergic activity and cognitive function: a review” Journal of Experimental Pharmacology 2012:4 163–172. 5. Anna Carotenuto, Raffaele Rea, Luisa Colucci, Antonio Rosario Ziello, Ivana Molino, Sabrina Carpi, Enea Traini, Francesco Amenta, Angiola Maria Fasanaro. “Late and early onset dementia: What is the role of vascular factors? A retrospective study”. J Neurol Sci. 2012 Nov 15;322(1-2):170-5. 6. Raffaele Rea, Angiola Maria Fasanaro, Valentino Manzo and Francesco Amenta. “Use of phospholipids containing Choline in the treatment of Mild Cognitive Impairment (MCI). Retrospective analysis of published studies” In press 7. Francesco Amenta, Anna Carotenuto, Angiola Maria Fasanaro, Raffaele Rea, Enea Traini. The ASCOMALVA trial: Association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: Interim results. J Neurol Sci. 2012 Nov 15;322(1-2):96-101. 8. Francesco.Amenta, Anna Carotenuto, Angiola Maria Fasanaro, Alessia Lanari, Raffaele Rea, Enea Traini. Preliminary results of ASCOMALVA trial on the association of donepezil and choline alphoscerate in Alzheimer’s disease with associated cerebrovascular injury G Gerontol 2011;59:1-10 9. Anna Carotenuto, Raffaele Rea, Ivana Molino, Antonio Rosario Ziello, Enea Traini, Francesco Amenta, Vincenzo Andreone, Angiola Maria Fasanaro. Malattia di Alzheimer: quanti sono i casi “misti”? Il Giornale dello Stroke, Giugno 2011. pp. 12-15. 10. Raffaele Rea, Anna Carotenuto, Angiola Mari Fasanaro. Associazione fra Malattia di Alzheimer e danno vascolare: i casi di AD puro e misto. EXEL 20-23 .2011. 10. Raffaele Rea, Anna Carotenuto, Angiola Mari Fasanaro. Associazione fra Malattia di Alzheimer e danno vascolare: i casi di AD puro e misto. EXEL 20-23 .2011.|
|Settori scientifico-disciplinari:||SCIENZE BIOLOGICHE > BIO/16 Anatomia umana|
|Depositato da:||Dr. Cristina Soave|
|Depositato su:||14 May 2014 10:51|
|Last Modified:||14 May 2014 10:51|
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