Ineligibility reasons and outcome measures of included studies.
| # | Study | Length of Intervention* | Ineligible/ declined | Ineligible due to tech | Outcome measures | Outcomes |
|---|---|---|---|---|---|---|
| Home (n=3) | ||||||
| 1 | Laver et al. (2020)20 | 4 months | NA | NA | Feasibility (caregiving mastery index) | Both groups reported improvements in the caregiving mastery index. |
| 2 | Lindauer et al. (2017)33 | 2 evaluations | 3 declined (poor health and time limitations) | 2 dyads ineligible due to technical difficulties | Feasibility (comparing the number of participants who attempted vs. completed the measures), test-retest reliability of all measures | Of the 28 dyads who completed the visits, 4 patients (14%) were unable to complete the telemedicine MoCA. Reliability was found to be good to excellent in all measures when used with telemedicine. |
| 3 | Moo et al. (2020)34 | 2 evaluations | 184 declined | 63 declined due to tech issues (not having a home computer (n=46), not being comfortable with computers (n=12), and computers being too old or lacking broadband service (n=5) | Feasibility/acceptability (participant willingness to participate, patient and care partner satisfaction) | 184 families declined to join telemedicine, 38 participated in telemedicine. Equivalent visit satisfaction was reported between in-person and telemedicine. |
| Adult Day Care Center, Nursing Home (n=2) | ||||||
| 4 | Castanho et al. (2016)35 | 3 evaluations | NA | NA | Acceptability (patient satisfaction), reliability/validity (correlation between testing modalities) | Participants’ acceptability of videoconference was satisfactory and on par with the acceptability of the telephone assessment. Correlation analyses showed high associations between the testing modalities: TICSM-PT VC and TICSM-PT telephone (r=0.885), TICSM-PT VC and MMSE face-to-face (r=0.801). |
| 5 | Jelcic et al. (2014)36 | 3 months | NA | NA | Feasibility (participant satisfaction) | 6/7 (86%) of patients undergoing telemedicine rated 10/10 for the satisfactory question item on general utility and appeal of exercises. All participants would advise the treatment to friends. |
| Remote Clinic (n=8) | ||||||
| 6 | Azad et al. (2012)21 | 1 evaluation | NA | NA | Feasibility (participant, provider, staff satisfaction) | Over 90% of physicians and patients indicated willingness to use telemedicine again. Physicians reported telemedicine provided enough information to assist in clinical decision-making (96%), and patients and case managers/geriatric assessors felt able to present the same information by video conferencing as in-person (92%). |
| 7 | Barton et al. (2011)22 | 1 evaluation | NA | NA | Feasibility (arriving at diagnosis, patient and provider satisfaction) | 12 patients were diagnosed with dementia, 2 with MCI, and 1 cognitively normal. Informal feedback from patients and providers indicated satisfaction with the evaluation and appreciation that the service could be provided locally. |
| 8 | Cheong et al. (2015)23 | 1 evaluation | 15 ineligible (did not return after initial evaluation) | NA | Evaluate the effectiveness of telemedicine for long-term follow-up of dementia patients in rural South Korea and identify the factors predicting long-term treatment | Lower age, lower CDR, and use of telemedicine were significant factors predicting long-term treatment. Mean treatment duration was significantly longer for the telemedicine group than for the clinical visit group (P < 0.001), with durations of 26.6 and 14.6 months, respectively. |
| 9 | Dang et al. (2018)24 | 1 evaluation | NA | NA | Feasibility/acceptability (arriving at a diagnosis, patient and care partnersatisfaction) | 15 patients were diagnosed with dementia and 20 were diagnosed with MCI. Patients and care partners expressed high satisfaction with the telemedicine and 90% of care partners indicated they would rather use telemedicine than travel to see the specialist in person. |
| 10 | Morgan et al. (2011)25 | alternating evaluations between in-person vs. telemedicine | 19 ineligible (admitted to nursing home (n=1), moved (n=2), missing data (n=1), discontinued (n=15) | NA | Feasibility/acceptability (participant and care partner satisfaction, distance saved) | On average, the distance saved by telemedicine was 213.4 km. Questionnaires showed similar satisfaction with telemedicine and in-person appointments, but telemedicine was rated as significantly more convenient. |
| 11 | Munro Cullum et al. (2014)26 | 2 evaluations | NA | NA | Reliability/validity (comparing scores in-person vs. videoconference) | Highly similar results across telemedicine and in-person conditions, with significant intraclass correlations between test scores. Findings remained consistent in subjects with or without cognitive impairment and in persons with MMSE scores as low as 15. |
| 12 | Powers et al. (2017)27 | 1 evaluation | 12 declined | NA | Feasibility (driving time and distance saved, participant and care partner satisfaction) | The estimated mean (SD) round trip distance saved in miles was 67.1 (39.7), and the estimated mean round trip on the road saved in minutes was 74.5 (43.2). Overall satisfaction score was 4.73/5. |
| 13 | Tso et al. (2016)28 | 1 evaluation | NA | NA | No explicit outcome measures stated | Overall satisfaction with the clinic was 4.84/5. |
| Hospital, Academic Center (n=4) | ||||||
| 14 | Burton et al. (2018)29 | 2 months | NA | NA | Feasibility/acceptability (comparison of cognitive rehabilitation delivered in-person vs. telemedicine) | 6/6 goals measured with the Canadian Occupational Performance Measure improved for those in the in-person group, and 7/9 goals improved for those in the telemedicine group. |
| 15 | Carotenuto et al. (2018)30 | 2 evaluations | NA | NA | Feasibility/reliability (comparing scores in-person vs. videoconference), acceptability (questionnaire on acceptance of videoconference for cognitive testing) | No differences in scores (MMSE, ADAS-cog) between videoconference and in-person for slight and moderate baseline MMSE impairment level. Patients in the severe baseline MMSE impairment level obtained lower scores on videoconference MMSE and higher scores on videoconference ADAS- cog. On the acceptance questionnaire, patients and care partners indicated they did not have concerns about privacy (4.8/5), and would like to repeat the experience (4.5/5). |
| 16 | Martin-Khan et al. (2012)31 | 1 evaluation | 65 declined | 1 ineligible due to technical problems | Reliability/validity (inter-rater reliability on the diagnosis of dementia) | No difference in levels of agreement for assessments conducted via telemedicine vs. in-person. |
| 17 | Parikh et al. (2013)32 | 2 evaluations | NA | NA | Acceptability (participant acceptability survey) | 98% participant satisfaction, with roughly two-thirds of indicating no preference between traditional face-to-face testing and examination by videoconference. |
*
For studies where length of intervention was not reported, number of interventions are reported.
ADAS-Cog - Alzheimer’s Disease Assessment Scale-Cognitive Subscale; CDR – clinical dementia rating; MCI – mild cognitive impairment; MMSE – Mini Mental Status Exam; MoCA – Montreal Cognitive Assessment; SD – standard deviation; TICSM-PT - Telephone Interview for Cognitive Status-Modified – Portuguese version videoconference