Feasibility Study of Assessing the Preclinical Alzheimer Cognitive Composite (PACC) Score via Videoconferencing

Background: Identifying mild cognitive impairment (MCI) at early stages is of importance both for research and for clinical practice. The Preclinical Alzheimer Cognitive Composite (PACC) is a composite score which can detect the first signs of cognitive impairment. It is designed to be administered in person, by a trained research psychologist or nurse, however, in-person assessments are costly, and are difficult during the current COVID-19 pandemic. The aims of this study are to assess the feasibility of performing the PACC assessment with videoconferencing, and to compare the validity of this remote PACC score with the in-person PACC score obtained previously. Methods: Participants from the HEalth and Ageing Data IN the Game of football (HEADING) Study who had already undergone an in-person assessment were re-contacted and re-assessed remotely. The correlation between the two PACC scores was estimated. The difference between the two PACC scores was calculated and used in multiple linear regression to assess which variables were associated with a difference in PACC scores. Findings: Of the 43 participants who were invited to this external study, 28 were re-assessed. The median duration in days between the in-person and the remote assessments was 236·5 days (7·9 months) (IQR 62·5). There was a strong positive correlation between the two assessments for the PACC score, with a Spearman correlation coefficient of 0·75 (95% CI 0·56, 0·95). The multiple linear regression found that the only predictor of the PACC difference was the time between assessments. Interpretation: This study provides evidence on the feasibility of performing cognitive tests online, with all four tests comprising the PACC being successfully administered through videoconferencing. This is relevant, especially during times when face-to-face assessments cannot be performed. Funding Statement: This study was funded by the Drake Foundation as part of the BRAIN study funded to London School of Hygiene and Tropical Medicine (EPMSZO61) in collaboration with Queen Mary University of London and the Institute of Occupational Health. Declaration of Interests: We declare that we have no conflict of interests. Ethics Approval Statement: The HEADING Study was approved by the London School of Hygiene & Tropical Medicine’s Ethical Committee (16282).