Remote Testing in Abbiategrasso (RTA)

The primary outcome is the recruitment of the 58 Brain Bank donors in our study on remote cognitive assessment. Fifteen days after the informed consent is sent, the healthcare assistant will conduct telephone calls to receive confirmation of participation in a remote cognitive assessment study from the donors who previously had expressed their willingness to adhere. The healthcare assistant will collect information about the reason of refusal if any (i.e. not interested, health problems, away from home for holidays). It will also asked confirmation of the modality preferred for the remote assessment, i.e. by phone, tablet or computer.

Immediately following each session of cognitive evaluation (both remotely and face-to-face) participants completed an acceptability questionnaire previously developed to evaluate the response to computerised cognitive tasks in both the clinic-based and home-based setting. Participants will be required to rate the enjoyability, level of anxiety, engagement, duration and repeatability of the tasks, rating them on a five-point Likert scale: 1, not at all; 2, a little bit; 3, neutral; 4, slightly; 5, very much. The questionnaire comprises the following questions: Did the test make you anxious? Did you enjoy the test? Did you find the test interesting? Would you be happy to repeat the test? What did you think about the duration of the test?

The MoCA Audiovisual is the version of the MoCA test used for video administration with little adaptation. It is a screening test including 5-word learning (attention), animal semantic fluency (language, executive function), 6-item orientation, and delayed recall (memory). The visual section (trail making, clock drawing and the cube copy) is displayed on the video using the share screen option (range 0-30).

The MoCA 5-minute is a brief version of the MoCA test with the visual elements removed and suitable for telephone administration. It is a screening test including 5-word learning (attention), animal semantic fluency (language, executive function), 6-item orientation, and delayed recall (memory). The MoCA 5-minute has been translated in Italian and it is commonly used in clinical setting (range 0-15).

The RAVLT evaluates verbal learning and memory in young and older adults. It is designed as a list-learning paradigm in which the subject hears a list of 15 nouns and is asked to recall as many words from the list as possible. After a 15 minutes delay (performing interference non-verbal tasks), the participant is immediately asked to recall the words from the list. The RAVLT provides immediate (sum of words recalled on the 5 learning trials; range 0-75) and delayed recall scores (sum of the words recalled after 15 min; range 0-15), with higher scores indicating better performance on verbal learning and long-term memory.

Digit span forward and backward are two subtests of the Wechsler Adult Intelligence Scale, assessing short-term memory and working memory respectively. Participants are asked to repeat sequences of numbers of increasing length in straight order (Digit span forward) or reverse order (Digit span backward). Performances are reported as span scores (the maximum number of digits correctly produced forwards or backwards by the subjects) (range 0-9), with higher scores indicative of better performance on short-term memory and working memory.

The alternate phonemic/semantic fluency test measures spontaneous verbal production, executive function, processing speed and memory. It consists of three subtests: letter-cued (phonemic) fluency, category-cued (semantic) fluency and alternate phonemic/semantic fluency. The subtests are administered in the following order: phonemic, semantic and alternate fluency. In the first, the subject is asked to produce words beginning with a specified letter (F, A and S). In the second, one is asked to produced words belonging to a specified category (colours, animals and fruits). The score is obtained by the sum of the correct responses (range 0-…) within 60 seconds, with higher scores indicating better performances. In the third, the subjects have to alternate letter-cued words with category-cued words as follows: trial (1) letter A and Colours; trial (2) letter F and Animals; trial (3) letter S and Fruits. Three trials are given, each lasting 60 seconds.

Verbal reasoning test evaluates the individual's ability to reason, i.e. solve problems, draw inferences and classify, based on previous knowledge.The test consists of four subtests: differences (for instance: what is the difference between glass and plate?), proverbs (for instance: what is the meaning of "The dress does not make the priest"?), nonsense (what's wrong or what's wrong with the following story?) and classifications (for instance: please, state the likeness between Milan, Rome, Naples and Venice). The score of items is attributed on the basis of predefined criteria, so that subtest scores varies between 0 and 15 (total range score 0-60), with higher scores indicative of better performance on verbal reasoning.

Copy figure tasks are generally included in most of the common screening tests and battery administered remotely, although the high level of variability between studies. The Constructional praxis test cannot be administered by telephone, but can be drawn during the videoconference and displayed in front of the camera. Subjects are requested to copy images representing bi-dimensional and three-dimensional shape (range 0-16), with higher scores indicative of better performance on constructional ability.

The term Theory of Mind (ToM) refers to the abilities to attribute mental states to others and to predict, describe, and explain behaviour on the basis of such mental state. ToM abilities are involved in social functioning and are affected in neurodegenerative diseases. The RME evaluates the cognitive component of ToM in adult and older people. The test consists of 36 black and white photographs depicting the eye region of adults, young and old people of both sexes. The subject is asked to indicate the term among four adjectives placed under the photograph, best describing the emotion expressed in the image (range 0-36). To limit the effect of the linguistic competences, a glossary is available to the subjects including definitions and clarifications for each of the words associated with the photos. To adapt the administration to the remote modality, the images will be projected on the shared screen.