NEUROvitalis - Therapy in Geriatrics

NeuroVitalis – Screening Test

Goal

The aim of the screening tests is to measure and evaluate cognitive deficits in older subjects and geriatric patients.

It is determined whether the subject’s performance is age-appropriate or whether there are any abnormalities.

In the event of any abnormalities, a specialist (usually a neurologist or neuropsychologist) should always be contacted.

The screening tests were developed by the Cologne University Hospital.

Uniklinik Köln

The tests were standardized in the dissertation by Yalda Khani, titled “TabScreen – A Tablet-Based Screening for Cognitive Impairment,” completed in 2019 at the Faculty of Medicine, University of Cologne.

The initial sample comprised 100 participants, including 52 cognitively normal individuals and 48 individuals with cognitive impairments. Subsequently, the sample size was expanded to a total of 1,325 participants to establish a very reliable normative data set across a broad range of ages. This expanded cohort included 529 males and 796 females, spanning age categories from under 20 years to over 70 years, with each age group having at least 28 males and 30 females. The age groups with the highest representation were between 25 to 30 years (63 males, 110 females) and 45 to 65 years, providing a robust dataset for cognitive screening benchmarks. Notably, the age range of 45 to 65 years contributed the most substantial data, enhancing the analysis with a significant number of reference values that comprehensively cover middle-aged adults.

Execution

NEUROvitalis Screening - choice of tests

The image (click to enlarge) shows the start of the screening tests. You can choose which individual tests should be carried out.

If all tests are selected, it takes about 30 minutes for healthy volunteers and about 45 minutes (or more) for those affected.

The results are saved and can be viewed later.

There are 3 parallel variants for each test. Nevertheless, each test cannot be repeated for a month after the test to prevent learning effects.

Results

NEUROvitalis - Screening results

The screening tests are evaluated in a table. The test result of the individual subtests is given as a percentile rank.

If the screening is repeated, the results of the different test times (with a date) appear one below the other. In this way, changes in performance are directly apparent.

Percentile rank

Percentile ranks are commonly used to clarify the interpretation of scores on standardized tests. For the test theory, the percentile rank of a raw score is interpreted as the percentages of examinees in the norm group who scored below the score of interest (Crocker & Algina, 1986).
For details see website Psychology Wiki.

The HeadApp program interprets the results
with a percentile rank <= 2% as “strongly impaired”
with a percentile rank <= 7% as “impaired”
with a percentile rank <= 16% as “lower average”
all other results as “normal” or better

The colored bars that show the patient’s performance are scaled logarithmically. This ensures that performance improvements in the lower percentile range are more pronounced.

Evaluation of results

The results of the screening are evaluated by HeadApp. If the performance in a test is “lower average” or worse, suitable therapy modules are suggested. When the patient starts training, a level of difficulty is automatically selected that corresponds to the level of performance. If the training offers special setting options, these are carried out according to the test results.

Peculiarity of the test result “laterality”

If the pathfinder test detects a slowdown on the right or left, this indicates a neglect or a hemianopsia.

The basic setting of the patient is changed in accordance with the test results, as a result of which this information affects all therapy programs. If the result is “strongly impaired”, the optokinetic stimulation (OKS) is activated. If the patient cannot tolerate OKS, this must be deactivated manually in the “Patient-> Edit” window.