Preliminary Findings from a Telephone-Based Cognitive Screening of an Adult HIV Research Cohort during the COVID-19 Pandemic

• Published in: Archives of clinical neuropsychology 2022-11, Vol.37 (8), p.1710-1719
• Main Authors: Gonzalez, Jairo A, Clark, Uraina S, Byrd, Desiree, Clarke, Yusuf, Greenwood, Kaitlyn, Tell, Elizabeth, Carrion-Park, Cira, Pizzirusso, Maria, Burgess, Rhonda, Morgello, Susan
• Format: Article
• Language: English
• Subjects: Adult; Cognition; COVID-19; HIV Infections - complications; Humans; Neuropsychological Tests; Original Empirical; Pandemics; Telephone
• ISSN: 1873-5843; 0887-6177; 1873-5843
• DOI: 10.1093/arclin/acac045

Few publications have documented the utility of in-home telephone-based cognitive screeners during COVID-19. This manuscript describes the adaptation of select face-to-face (FTF) neuropsychological tests to telephonic administration in a longitudinal cohort of people with HIV (PWH). Using the cohort's pre-pandemic neuropsychological data, we explore the utility of telephonic administration in this population. Of a longitudinal cohort of 170 adult PWH, 59 completed telephonic medical and cognitive screenings with comparable pre-pandemic FTF data. Telephone screeners and FTF evaluations were compared using repeated measures ANCOVAs to examine whether test performance differed between administration types and levels of pre-pandemic cognitive performance. Individuals with pre-pandemic test scores more than a standard deviation below the demographically-corrected mean were categorized as "below average" cognitive performance (n = 23), and the remainder as "average" (n = 36). Over 90% of participants gave positive feedback about the telephone encounter. The average cognitive performance group scored higher than the below average group on all measures across both administration types. Telephone and FTF test scores did not differ significantly for measures of category fluency, letter fluency, and verbal learning. However, the below average group scored higher on a verbal memory measure administered via telephone compared with FTF. Support for telephonic adaptation of select FTF measures in longitudinal research is mixed, with verbal fluency tasks showing the strongest equivalency. When employed carefully with a clear understanding of their limitations, telephone adaptations can provide an opportunity to continue study objectives, promote equity, and monitor participant well-being during times of duress.