From Face-to-Face to Home-to-Home: Validity of a Teleneuropsychological Battery

J Alzheimers Dis. 2021;81(4):1541-1553. doi: 10.3233/JAD-201389.


Background: Over the last decade, teleneuropsychology has increased substantially. There is a need for valid neuropsychological batteries to be administered home-to-home. Since 2006, the neuropsychological battery of Fundació ACE (NBACE) has been administered face-to-face in our clinical settings. Recently, we adapted the NBACE for teleneuropsychology use to be administered home-to-home (NBACEtn).

Objective: The aims of the present study are: 1) to determine the home-to-home NBACE equivalence compared to its original face-to-face version; and 2) to examine home-to-home NBACE discriminant capacity by differentiating among cognitively healthy, mild cognitive impairment, or mild dementia subjects and comparing it with the face-to-face version.

Methods: Data from 338 individuals assessed home-to-home (NBACEtn) were contrasted with 7,990 participants assessed with its face-to-face version (NBACE). Exploratory and confirmatory factorial structure, and invariance analysis of the two versions of the battery were performed.

Results: Exploratory and confirmatory factor analysis supported the four-factor model (attention, memory, executive, and visuospatial/constructional functions). Configural, metric, and scalar measurement invariance was found between home-to-home and face-to-face NBACE versions. Significant differences in most of the neuropsychological variables assessed were observed between the three clinical groups in both versions of administration. No differences were found between the technological devices used by participants (computer or tablet and mobile devices).

Conclusion: For the first time, invariance analysis findings were addressed by determining a teleneuropsychological battery's equivalence in comparison with its face-to-face version. This study amplifies the neuropsychological assessment's applicability using a home-to-home format, maintaining the original measure's structure, interpretability, and discriminant capacity.

Keywords: Alzheimer’s disease; cognitive impairment; construct validity; face-to-face; home-to-home; invariance; neuropsychological assessment; telemedicine; teleneuropsychology.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attention / physiology*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / psychology
  • Computers, Handheld
  • Female
  • Humans
  • Male
  • Memory / physiology*
  • Middle Aged
  • Neuropsychological Tests*
  • Remote Consultation*