Telemedicine and the rural dementia population: A systematic review

Harmehr Sekhon; Kerman Sekhon; Cyrille Launay; Marc Afililo; Nathan Innocente; Ipsit Vahia; Soham Rej; Olivier Beauchet

doi:10.1016/j.maturitas.2020.09.001

Telemedicine and the rural dementia population: A systematic review

Maturitas. 2021 Jan:143:105-114. doi: 10.1016/j.maturitas.2020.09.001. Epub 2020 Sep 24.

Authors

Harmehr Sekhon¹, Kerman Sekhon², Cyrille Launay³, Marc Afililo⁴, Nathan Innocente⁵, Ipsit Vahia⁶, Soham Rej⁷, Olivier Beauchet⁸

Affiliations

¹ Postdoctoral Research Fellow, Department of Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada.
² Division of Experimental Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada.
³ Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada.
⁴ Emergency Department, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada.
⁵ University of Toronto Mississauga, Mississauga, ON, Canada.
⁶ Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, 02215, USA.
⁷ GeriPARTy Research Group, Jewish General Hospital, Montreal, Canada; Department of Psychiatry, McGill University, 1033 Avenue des Pins, Montreal, H3A 1A1, Canada; McGill Meditation and Mind-Body Medicine Research Clinic (MMMM-RC), Canada.
⁸ Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Medicine, Faculty of Medicine, University of Montreal, Quebec, Canada; Centre of Research of "Institut Universitaire de Montreal", Quebec, Canada; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Electronic address: olivier.beauchet@mcgill.ca.

PMID: 33308615
DOI: 10.1016/j.maturitas.2020.09.001

Abstract

Background: Telemedicine is a timely solution for the restrictions that COVID-19 social distancing places upon conventional modalities of healthcare provision. Geriatric populations affected by dementia require greater access to healthcare services, particularly in rural areas. As such, the aim of this systematic review is to examine the impact of telemedicine on health outcomes in elderly individuals with dementia living in rural areas.

Methods: A systematic review was completed using Ovid Medline, Web of Science and ACM Digital Libraries. The keywords for the selection of articles were: (telemedicine OR Telehealth) AND (Rural) AND (Age* OR Eld*) AND (Dementia) and (Telemedicine) AND (Rural Health OR Rural Population OR Hospitals, Rural OR Rural Health Services) AND (Aged OR Aging) AND (Dementia OR Multi-Infarct Dementia OR Vascular Dementia OR Frontotemporal Dementia). Among the 94 articles identified, 79 (84.0 %) were screened, 58 (61.7 %) were assessed and 12 (12.8 %) were included.

Results: The studies had diverse populations. Two were conducted in Australia, five in Canada, one in Korea, and four in the United States of America. The studies used a variety of cognitive tests and reported mixed results regarding the differences in patient performance when assessed in-person as compared to telemedicine consultation. Overall, both patients and physicians reported satisfaction with telemedicine; however, there were mixed results regarding the reliability of cognitive tests and the infrastructure required. Convenience, satisfaction, comfort and recommending telemedicine were reported to be high in the telemedicine group and physicians reported they would use telemedicine again.

Conclusion: The testing conditions and the accessibility of telemedicine yield inconclusive results as to whether telemedicine can improve the management of dementia in geriatric individuals.

Keywords: COVID-19; Dementia; Healthcare accessibility; Older adults; Rural; Telemedicine/telehealth.

Publication types

Systematic Review

MeSH terms

Aged
Attitude of Health Personnel
COVID-19 / prevention & control*
Dementia / therapy*
Health Services Accessibility*
Humans
Neuropsychological Tests
Patient Satisfaction
Reproducibility of Results
Rural Population*
SARS-CoV-2
Telemedicine*