key: cord-0823692-bk07n0lu
authors: Coetzer, Rudi
title: First impressions of performing bedside cognitive assessment of COVID‐19 inpatients.
date: 2020-05-12
journal: J Am Geriatr Soc
DOI: 10.1111/jgs.16561
sha: 17169c84bf8826255a2df5f088e74a81ca6ce6d0
doc_id: 823692
cord_uid: bk07n0lu

nan

To the Editor Natalie Philips and colleagues very helpfully outline some of the challenges encountered when performing cognitive screening via telemedicine. 1 The authors focus in particular on the use of the Montreal Cognitive Assessment 2, and the significant obstacles encountered during non-standardized remote administration of the test. Below I outline some of the challenges encountered when performing bedside cognitive assessment of COVID-19 inpatients with acquired brain injury, degenerative conditions or other neurological diagnoses.

1. Wearing PPE poses several logistical challenges for performing bedside cognitive assessment.

For example, paper and pencil tasks cannot be taken into the ward for use during the assessment.

For timed tasks, even where permissible to wear a wristwatch, these cannot be seen underneath the PPE. Furthermore, ward wall-mounted clocks may not always be visible to time tasks.

2. Perceptual problems are accentuated by wearing PPE. Speaking through a mask to patients who might have processing or hearing impairment as part of acquired brain injury or other neurological insult, makes bedside cognitive assessment difficult to perform with assured reliability and validity. Conversely, wearing PPE is uncomfortable and hot, and can make it difficult to observe your patient's performance as well as you would like to.

Patients with COVID-19 often experience debilitating fatigue, which may adversely affect their cognitive performance. Patients may only be able to tolerate short bedside cognitive screening. It 

Montreal Cognitive Assessment for telemedicine assessment during COVID-19

MoCA: a brief screening tool for mild cognitive impairment

Author Contributions: The author is solely responsible for this work Sponsor's Role: No specific funding was received for this work