"You can't touch this": Delivery of inpatient neuropsychological assessment in the era of COVID-19 and beyond.

Objective: The COVID-19 pandemic is a global health crisis that has created sudden and unique challenges within the field of clinical neuropsychology. Adapting neuropsychology services using teleneuropsychology models (e.g. video or telephone assessments) may not always be a viable option for all providers and settings. Based on the existing teleneuropsychology literature, we propose a "contactless" evidence-based inpatient test battery to be used for in-person assessments amenable to physical distancing. Method: In addition to the proposed test battery, we suggest a decision-making workflow process to help readers determine the appropriateness of the proposed methods given their patients' needs. Considerations for special populations (i.e. seniors, patients with brain injury, psychiatric patients), feedback, limitations of the proposed physical distancing approach, and future directions are also discussed. Conclusions: Our aim is that the suggested teleneuropsychology-informed battery and model may inform safe and practical neuropsychological inpatient assessments during the COVID-19 pandemic and other situations requiring contact precautions for infection prevention and control.

Facilitating change in health-related behaviors and intentions: a randomized controlled trial of a multidimensional memory program for older adults.

OBJECTIVES: Many older adults are concerned about memory changes with age and consequently seek ways to optimize their memory function. Memory programs are known to be variably effective in improving memory knowledge, other aspects of metamemory, and/or objective memory, but little is known about their impact on implementing and sustaining lifestyle and healthcare-seeking intentions and behaviors. METHODS: We evaluated a multidimensional, evidence-based intervention, the Memory and Aging Program, that provides education about memory and memory change, training in the use of practical memory strategies, and support for implementation of healthy lifestyle behavior changes. In a randomized controlled trial, 42 healthy older adults participated in a program (n = 21) or a waitlist control (n = 21) group. RESULTS: Relative to the control group, participants in the program implemented more healthy lifestyle behaviors by the end of the program and maintained these changes 1 month later. Similarly, program participants reported a decreased intention to seek unnecessary medical attention for their memory immediately after the program and 1 month later. CONCLUSIONS: Findings support the use of multidimensional memory programs to promote healthy lifestyles and influence healthcare-seeking behaviors. Discussion focuses on implications of these changes for maximizing cognitive health and minimizing impact on healthcare resources.

The role of premorbid expertise on object identification in a patient with category-specific visual agnosia.

The role of premorbid expertise in object identification was investigated in the category-specific visual agnosia patient ELM. For several years prior to his stroke ELM played bugle in a military band. We surmised that band membership would lead to preferential exposure to, and expertise for, brass instruments relative to other musical-instrument families. To test this hypothesis we assessed ELM's musical instrument identification capability for brass and stringed instruments. Testing was conducted 14 years post-stroke. ELM listed significantly more correct attributes for five brass instruments than for five stringed instruments. On a picture-word matching task ELM showed significantly better identification of brass, relative to stringed, musical instruments. Finally, when ELM was required to pair novel shapes with labels denoting brass or stringed instruments, he made significantly more errors in the stringed-instrument condition than in the brass-instrument condition. We conclude that the elevated attribute knowledge accompanying expertise serves to increase the visual and semantic distance between objects within a category, thereby protecting them against identification deficits in the context of category-specific visual agnosia.