Assessment of Neurocognitive Functions, Olfaction, Taste, Mental, and Psychosocial Health in COVID-19 in Adults: Recommendations for Harmonization of Research and Implications for Clinical Practice.

OBJECTIVE: To propose a set of internationally harmonized procedures and methods for assessing neurocognitive functions, smell, taste, mental, and psychosocial health, and other factors in adults formally diagnosed with COVID-19 (confirmed as SARS-CoV-2 + WHO definition). METHODS: We formed an international and cross-disciplinary NeuroCOVID Neuropsychology Taskforce in April 2020. Seven criteria were used to guide the selection of the recommendations' methods and procedures: (i) Relevance to all COVID-19 illness stages and longitudinal study design; (ii) Standard, cross-culturally valid or widely available instruments; (iii) Coverage of both direct and indirect causes of COVID-19-associated neurological and psychiatric symptoms; (iv) Control of factors specifically pertinent to COVID-19 that may affect neuropsychological performance; (v) Flexibility of administration (telehealth, computerized, remote/online, face to face); (vi) Harmonization for facilitating international research; (vii) Ease of translation to clinical practice. RESULTS: The three proposed levels of harmonization include a screening strategy with telehealth option, a medium-size computerized assessment with an online/remote option, and a comprehensive evaluation with flexible administration. The context in which each harmonization level might be used is described. Issues of assessment timelines, guidance for home/remote assessment to support data fidelity and telehealth considerations, cross-cultural adequacy, norms, and impairment definitions are also described. CONCLUSIONS: The proposed recommendations provide rationale and methodological guidance for neuropsychological research studies and clinical assessment in adults with COVID-19. We expect that the use of the recommendations will facilitate data harmonization and global research. Research implementing the recommendations will be crucial to determine their acceptability, usability, and validity.

Performance of everyday actions in mild Alzheimer's disease.

Early neuropsychological deficits associated with mild Alzheimer's disease (AD) have been characterized as memory deficits and impaired executive function or attention. The functional impact of early impairment was investigated by evaluating performance of everyday actions in older adults with mild AD (n = 15) as compared with healthy age-matched controls (n = 16). Everyday actions were familiar activities, for example, making a cup of tea, but were varied in complexity (simple, complex) and were performed under varied attention demand (single task, dual task). Although both participant groups responded to increasing task complexity by making more errors, the AD group made more errors under dual-task conditions regardless of the complexity of the task. Furthermore, a task requiring strategic retrieval of semantic information from long-term memory and manipulation of attention online (category fluency) was able to account for a large proportion of the group-related variance in everyday task performance. Results are discussed in relation to the role of components of working memory in performance of everyday actions in mild AD.