Comparison of Telehealth Versus Face-to-Face Administration of the Oral Trail Making Test in Older Adults with and without Cognitive Impairment: A Brief Report.

Objectives: To examine the performance reliability of the Oral Trail Making Test (OTMT) in face-to-face (FTF) and teleneuropsychology (TeleNP) conditions among older individuals with and without cognitive impairment.

Methods: Two hundred participants (with [n = 81], and without cognitive impairment [n = 119]) completed the OTMT in both conditions, in a counterbalanced design. Paired sample t-tests compared OTMT scores and intra-class correlation coefficients examined the degree of agreement between the two testing conditions for both diagnostic groups.

Results: For both groups, mean scores were similar across test conditions, with small yet statistically significant differences for OTMT-A (p < .001), though OTMT-B scores did not significantly differ (p-values: .702-.749). Despite substantial variability in OTMT scores, there was a strong agreement between testing formats for OTMT-A (α values = 0.845-0.939) and moderate to strong agreement for OTMT-B scores (α-values = 0.657-0.837).

Conclusions: OTMT administration may be feasible and reliable for TeleNP, though caution is advised for clinicians when interpreting overall test performances given large score variability.