Background: Given the current COVID-19 pandemic situation, now more than ever, remote solutions for assessing and monitoring individuals with cognitive impairment are urgently needed. Older adults in particular, living in isolated rural areas or so-called ‘medical deserts’, are facing major difficulties in getting access to diagnosis and care. Telemedical approaches to assessments are promising and seem well accepted, reducing the burden of bringing patients to specialized clinics. However, many older adults are not yet adequately equipped to allow for proper implementation of this technology. A potential solution could be a mobile unit in the form of a van, equipped with the telemedical system which comes to the patients’ home. The aim of this proof-of-concept study is to evaluate the feasibility and reliability of such mobile unit settings for remote cognitive testing. Methods and analysis: eight participants (aged between 69 and 86 years old) from the city of Digne-Les-Bains volunteered for this study. A basic neuropsychological assessment, including a short clinical interview, is administered in two conditions, by telemedicine in a mobile clinic (equipped van) at a participants’ home and face to face in a specialized clinic. The administration procedure order is randomized, and the results are compared with each other. Acceptability and user experience are assessed among participants and clinicians in a qualitative and quantitative manner. Measurements of stress indicators were collected for comparison. Results: The analysis revealed no significant differences in test results between the two administration procedures. Participants were, overall, very satisfied with the mobile clinic experience and found the use of the telemedical system relatively easy. Conclusion: A mobile unit equipped with a telemedical service could represent a solution for remote cognitive testing overcoming barriers in rural areas to access specialized diagnosis and care.

Today, in rural isolated areas or so-called ‘medical deserts’, access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, telemedicine platforms are gradually more employed for remote medical assessment. Only a few are tailored to comprehensive teleneuropsychological assessment of older adults. Hence, our study focuses on evaluating the feasibility of performing a remote neuropsychological assessment of older adults suffering from a cognitive complaint. 50 participants (aged 55 and older) were recruited at the local hospital of Digne-les-Bains, France. A brief neuropsychological assessment including a short clinical interview and several validated neuropsychological tests was administered in two conditions, once by Teleneuropsychology (TNP) and once by Face-to-Face (FTF) in a crossover design. Acceptability and user experience was assessed through questionnaires. Results show high agreement in most tests between the FTF and TNP conditions. The TNP was overall well accepted by the participants. However, differences in test performances were observed, which urges the need to validate TNP tests with broader samples with normative data.

Background/Objectives: Access to specialists and diagnostic resources continues to limit differential diagnosis of cognitive impairment in primary care. This pilot study examined the feasibility, usability, and clinical integration of a digitally supported Remote Cognitive Assessment (RCA) model embedded in general practice settings. Methods: A mixed-method design was used, combining structured quantitative surveys from patients (n = 10; mean age = 77.03; SD = 14.1) and neuropsychologists (10 RCAs completed by three neuropsychologists) with qualitative interviews from general practitioners (GP; n = 4). Patients were assessed remotely via a secure videoconference system operated by trained neuropsychologists. Assessments were conducted in the GP’s office, supported by local staff, to facilitate the process. Results: Patients reported high satisfaction with audio (M = 8; SD = 2.28) and video quality (M = 9.17; SD = 1.17) and expressed a strong willingness to recommend RCA (M = 8.83; SD = 1.17) on a 10-point Likert scale. Despite moderate scores for perceived simplicity (M = 5; SD = 3.41) and effectiveness (M = 5.83; SD = 2.14), overall acceptance (M = 8.33; SD = 0.82) was favorable, especially given the older age of participants. Neuropsychologists rated technical functionality positively (audio quality M = 8.17; SD = 1.18; video quality M = 8; SD = 1.67) but raised concerns about clinical utility and diagnostic depth (effectiveness M = 2.83; SD = 2.71). GPs highlighted the benefits of local facilitation, early screening, and improved access to specialist input while also noting space limitations, communication gaps, and the need for sustainable infrastructure. Conclusions: The RCA model was well accepted by patients and GPs, and technically feasible for neuropsychologists. However, neuropsychologists reported important reservations regarding usability and effectiveness. The results suggest an important mismatch between patient satisfaction and clinical confidence and RCA cannot yet be recommended for routine clinical implementations based on patient acceptability alone. This model holds promises for hybrid cognitive care, particularly in underserved or rural areas, but future development must prioritize diagnostic confidence and clinician workflow usability before scalable integration into rural cognitive care pathways can be established.