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Article

Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece

by
Efthalia Angelopoulou
1,
Ioannis Stamelos
1,
Evangelia Smaragdaki
1,
Kalliopi Vourou
1,
Evangelia Stanitsa
1,
Dionysia Kontaxopoulou
1,
Christos Koros
1,
John Papatriantafyllou
1,
Vasiliki Zilidou
2,
Evangelia Romanopoulou
2,
Efstratia-Maria Georgopoulou
3,
Paraskevi Sakka
4,
Haralampos Karanikas
5,
Leonidas Stefanis
1,
Panagiotis Bamidis
2 and
Sokratis Papageorgiou
1,*
1
1st Neurology Department, Aiginition University Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece
2
Laboratory of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
3
General Hospital of Leros, 85400 Lakki, Dodecanese, Greece
4
Athens Association of Alzheimer’s Disease and Related Disorders, 11636 Marousi, Greece
5
Department of Computer Science and Biomedical Informatics, University of Thessaly, 35131 Lamia, Greece
*
Author to whom correspondence should be addressed.
Geriatrics 2025, 10(4), 94; https://doi.org/10.3390/geriatrics10040094
Submission received: 25 May 2025 / Revised: 8 July 2025 / Accepted: 11 July 2025 / Published: 16 July 2025
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Abstract

Background/Objectives: Access to specialized care for patients with cognitive impairment in remote areas is often limited. Despite the increasing adoption of telemedicine, standardized guidelines have not yet been specified. This study aimed to develop a comprehensive protocol for the specialized neurological, neuropsychological, and neuropsychiatric assessment of patients with cognitive disorders in remote areas through telemedicine. Methods: We analyzed data from (i) a comprehensive literature review of the existing recommendations, reliability studies, and telemedicine models for cognitive disorders, (ii) insights from a three-year experience of a specialized telemedicine outpatient clinic for cognitive movement disorders in Greece, and (iii) suggestions coming from dementia specialists experienced in telemedicine (neurologists, neuropsychologists, psychiatrists) who took part in three focus groups. A critical synthesis of the findings was performed in the end. Results: The final protocol included: technical and organizational requirements (e.g., a high-resolution screen and a camera with zoom, room dimensions adequate for gait assessment, a noise-canceling microphone); medical history; neurological, neuropsychiatric, and neuropsychological assessment adapted to videoconferencing; ethical–legal aspects (e.g., data security, privacy, informed consent); clinician–patient interaction (e.g., empathy, eye contact); diagnostic work-up; linkage to other services (e.g., tele-psychoeducation, caregiver support); and instructions for treatment and follow-up. Conclusions: This protocol is expected to serve as an example of good clinical practice and a source for official telemedicine guidelines for cognitive disorders. Ultimate outcomes include the potential enhanced access to specialized care, minimized financial and logistical costs, and the provision of a standardized, effective model for the remote diagnosis, treatment, and follow-up. This model could be applied not only in Greece, but also in other countries with similar healthcare systems and populations living in remote, difficult-to-access areas.
Keywords: telemedicine; telemedicine protocol; cognitive disorders; dementia; telecare; remote; specialized care telemedicine; telemedicine protocol; cognitive disorders; dementia; telecare; remote; specialized care
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MDPI and ACS Style

Angelopoulou, E.; Stamelos, I.; Smaragdaki, E.; Vourou, K.; Stanitsa, E.; Kontaxopoulou, D.; Koros, C.; Papatriantafyllou, J.; Zilidou, V.; Romanopoulou, E.; et al. Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece. Geriatrics 2025, 10, 94. https://doi.org/10.3390/geriatrics10040094

AMA Style

Angelopoulou E, Stamelos I, Smaragdaki E, Vourou K, Stanitsa E, Kontaxopoulou D, Koros C, Papatriantafyllou J, Zilidou V, Romanopoulou E, et al. Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece. Geriatrics. 2025; 10(4):94. https://doi.org/10.3390/geriatrics10040094

Chicago/Turabian Style

Angelopoulou, Efthalia, Ioannis Stamelos, Evangelia Smaragdaki, Kalliopi Vourou, Evangelia Stanitsa, Dionysia Kontaxopoulou, Christos Koros, John Papatriantafyllou, Vasiliki Zilidou, Evangelia Romanopoulou, and et al. 2025. "Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece" Geriatrics 10, no. 4: 94. https://doi.org/10.3390/geriatrics10040094

APA Style

Angelopoulou, E., Stamelos, I., Smaragdaki, E., Vourou, K., Stanitsa, E., Kontaxopoulou, D., Koros, C., Papatriantafyllou, J., Zilidou, V., Romanopoulou, E., Georgopoulou, E.-M., Sakka, P., Karanikas, H., Stefanis, L., Bamidis, P., & Papageorgiou, S. (2025). Development of a Specialized Telemedicine Protocol for Cognitive Disorders: The TeleCogNition Project in Greece. Geriatrics, 10(4), 94. https://doi.org/10.3390/geriatrics10040094

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