Researchers at Johns Hopkins Medical Institutions are testing a videotaped patient exam system designed to diagnose dementia and depression in patients without an in-person doctor visit. If the Mobile Dementia and Depression Exam, or MODEX, proves accurate, it could be offered to patients in private homes, nursing homes and rural areas.

"Many seniors become quite accustomed to their day-to-day routine," says Cynthia Steele, a nurse who is testing MODEX. "Even taking them to the hospital for a few hours can disrupt that routine, producing stress and abnormal behavior that makes it harder to get an accurate evaluation."

The system involves videotaping diagnostic procedures including tests of physical coordination, gait and balance, and tests of memory, mood and other cognitive functions. All are reviewed later by a doctor.

With support from the Hilda and Jacob Blaustein Foundation, Hopkins researchers will test MODEX on 90 patients who agree to be videotaped. The footage and other basic patient information are sent on CD-ROM to a team of Boston psychiatrists, but without the Hopkins doctor's final evaluation of the patient.

"We intend to use our colleagues' feedback both to check the accuracy of MODEX and to assess how much information is needed to get a good diagnosis," says Constantine Lyketsos, director of Hopkins' Comprehensive Alzheimer's Program.