Virtual Reality-Based Assessment of Functional Capacities in Individuals with Alzheimers Disease or Alzheimers Disease-Related Dementia
Abstract
Background: The aging of the U.S. population will be accompanied by an increase in the prevalence of cognitive impairment in Veterans’ health care and throughout the health care system. Improvements in the ability to diagnose cognitive impairment and manage care for individuals with cognitive impairment holds the potential to reduce health care spending while improving quality of life for older adults and their caregivers. Traumatic brain injury (TBI) and Alzheimer’s disease (AD)/AD-related dementia (ADRD) are prevalent among Veterans and the general population. Individuals who have suffered even a mild TBI are at greater risk of developing AD/ADRD. TBI and AD/ADRD are associated with significant deficits in both cognitive functioning and everyday functioning, and these deficits may worsen with age. The cognitive deficits associated with TBI and AD/ADRD are associated with decreased functional capacities, such as greater difficulty shopping, managing money, and taking medications. Deficits in cognitive functioning and everyday functional capacities reduce patients’ quality of life and increase caregiver burden. More accurate diagnosis of cognitive impairment is needed, and particularly assessment of individuals’ everyday functional capacities. Compared to the traditional tests that clinicians use to diagnose cognitive impairment, virtual reality technology makes it possible to simulate real-life situations, in which distractors are often present and in which individuals must prioritize competing demands. Thus, virtual-reality based assessment yields information that is more germane to how individuals may operate in daily life, which is of greater use to patients and caregivers. Our team has developed and conducted preliminary research with two virtual environments: the Virtual Environment Grocery Store (VEGS) and the Virtual Apartment. In the VEGS, individuals must navigate a shopping scenario, drop off a prescription, shop for items from a list, maintain a budget, and remember to listen for their number as they shop for items. The Virtual Apartment measures the ability to control responses to stimuli in a comfortable, home-like environment. Traditional cognitive testing often generates reports that contain statistical data and technical jargon that may be difficult for laypersons to understand. We aim to develop reports that can provide patients and caregivers practical information about what kinds of everyday activities may be difficult for an individual to perform. This may lead to better treatment planning and coordination of care and reduce caregiver burden. Objective: The objective of the proposed project is to pilot the use of the VEGS and the Virtual Apartment for use among older adults with cognitive impairment. We believe that our previously developed and validated virtual reality simulations of real-world activities can be harnessed to improve the diagnosis of cognitive impairment and everyday functional capacities of older adults with cognitive impairment. We will develop the ability for the VEGS and Virtual Apartment to generate reports that are practical and easy to understand for patients and caregivers. We will solicit feedback from participants and caregivers about the usefulness of these reports and the relative usefulness of those reports in comparison to traditional clinical reports. Study Design: We will compare measures embedded in the virtual environments with measures obtained from the cognitive tests currently employed by clinicians by using strategies similar to those used to validate the VEGS and Virtual Apartment. We will compare how older adults with cognitive impairment (AD/ADRD with and without a history of TBI) and healthy controls perform on the VEGS, Virtual Apartment, and traditional cognitive tests. We will gather patient/caregiver feedback regarding the utility of the reports generated by the virtual environments and whether these reports provide more helpfu
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910798
Entities
People
- Michael D Barnett
Organizations
- United States Army
- University of Texas at Tyler