Development and Feasibility of a Virtual Reality Task for the Cognitive Assessment of Older Adults: The ECO-VR

Abstract Cognitive assessment with virtual reality (VR) may have superior ecological validity for older adults compared to traditional pencil-and-paper cognitive assessment. However, few studies have reported the development of VR tasks. The aim of this study was to present the development, feasibility, content validity, and preliminary evidence of construct validity of an ecological task of cognitive assessment for older adults in VR (ECO-VR). The tasks were prepared based on theoretical and clinical backgrounds. We had 29 non-expert judges identify virtual visual stimuli and three-dimensional scenarios, and five expert judges assisted with content analysis and developing instructions. Finally, six older persons participated in three pilot studies and thirty older persons participated in the preliminary study to identify construct validity evidence. Data were analyzed by descriptive statistics and partial correlation. Target stimuli and three-dimensional scenarios were judged adequate and the content analysis demonstrated that ECO-VR evaluates temporo-spatial orientation, memory, language and executive functioning. We made significant changes to the instructions after the pilot studies to increase comprehensibility and reduce the completion time. The total score of ECO-VR was positively correlated mainly with performance in executive function (r = .172, p < .05) and memory tests (r = .488, p ≤ .01). The ECO-VR demonstrated feasibility for cognitive assessment in older adults, as well as content and construct validity evidences.

[1]  E. Olivier,et al.  Pupil size variations correlate with physical effort perception , 2014, Front. Behav. Neurosci..

[2]  Aditi Joshi,et al.  Virtual reality for the assessment of frontotemporal dementia, a feasibility study , 2015, Disability and rehabilitation. Assistive technology.

[3]  O. Almeida,et al.  Confiabilidade da Versao Brasileira da Escala de Depressao em Geriatria (GDS), versao reduzida. [English translation: Reliability of the Brazilian version of the Geriatric Depression Scale, short-form] , 1999 .

[4]  Paul W. Burgess,et al.  Behavioural Assessment of the Dysexecutive Syndrome , 1997 .

[5]  K. Zakzanis,et al.  Ecologically Valid Assessment of Executive Dysfunction Using a Novel Virtual Reality Task in Patients with Acquired Brain Injury , 2012, Applied neuropsychology. Adult.

[6]  Ioannis Tarnanas,et al.  Ecological Validity of Virtual Reality Daily Living Activities Screening for Early Dementia: Longitudinal Study , 2013, JMIR serious games.

[7]  Alain Berthoz,et al.  Effects of Enactment in Episodic Memory: A Pilot Virtual Reality Study with Young and Elderly Adults , 2014, Front. Aging Neurosci..

[8]  J. Tirapu-Ustárroz,et al.  Evaluación neuropsicológica de las funciones ejecutivas mediante realidad virtual , 2014 .

[9]  V. Gyselinck,et al.  Using virtual reality to characterize episodic memory profiles in amnestic mild cognitive impairment and Alzheimer's disease: Influence of active and passive encoding , 2012, Neuropsychologia.

[10]  G. Dunn,et al.  The Use of Immersive Virtual Reality (VR) to Predict the Occurrence 6 Months Later of Paranoid Thinking and Posttraumatic Stress Symptoms Assessed by Self-Report and Interviewer Methods: A Study of Individuals Who Have Been Physically Assaulted , 2014, Psychological assessment.

[11]  Godehard Weniger,et al.  Egocentric and allocentric memory as assessed by virtual reality in individuals with amnestic mild cognitive impairment , 2011, Neuropsychologia.

[12]  M. Chaves,et al.  The Mini Mental State Examination: Review of cutoff points adjusted for schooling in a large Southern Brazilian sample , 2010, Dementia & neuropsychologia.

[13]  H. Markowitsch,et al.  Real-life memory and spatial navigation in patients with focal epilepsy: Ecological validity of a virtual reality supermarket task , 2014, Epilepsy & Behavior.

[14]  Anne-Marthe Sanders,et al.  Virtual reality training for upper extremity in subacute stroke (VIRTUES): study protocol for a randomized controlled multicenter trial , 2014, BMC Neurology.

[15]  David Rindskopf,et al.  APA handbook of research methods in psychology, Vol 1: Foundations, planning, measures, and psychometrics. , 2012 .

[16]  I Izquierdo,et al.  Differential diagnosis between dementia and depression: a study of efficiency increment , 1992, Acta neurologica Scandinavica.

[17]  Carl Machover,et al.  Virtual reality , 1994, IEEE Computer Graphics and Applications.

[18]  Ioannis Tarnanas,et al.  Can a novel computerized cognitive screening test provide additional information for early detection of Alzheimer's disease? , 2014, Alzheimer's & Dementia.

[19]  T. Shallice,et al.  The cognitive and neuroanatomical correlates of multitasking , 2000, Neuropsychologia.

[20]  Brian Hobbs,et al.  Developing a Virtual Reality-Based Methodology for People with Dementia: A Feasibility Study , 2003, Cyberpsychology Behav. Soc. Netw..

[21]  A. Rizzo,et al.  Virtual Reality and Neuropsychology: Upgrading the Current Tools , 2002, The Journal of head trauma rehabilitation.

[22]  J. Masur,et al.  Validation of the "CAGE" alcoholism screening test in a Brazilian psychiatric inpatient hospital setting. , 1983, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[23]  Francesca Morganti,et al.  Virtual interaction in cognitive neuropsychology , 2004, Cybertherapy.

[24]  A. Stuchlik,et al.  A virtual reality task based on animal research – spatial learning and memory in patients after the first episode of schizophrenia , 2014, Front. Behav. Neurosci..

[25]  David H K Shum,et al.  Evaluation of a virtual reality prospective memory task for use with individuals with severe traumatic brain injury , 2014, Neuropsychological rehabilitation.

[26]  Sergi Grau,et al.  Serious games for screening pre-dementia conditions: from virtuality to reality? A pilot project. , 2014, Functional neurology.

[27]  G. Riva,et al.  Cybertherapy - Internet and Virtual Reality as Assessment and Rehabilitation Tools for Clinical Psychology and Neuroscience , 2004, Cybertherapy.

[28]  Giuseppe Riva,et al.  Validation of a Neuro Virtual Reality-based Version of the Multiple Errands Test for the Assessment of Executive Functions , 2011, Annual Review of Cybertherapy and Telemedicine.

[29]  Andrea Gaggioli,et al.  NeuroVR: An Open Source Virtual Reality Platform for Clinical Psychology and Behavioral Neurosciences , 2007, MMVR.