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Sánchez-Escudero JP, Galvis-Herrera AM, Sánchez-Trujillo D, Torres-López LC, Kennedy CJ, Aguirre-Acevedo DC, Garcia-Barrera MA, Trujillo N. Virtual Reality and Serious Videogame-Based Instruments for Assessing Spatial Navigation in Alzheimer's Disease: A Systematic Review of Psychometric Properties. Neuropsychol Rev 2024:10.1007/s11065-024-09633-7. [PMID: 38403731 DOI: 10.1007/s11065-024-09633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
Over the past decade, research using virtual reality and serious game-based instruments for assessing spatial navigation and spatial memory in at-risk and AD populations has risen. We systematically reviewed the literature since 2012 to identify and evaluate the methodological quality and risk of bias in the analyses of the psychometric properties of VRSG-based instruments. The search was conducted primarily in July-December 2022 and updated in November 2023 in eight major databases. The quality of instrument development and study design were analyzed in all studies. Measurement properties were defined and analyzed according to COSMIN guidelines. A total of 1078 unique records were screened, and following selection criteria, thirty-seven studies were analyzed. From these studies, 30 instruments were identified. Construct and criterion validity were the most reported measurement properties, while structural validity and internal consistency evidence were the least reported. Nineteen studies were deemed very good in construct validity, whereas 11 studies reporting diagnostic accuracy were deemed very good in quality. Limitations regarding theoretical framework and research design requirements were found in most of the studies. VRSG-based instruments are valuable additions to the current diagnostic toolkit for AD. Further research is required to establish the psychometric performance and clinical utility of VRSG-based instruments, particularly the instrument development, content validity, and diagnostic accuracy for preclinical AD screening scenarios. This review provides a straightforward synthesis of the state of the art of VRSG-based instruments and suggests future directions for research.
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Affiliation(s)
| | | | | | | | - Cole J Kennedy
- Department of Psychology & Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | | | - Mauricio A Garcia-Barrera
- Department of Psychology & Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Natalia Trujillo
- National College of Public Health, University of Antioquia, Antioquia, Colombia
- Atlantic Fellowship in Equity in Brain Health, Global Brain Health Institute, University of California, San Francisco, CA, USA
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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2
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Liu Q, Song H, Yan M, Ding Y, Wang Y, Chen L, Yin H. Virtual reality technology in the detection of mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2023; 87:101889. [PMID: 36806377 DOI: 10.1016/j.arr.2023.101889] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND In recent years, virtual reality technology has developed the potential to help in the early detection of mild cognitive impairment (MCI). However, integrative evidence of its detection performance for mild cognitive impairment is lacking, and meta-analysis or systematic reviews are required to further determine the effectiveness of virtual reality technology in screening for MCI. METHODS Literature searches were performed for MCI screening tests in the Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus. The primary outcome was the performance of VR tests for MCI detection. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022302139). RESULTS A total of 14 studies in 13 reports were eventually included. The combined data with the bivariate random-effects model gave a summary point of 0.89 sensitivity (95 % confidence interval [CI]: 0.82-0.94) and 0.91 specificity (95 % CI: 0.82-0.96). The SROC curve was plotted, the DOR was 79.25 (95 % CI: 22.59-277.99), and the AUC was 0.95 (95 % CI: 0.93-0.97). CONCLUSIONS Virtual reality-based tests have shown considerable detection performance in detecting MCI, and therefore, virtual reality-based tests can serve as recommended screening methods. Future studies can consider longitudinal assessment and follow-up programs to identify progressive changes.
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Affiliation(s)
- Qian Liu
- Jilin University School of Nursing, Changchun, China.
| | - Huali Song
- The First Hospital of Jilin University, Changchun, China.
| | - Mingli Yan
- Jilin University School of Nursing, Changchun, China.
| | - Yiwen Ding
- Jilin University School of Nursing, Changchun, China.
| | - Yinuo Wang
- Jilin University School of Nursing, Changchun, China.
| | - Li Chen
- Jilin University School of Nursing, Changchun, China.
| | - Huiru Yin
- Jilin University School of Nursing, Changchun, China.
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Abstract
IMPORTANCE Virtual reality (VR) is a promising tool with the potential to enhance care of cognitive and affective disorders in the aging population. VR has been implemented in clinical settings with adolescents and children; however, it has been less studied in the geriatric population. OBJECTIVE The objective of this study is to determine the existing levels of evidence for VR use in clinical settings and identify areas where more evidence may guide translation of existing VR interventions for older adults. DESIGN AND MEASUREMENTS We conducted a systematic review in PubMed and Web of Science in November 2019 for peer-reviewed journal articles on VR technology and its applications in older adults. We reviewed article content and extracted the number of study participants, study population, goal of the investigation, the level of evidence, and categorized articles based on the indication of the VR technology and the study population. RESULTS The database search yielded 1554 total results, and 55 articles were included in the final synthesis. The most represented study design was cross-sectional, and the most common study population was subjects with cognitive impairment. Articles fell into three categories for VR Indication: Testing, Training, and Screening. There was a wide variety of VR environments used across studies. CONCLUSIONS Existing evidence offers support for VR as a screening and training tool for cognitive impairment in older adults. VR-based tasks demonstrated validity comparable to some paper-based assessments of cognition, though more work is needed to refine diagnostic specificity. The variety of VR environments used shows a need for standardization before comparisons can be made across VR simulations. Future studies should address key issues such as usability, data privacy, and confidentiality. Since most literature was generated from high-income countries (HICs), it remains unclear how this may be translated to other parts of the world.
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Neuropsychology of posteromedial parietal cortex and conversion factors from Mild Cognitive Impairment to Alzheimer's disease: systematic search and state-of-the-art review. Aging Clin Exp Res 2022; 34:289-307. [PMID: 34232485 PMCID: PMC8847304 DOI: 10.1007/s40520-021-01930-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
In the present review, we discuss the rationale and the clinical implications of assessing visuospatial working memory (VSWM), awareness of memory deficits, and visuomotor control in patients with mild cognitive impairment (MCI). These three domains are related to neural activity in the posteromedial parietal cortex (PMC) whose hypoactivation seems to be a significant predictor of conversion from MCI to Alzheimer’s disease (AD) as indicated by recent neuroimaging evidence. A systematic literature search was performed up to May 2021. Forty-eight studies were included: 42 studies provided analytical cross-sectional data and 6 studies longitudinal data on conversion rates. Overall, these studies showed that patients with MCI performed worse than healthy controls in tasks assessing VSWM, awareness of memory deficits, and visuomotor control; in some cases, MCI patients’ performance was comparable to that of patients with overt dementia. Deficits in VSWM and metamemory appear to be significant predictors of conversion. No study explored the relationship between visuomotor control and conversion. Nevertheless, it has been speculated that the assessment of visuomotor abilities in subjects at high AD risk might be useful to discriminate patients who are likely to convert from those who are not. Being able to indirectly estimate PMC functioning through quick and easy neuropsychological tasks in outpatient settings may improve diagnostic and prognostic accuracy, and therefore, the quality of the MCI patient’s management.
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Jang S, Choi SW, Son SJ, Oh J, Ha J, Kim WJ, Roh HW, Kim KY, Lee S, Jung E, Cha W, Chae H, Kang S, Kwon JH, Kim IY, Lee JY, Shin HK, Ryu JS, Ahn R, Hong CH, Seok JH. Virtual reality-based monitoring test for MCI: A multicenter feasibility study. Front Psychiatry 2022; 13:1057513. [PMID: 36741575 PMCID: PMC9891464 DOI: 10.3389/fpsyt.2022.1057513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES As the significance of the early diagnosis of mild cognitive impairment (MCI) has emerged, it is necessary to develop corresponding screening tools with high ecological validity and feasible biomarkers. Virtual reality (VR)-based cognitive assessment program, which is close to the daily life of the older adults, can be suitable screening tools for MCI with ecological validity and accessibility. Meanwhile, dehydroepiandrosterone (DHEA) has been observed at a low concentration in the older adults with dementia or cognitive decline, indicating its potential as a biomarker of MCI. This study aimed to determine the efficacy and usability of a VR cognitive assessment program and salivary DHEA for screening MCI. METHODS The VR cognitive assessment program and the traditional Montreal Cognitive Assessment (MOCA) test were performed on 12 patients with MCI and 108 healthy older adults. The VR program operates in a situation of caring for a grandchild, and evaluates the memory, attention, visuospatial, and executive functions. An analysis of covariance (ANCOVA), a partial correlation analysis, and receiving operating characteristic (ROC) curve analysis were conducted for statistical analysis. RESULTS According to the ANCOVA, no significant difference in MOCA scores was found between the normal and MCI groups (F = 2.36, p = 0.127). However, the VR total score of the MCI group was significantly lower than that of the normal group (F = 8.674, p = 0.004). There was a significant correlation between the MOCA and VR scores in the total and matched subdomain scores. The ROC curve analysis also showed a larger area under the curve (AUC) for the VR test (0.765) than for the MOCA test (0.598), and the sensitivity and specificity of the VR program were 0.833 and 0.722, respectively. Salivary DHEA was correlated with VR total (R 2 = 0.082, p = 0.01) and attention scores (R 2 = 0.086, p = 0.009). CONCLUSION The VR cognitive test was as effective as the traditional MOCA test in the MCI classification and safe enough for older adults to perform, indicating its potential as a diagnostic tool. It has also been shown that salivary DHEA can be used as a biomarker for MCI.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sun-Woo Choi
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junghee Ha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Keun You Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Eunjin Jung
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woojin Cha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heonjoo Chae
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Suzi Kang
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Ji Hye Kwon
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Ju-Yeal Lee
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Hyun Kyung Shin
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Sun Ryu
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ryunsup Ahn
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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From aMCI to AD: The Role of Visuo-Spatial Memory Span and Executive Functions in Egocentric and Allocentric Spatial Impairments. Brain Sci 2021; 11:brainsci11111536. [PMID: 34827534 PMCID: PMC8615504 DOI: 10.3390/brainsci11111536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022] Open
Abstract
A difficulty in encoding spatial information in an egocentric (i.e., body-to-object) and especially allocentric (i.e., object-to-object) manner, and impairments in executive function (EF) are typical in amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD). Since executive functions are involved in spatial encodings, it is important to understand the extent of their reciprocal or selective impairment. To this end, AD patients, aMCI and healthy elderly people had to provide egocentric (What object was closest to you?) and allocentric (What object was closest to object X?) judgments about memorized objects. Participants’ frontal functions, attentional resources and visual-spatial memory were assessed with the Frontal Assessment Battery (FAB), the Trail Making Test (TMT) and the Corsi Block Tapping Test (forward/backward). Results showed that ADs performed worse than all others in all tasks but did not differ from aMCIs in allocentric judgments and Corsi forward. Regression analyses showed, although to different degrees in the three groups, a link between attentional resources, visuo-spatial memory and egocentric performance, and between frontal resources and allocentric performance. Therefore, visuo-spatial memory, especially when it involves allocentric frames and requires demanding active processing, should be carefully assessed to reveal early signs of conversion from aMCI to AD.
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Jonson M, Avramescu S, Chen D, Alam F. The Role of Virtual Reality in Screening, Diagnosing, and Rehabilitating Spatial Memory Deficits. Front Hum Neurosci 2021; 15:628818. [PMID: 33613216 PMCID: PMC7893135 DOI: 10.3389/fnhum.2021.628818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
Impairment of spatial memory, including an inability to recall previous locations and navigate the world, is often one of the first signs of functional disability on the road to cognitive impairment. While there are many screening and diagnostic tools which attempt to measure spatial memory ability, they are often not representative of real-life situations and can therefore lack applicability. One potential solution to this problem involves the use of virtual reality (VR), which immerses individuals in a virtually-simulated environment, allowing for scenarios more representative of real-life without any of the associated risks. Here, we review the evidence surrounding the use of VR for the screening and diagnosis of spatial memory impairments, including potential limitations and how it compares to standard neuropsychological tests. We will also discuss the evidence regarding the potential use of VR in the rehabilitation of spatial memory deficits, which has not been well studied, but which could be game-changing if proven successful.
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Affiliation(s)
- Miles Jonson
- School of Medicine, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Sinziana Avramescu
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Anesthesia and Pain Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Anesthesia, Humber River Hospital, Toronto, ON, Canada
| | - Derek Chen
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Fahad Alam
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Anesthesia and Pain Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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8
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Costa RQMD, Pompeu JE, Viveiro LAPD, Brucki SMD. Spatial orientation tasks show moderate to high accuracy for the diagnosis of mild cognitive impairment: a systematic literature review. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:713-723. [DOI: 10.1590/0004-282x20200043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
Abstract Spatial disorientation has been observed in mild cognitive impairment (MCI) and is associated with a higher risk of progression to Alzheimer's disease (AD). However, there is no gold standard assessment for spatial orientation and paper-and-pencil tests lack ecological validity. Recently, there has been an increasing number of studies demonstrating the role of spatial disorientation as a cognitive marker of pathological decline, shedding new light on its importance for MCI. This systematic review aimed to investigate the accuracy of spatial orientation tasks for the diagnosis of MCI by comparison with cognitively healthy elderly. The search was conducted in the databases Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Web of Science, Scopus, Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Scientific Electronic Library Online (SciELO). Only original studies reporting spatial orientation assessment in MCI patients compared to a healthy control group were included. Studies were excluded if the MCI classification did not follow well described criteria and/or if accuracy results of spatial orientation assessment were not provided. Seven studies met the eligibility criteria, describing a variety of spatial orientation assessments including questionnaires, paper-and-pencil, office-based route learning, and computer-based and virtual reality tasks. Spatial orientation tasks demonstrated moderate to high accuracy in detecting elderly with MCI compared to cognitively healthy elderly, with areas under the curve (AUC) ranging from 0.77 to 0.99. However, important methodological issues were found in the selected studies which should be considered when interpreting results. Although the inclusion of spatial orientation assessments in MCI evaluations seems to have significant value, further studies are needed to clarify their true capacity to distinguish pathological from non-pathological aging.
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Ruggiero G, Ruotolo F, Iavarone A, Iachini T. Allocentric coordinate spatial representations are impaired in aMCI and Alzheimer's disease patients. Behav Brain Res 2020; 393:112793. [PMID: 32619567 DOI: 10.1016/j.bbr.2020.112793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/19/2020] [Accepted: 06/27/2020] [Indexed: 12/18/2022]
Abstract
Research has reported deficits in egocentric (subject-to-object) and mainly allocentric (object-to-object) spatial representations in the early stages of the Alzheimer's disease (eAD). To identify early cognitive signs of neurodegenerative conversion, several studies have shown alterations in both reference frames, especially the allocentric ones in amnestic-Mild Cognitive Impairment (aMCI) and eAD patients. However, egocentric and allocentric spatial frames of reference are intrinsically connected with coordinate (metric/variant) and categorical (non-metric/invariant) spatial relations. This raises the question of whether allocentric deficit found to detect the conversion from aMCI to dementia is differently affected when combined with categorical or coordinate spatial relations. Here, we compared eAD and aMCI patients to Normal Controls (NC) on the Ego-Allo/Cat-Coor spatial memory task. Participants memorized triads of objects and then were asked to provide right/left (i.e. categorical) and distance based (i.e. coordinate) judgments according to an egocentric or allocentric reference frame. Results showed a selective deficit of coordinate, but not categorical, allocentric judgments in both aMCI and eAD patients as compared to NC group. These results suggest that a sign of the departure from normal/healthy aging towards the AD may be traced in elderly people's inability to represent metric distances among elements in the space.
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Affiliation(s)
- Gennaro Ruggiero
- Laboratory of Cognitive Science and Immersive Virtual Reality, CS-IVR, Department of Psychology, University of Campania L. Vanvitelli, Caserta, Italy.
| | - Francesco Ruotolo
- Laboratory of Cognitive Science and Immersive Virtual Reality, CS-IVR, Department of Psychology, University of Campania L. Vanvitelli, Caserta, Italy
| | - Alessandro Iavarone
- Laboratory of Clinical Neuropsychology, Neurological Unit of "Ospedali dei Colli", Naples, Italy
| | - Tina Iachini
- Laboratory of Cognitive Science and Immersive Virtual Reality, CS-IVR, Department of Psychology, University of Campania L. Vanvitelli, Caserta, Italy
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Mild Cognitive Impairment Subtypes and Type 2 Diabetes in Elderly Subjects. J Clin Med 2020; 9:jcm9072055. [PMID: 32629878 PMCID: PMC7408775 DOI: 10.3390/jcm9072055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/09/2020] [Accepted: 06/24/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Type 2 diabetes (T2D) is correlated to amnestic mild cognitive impairment (aMCI) and to non-amnestic mild cognitive impairment (naMCI). This study evaluated whether the T2D variable characterizes a peculiar cognitive profile in elderly patients. Moreover, it explores the association between glycated hemoglobin levels (HbA1c), T2D duration, insulin and oral hypoglycemic agent treatment, and cognition in elderly diabetic patients. Methods: Detailed neuropsychological battery was used to diagnose MCI subtypes. A total of 39 MCI subjects with T2D (T2D-MCI) and 37 MCI subjects without T2D (ND-MCI), matched for age, educational level, and Mini-Mental State Examination score, were included. Results: ND-MCI performed worse in memory and language domains than T2D-MCI. The amnestic subtype is more frequent among ND-MCI and non-amnestic subtype in T2D-MCI. In T2D-MCI, high HbA1c levels correlate with episodic memory (immediate recall) and T2D duration. Some indexes of episodic memory (immediate recall), attention, and visual-spatial ability correlate with insulin treatment. Conclusions: An association between T2D and non-amnestic MCI is suggested. In the T2D-MCI group, significant associations between insulin treatment and memory (immediate recall), complex figure copy, and attention were found.
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11
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Wang S, Yin H, Li G, Jia Y, Leng M, Meng Q, Wang C, Chen L. Detection of Mild Cognitive Impairment Based on Virtual Reality: A Scoping Review. Curr Alzheimer Res 2020; 17:126-140. [PMID: 32183674 DOI: 10.2174/1567205017666200317100421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 12/09/2019] [Accepted: 02/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND To delay the decline in cognition and reduce the incidence of dementia, the precise detection of Mild Cognitive Impairment (MCI) is necessary. The application of Virtual Reality (VR) technology in this detection can overcome the shortage of traditional paper-and-pencil tests. OBJECTIVE This review aimed to summarize the research progress of the detection of MCI using VR. METHODS Eight databases from their inception to November 19, 2019, were systematically searched for studies applying VR in the detection of MCI. A thematic analysis was conducted according to the specific detection purpose and the main corresponding cognitive domains assessed were summarized; characteristics of the VR applications were also summarized. RESULTS Twenty-eight studies were finally included. The detection purposes included discrimination between healthy controls and those with MCI, discrimination between aMCI subtypes, detection of MCI patients at risk of Alzheimer's Disease (AD), and discrimination between MCI and AD. VR tasks assessing spatial memory were applicable for all detection purposes, and the assessment of combinations of memory and executive function seemed more sensitive. Executive function and intentional episodic memory could be assessed to discriminate among healthy controls, individuals with MCI and those with AD. Incidental episodic memory was effective in detecting MCI with hippocampal atrophy. The most common characteristics of the VR applications were the use of semi-immersion, joysticks or gamepad interactions and simple, one-time behavioral assessments. CONCLUSION VR applications are promising in the detection of MCI, but further research is needed for clinical use.
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Affiliation(s)
- Shuo Wang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Huiru Yin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Guichen Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Yong Jia
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Minmin Leng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Qiuyan Meng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Chunyan Wang
- Senior Officials Inpatient Ward, First Hospital of Jilin University, Changchun, 130000, China
| | - Li Chen
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
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Zhou Y, Wen D, Lu H, Yao W, Liu Y, Qian W, Yuan J. The Current Research of Spatial Cognitive Evaluation and Training With Brain-Computer Interface and Virtual Reality. Front Neurosci 2020; 13:1439. [PMID: 32116484 PMCID: PMC7025557 DOI: 10.3389/fnins.2019.01439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yanhong Zhou
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Dong Wen
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Huibin Lu
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory of Information Transmission and Signal Processing of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Wang Yao
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Yijun Liu
- School of Science, Yanshan University, Qinhuangdao, China
| | - Wenbo Qian
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory of Information Transmission and Signal Processing of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Jingpeng Yuan
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
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Lopez A, Caffò AO, Bosco A. Memory for familiar locations: The impact of age, education and cognitive efficiency on two neuropsychological allocentric tasks. Assessment 2019; 27:1588-1603. [PMID: 30818973 DOI: 10.1177/1073191119831780] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This research aims to reconsider and support the use of spatial tasks based on familiar geographical information in the neuropsychological assessment of topographical (dis)orientation. Performance on two spatial tasks based on familiar information -l andmark positioning on a map and map of Italy - were compared in two studies assessing allocentric orientation among young and healthy elderly with different levels of education (Study 1) and elderly with and without probable cognitive impairment (Study 2). Results from Study 1 showed that the map of Italy task was affected by education, while the landmark positioning on a map was not. Results of Study 2 showed that both tasks were sensitive to different levels of cognitive functioning in a sample of community-dwelling seniors. Overall, spatial tasks based on mental representation of the hometown environment may be an important supplement in the assessment of allocentric topographical disorientation, discriminating typical from atypical aging.
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Lopez A, O. Caffò A, Spano G, Bosco A. The Effect of Aging on Memory for Recent and Remote Egocentric and Allocentric Information. Exp Aging Res 2018; 45:57-73. [DOI: 10.1080/0361073x.2018.1560117] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Antonella Lopez
- Department of Educational Sciences, Psychology, Communication, University of Study Bari, Bari, Italy
| | - Alessandro O. Caffò
- Department of Educational Sciences, Psychology, Communication, University of Study Bari, Bari, Italy
| | - Giuseppina Spano
- Department of Educational Sciences, Psychology, Communication, University of Study Bari, Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Study Bari, Bari, Italy
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Caffò AO, Lopez A, Spano G, Serino S, Cipresso P, Stasolla F, Savino M, Lancioni GE, Riva G, Bosco A. Spatial reorientation decline in aging: the combination of geometry and landmarks. Aging Ment Health 2018; 22:1372-1383. [PMID: 28726502 DOI: 10.1080/13607863.2017.1354973] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The study is focused on the assessment of reorientation skills in a sample of community-dwelling elderly people, manipulating landmarks and geometric (layout) information. METHOD A neuropsychological assessment was administered to 286 elderly participants, divided into six groups (healthy controls, HC; four subgroups of participants with mild cognitive impairment, MCI; participants with probable dementia, Prob_D) and tested with the Virtual Reorientation Test (VReoT). VReoT manipulated different spatial cues: geometry and landmarks (proximal and distal). RESULT Compared with HC, participants with MCI and Prob_D showed to be impaired in tasks involving geometry, landmarks and a combination of them. Both single and multiple domain impairment in MCI had an impact on reorientation performance. Moreover, VReoT was marginally able to discriminate between amnesic and non-amnesic MCI. The occurrence of getting lost events seemed to be associated to learning of geometric information. CONCLUSION The associative strength between landmark and target plays an important role in affecting spatial orientation performance of cognitively impaired participants. Geometry significantly supports landmark information and becomes helpful with the increase of cognitive impairment which is linked to a decrement in landmark encoding. VReoT seems to represent a reliable evaluation supplement for spatial orientation deficits in prodromal stages of dementia.
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Affiliation(s)
- Alessandro O Caffò
- a Department of Educational Sciences, Psychology, Communication , University of Studies of Bari , Bari , Italy
| | - Antonella Lopez
- a Department of Educational Sciences, Psychology, Communication , University of Studies of Bari , Bari , Italy
| | - Giuseppina Spano
- a Department of Educational Sciences, Psychology, Communication , University of Studies of Bari , Bari , Italy
| | - Silvia Serino
- b Applied Technology for Neuro-Psychology Lab , IRCCS Istituto Auxologico Italiano , Milan , Italy.,c Department of Psychology , Università Cattolica del Sacro Cuore , Milan , Italy
| | - Pietro Cipresso
- c Department of Psychology , Università Cattolica del Sacro Cuore , Milan , Italy
| | - Fabrizio Stasolla
- d Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Studies of Bari , Bari , Italy
| | - Michelina Savino
- a Department of Educational Sciences, Psychology, Communication , University of Studies of Bari , Bari , Italy
| | - Giulio E Lancioni
- d Department of Basic Medical Sciences, Neuroscience and Sense Organs , University of Studies of Bari , Bari , Italy
| | - Giuseppe Riva
- b Applied Technology for Neuro-Psychology Lab , IRCCS Istituto Auxologico Italiano , Milan , Italy.,c Department of Psychology , Università Cattolica del Sacro Cuore , Milan , Italy
| | - Andrea Bosco
- a Department of Educational Sciences, Psychology, Communication , University of Studies of Bari , Bari , Italy
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Topographical disorientation in aging. Familiarity with the environment does matter. Neurol Sci 2018; 39:1519-1528. [DOI: 10.1007/s10072-018-3464-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/24/2018] [Indexed: 02/06/2023]
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Serino S, Morganti F, Colombo D, Pedroli E, Cipresso P, Riva G. Disentangling the Contribution of Spatial Reference Frames to Executive Functioning in Healthy and Pathological Aging: An Experimental Study with Virtual Reality. SENSORS 2018; 18:s18061783. [PMID: 29865196 PMCID: PMC6022116 DOI: 10.3390/s18061783] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/26/2018] [Accepted: 05/28/2018] [Indexed: 01/03/2023]
Abstract
A growing body of evidence pointed out that a decline in effectively using spatial reference frames for categorizing information occurs both in normal and pathological aging. Moreover, it is also known that executive deficits primarily characterize the cognitive profile of older individuals. Acknowledging this literature, the current study was aimed to specifically disentangle the contribution of the cognitive abilities related to the use of spatial reference frames to executive functioning in both healthy and pathological aging. 48 healthy elderly individuals and 52 elderly suffering from probable Alzheimer’s Disease (AD) took part in the study. We exploited the potentiality of Virtual Reality to specifically measure the abilities in retrieving and syncing between different spatial reference frames, and then we administrated different neuropsychological tests for evaluating executive functions. Our results indicated that allocentric functions contributed significantly to the planning abilities, while syncing abilities influenced the attentional ones. The findings were discussed in terms of previous literature exploring relationships between cognitive deficits in the first phase of AD.
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Affiliation(s)
- Silvia Serino
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy.
| | - Francesca Morganti
- Department of Human and Social Sciences, University of Bergamo, Piazzale S. Agostino 2, 24129 Bergamo, Italy.
| | - Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Av. Sos Baynat, s/n, 12071 Castellón, Spain.
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy.
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy.
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli 1, 20100 Milan, Italy.
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Wen D, Lan X, Zhou Y, Li G, Hsu SH, Jung TP. The Study of Evaluation and Rehabilitation of Patients With Different Cognitive Impairment Phases Based on Virtual Reality and EEG. Front Aging Neurosci 2018; 10:88. [PMID: 29666577 PMCID: PMC5891607 DOI: 10.3389/fnagi.2018.00088] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/15/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dong Wen
- Department of Software Engineering, School of Information Science and Engineering, Yanshan University, Qinhuangdao, China.,The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Xifa Lan
- Department of Neurology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yanhong Zhou
- Department of Computer Science and Technology, School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Guolin Li
- Department of Computer Science and Technology, School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Sheng-Hsiou Hsu
- Swartz Center for Computational Neuroscience, University of California, San Diego, San Diego, CA, United States
| | - Tzyy-Ping Jung
- Swartz Center for Computational Neuroscience, University of California, San Diego, San Diego, CA, United States
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Italians do it worse. Montreal Cognitive Assessment (MoCA) optimal cut-off scores for people with probable Alzheimer's disease and with probable cognitive impairment. Aging Clin Exp Res 2017; 29:1113-1120. [PMID: 28155182 DOI: 10.1007/s40520-017-0727-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 01/13/2017] [Indexed: 01/05/2023]
Abstract
Montreal cognitive assessment (MoCA) is a test providing a brief screening for people with cognitive impairment due to aging or neurodegenerative syndromes. In Italy, as in the rest of the world, several validation studies of MoCA have been carried out. This study compared, for the first time in Italy, a sample of people with probable Alzheimer's Disease (AD) with healthy counterparts. The study also compared two community-dwelling groups of aged participants with and without probable cognitive impairment, as discriminated by two cut-off points of adjusted MMSE score. All the comparisons were carried out according to ROC statistics. Optimal cutoff for a diagnosis of probable AD was a MoCA score ≤14. Optimal cutoff for the discrimination of probable cognitive impairment was a MoCA score ≤17 (associated to MMSE cutoff of 23.8). Results confirm the substantial discrepancy in cut-off points existing between Italian and other international validation studies, showing that Italian performance on MoCA seems to be globally lower than that in other Countries. Characteristics of population might explain these results.
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Colombo D, Serino S, Tuena C, Pedroli E, Dakanalis A, Cipresso P, Riva G. Egocentric and allocentric spatial reference frames in aging: A systematic review. Neurosci Biobehav Rev 2017; 80:605-621. [DOI: 10.1016/j.neubiorev.2017.07.012] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/29/2017] [Accepted: 07/27/2017] [Indexed: 01/07/2023]
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Garms-Homolová V, Notthoff N, Declercq A, van der Roest HG, Onder G, Jónsson P, van Hout H. Social and functional health of home care clients with different levels of cognitive impairments. Aging Ment Health 2017; 21:18-23. [PMID: 27813416 DOI: 10.1080/13607863.2016.1247426] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The ability to manage one's life with some degree of independence, to fulfill basic obligations, and to participate in social activities are social functions that delineate the core of 'social health'. We examine to what extent clients of community care in Europe (n = 2884) complete such activities despite their cognitive problems. We focus on mildly and moderately impaired people, aged 65+ years. METHODS Data were collected using the interRAI HC-Assessment in IBenC-project. We tested the association between participants' capacity and performance in three LADLs (instrumental activities of daily living) and their cognitive performance and specific memory problems. RESULTS About 30% of home care clients in Europe suffer from mild-to-moderate cognitive impairment. Their relatively independent coping with requirements of routine activities is strongly determined by overall cognitive performance. Specific memory functions seem unimportant, except for procedural memory. It is striking that all clients, and particularly those with mild-to-moderate cognitive impairment, interact mostly with close relatives and friends. Mild-to-moderate cognitive limitations do not hinder clients from coping semi-independently with routine requirements. DISCUSSION When considering the influence of cognitive function on clients' capacity and performance in everyday activities and social relations, a comprehensive construct of cognitive function has to be applied.
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Affiliation(s)
- Vjenka Garms-Homolová
- a Department of Economics and Law , HTW Berlin University of Applied Sciences , Berlin , Germany
| | - Nanna Notthoff
- b Institute of Psychology, Humboldt University , Berlin , Germany
| | - Anja Declercq
- c Centre for Sociological Research , LUCAS - KU Leuven , Belgium
| | | | - Graziano Onder
- e Medical School, Università Cattolica del Sacro Cuore , Milan , Italy
| | - Pálmi Jónsson
- f Department of Geriatrics , Landspitali University Hospital, University of Iceland, Reykjavík , Iceland
| | - Hein van Hout
- d Department of General Practice and Elderly Care Medicine , VU Amsterdam , Amsterdam , Netherlands
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Caffò AO, Lopez A, Spano G, Saracino G, Stasolla F, Ciriello G, Grattagliano I, Lancioni GE, Bosco A. The role of pre-morbid intelligence and cognitive reserve in predicting cognitive efficiency in a sample of Italian elderly. Aging Clin Exp Res 2016; 28:1203-1210. [PMID: 27149863 DOI: 10.1007/s40520-016-0580-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/22/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Models of cognitive reserve in aging suggest that individual's life experience (education, working activity, and leisure) can exert a neuroprotective effect against cognitive decline and may represent an important contribution to successful aging. AIM The objective of the present study is to investigate the role of cognitive reserve, pre-morbid intelligence, age, and education level, in predicting cognitive efficiency in a sample of healthy aged individuals and with probable mild cognitive impairment. METHODS Two hundred and eight aging participants recruited from the provincial region of Bari (Apulia, Italy) took part in the study. A battery of standardized tests was administered to them to measure cognitive reserve, pre-morbid intelligence, and cognitive efficiency. Protocols for 10 participants were excluded since they did not meet inclusion criteria, and statistical analyses were conducted on data from the remaining 198 participants. A path analysis was used to test the following model: age, education level, and intelligence directly influence cognitive reserve and cognitive efficiency; cognitive reserve mediates the influence of age, education level, and intelligence on cognitive efficiency. RESULTS Cognitive reserve fully mediates the relationship between pre-morbid intelligence and education level and cognitive efficiency, while age maintains a direct effect on cognitive efficiency. DISCUSSION Cognitive reserve appears to exert a protective effect regarding cognitive decline in normal and pathological populations, thus masking, at least in the early phases of neurodegeneration, the decline of memory, orientation, attention, language, and reasoning skills. CONCLUSIONS The assessment of cognitive reserve may represent a useful evaluation supplement in neuropsychological screening protocols of cognitive decline.
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Affiliation(s)
- Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy.
| | - Antonella Lopez
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy
| | - Giuseppina Spano
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy
| | - Giuseppe Saracino
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy
| | - Fabrizio Stasolla
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Studies of Bari, Bari, Italy
| | - Giuseppe Ciriello
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy
| | - Ignazio Grattagliano
- Interdisciplinary Department of Medicine, University of Studies of Bari, Bari, Italy
| | - Giulio E Lancioni
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Studies of Bari, Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Studies of Bari, Via Crisanzio 42, 70122, Bari, Italy
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Boccia M, Silveri MC, Sabatini U, Guariglia C, Nemmi F. Neural Underpinnings of the Decline of Topographical Memory in Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2016; 31:618-630. [PMID: 27307142 PMCID: PMC10852657 DOI: 10.1177/1533317516654757] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Spatial navigation is one of the cognitive functions known to decline in both normal and pathological aging. In the present study, we aimed to assess the neural correlates of the decline of topographical memory in patients with amnestic mild cognitive impairment (aMCI). Patients with aMCI and age-matched controls were engaged in an intensive learning paradigm, lasting for 5 days, during which they had to encode 1 path from an egocentric perspective and 1 path from an allocentric perspective. After the learning period, they were asked to retrieve each of these paths using an allocentric or egocentric frame of reference while undergoing a functional magnetic resonance imaging scan. We found that patients with aMCI showed a specific deficit in storing new topographical memories from an allocentric perspective and retrieving stored information to perform the egocentric task. Imaging data suggest that this general decline is correlated with hypoactivation of the brain areas generally involved in spatial navigation.
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Affiliation(s)
- Maddalena Boccia
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
| | | | - Umberto Sabatini
- Radiology Department, IRCCS Fondazione Santa Lucia of Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, "Sapienza" University of Rome, Rome, Italy
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia of Rome, Rome, Italy
| | - Federico Nemmi
- Klingberg Lab, Neuroscience Department, Karolinska Institute, Stockholm, Sweden
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24
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Cogné M, Taillade M, N'Kaoua B, Tarruella A, Klinger E, Larrue F, Sauzéon H, Joseph PA, Sorita E. The contribution of virtual reality to the diagnosis of spatial navigation disorders and to the study of the role of navigational aids: A systematic literature review. Ann Phys Rehabil Med 2016; 60:164-176. [PMID: 27017533 DOI: 10.1016/j.rehab.2015.12.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 12/23/2015] [Accepted: 12/23/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Spatial navigation, which involves higher cognitive functions, is frequently implemented in daily activities, and is critical to the participation of human beings in mainstream environments. Virtual reality is an expanding tool, which enables on one hand the assessment of the cognitive functions involved in spatial navigation, and on the other the rehabilitation of patients with spatial navigation difficulties. Topographical disorientation is a frequent deficit among patients suffering from neurological diseases. The use of virtual environments enables the information incorporated into the virtual environment to be manipulated empirically. But the impact of manipulations seems differ according to their nature (quantity, occurrence, and characteristics of the stimuli) and the target population. METHODS We performed a systematic review of research on virtual spatial navigation covering the period from 2005 to 2015. We focused first on the contribution of virtual spatial navigation for patients with brain injury or schizophrenia, or in the context of ageing and dementia, and then on the impact of visual or auditory stimuli on virtual spatial navigation. RESULTS On the basis of 6521 abstracts identified in 2 databases (Pubmed and Scopus) with the keywords « navigation » and « virtual », 1103 abstracts were selected by adding the keywords "ageing", "dementia", "brain injury", "stroke", "schizophrenia", "aid", "help", "stimulus" and "cue"; Among these, 63 articles were included in the present qualitative analysis. CONCLUSION Unlike pencil-and-paper tests, virtual reality is useful to assess large-scale navigation strategies in patients with brain injury or schizophrenia, or in the context of ageing and dementia. Better knowledge about both the impact of the different aids and the cognitive processes involved is essential for the use of aids in neurorehabilitation.
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Affiliation(s)
- M Cogné
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Service de médecine physique et de réadaptation, centre hospitalier universitaire, 33076 Bordeaux, France.
| | - M Taillade
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France
| | - B N'Kaoua
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Institut national de recherche en informatique et automatique (INRIA), 33405 Talence cedex, France
| | - A Tarruella
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Institut de formation en ergothérapie, centre hospitalier universitaire, 33076 Bordeaux, France
| | - E Klinger
- Laboratoire interactions numériques santé handicap, ESIEA, 53000 Laval, France
| | - F Larrue
- Laboratoire Bordelais de recherche en informatique (LaBRI), université de Bordeaux, 33045 Bordeaux, France
| | - H Sauzéon
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Institut national de recherche en informatique et automatique (INRIA), 33405 Talence cedex, France
| | - P-A Joseph
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Service de médecine physique et de réadaptation, centre hospitalier universitaire, 33076 Bordeaux, France
| | - E Sorita
- EA4136 handicap et système nerveux, université de Bordeaux, 33076 Bordeaux, France; Institut de formation en ergothérapie, centre hospitalier universitaire, 33076 Bordeaux, France
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, D'Amico F, Ferlisi G, Denitto F, De Vanna F, Belardinelli MO. Patients with moderate Alzheimer's disease engage in verbal reminiscence with the support of a computer-aided program: a pilot study. Front Aging Neurosci 2015; 7:109. [PMID: 26089797 PMCID: PMC4452885 DOI: 10.3389/fnagi.2015.00109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/22/2015] [Indexed: 11/24/2022] Open
Abstract
This study focused on the assessment of a program recently developed for helping patients with moderate Alzheimer’s disease engage in computer-mediated verbal reminiscence (Lancioni et al., 2014a). Sixteen participants were involved in the study. Six of them used the original program version with the computer showing a virtual partner posing questions and providing attention and guidance. The other 10 used a slightly modified program version with the computer presenting photos and videos and providing encouragements to talk as well as attention and guidance. Participants were exposed to brief program sessions individually. The results showed that 15 participants (five of those using the first version and all of those using the second version) had a clear and lasting increase in verbal engagement/reminiscence during the intervention sessions with the program. Those 15 participants had mean percentages of intervals with verbal engagement/reminiscence below 10 during baseline and between about 45 and 75 during the intervention. The results’ implications and the need for new research were discussed.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari Bari, Italy
| | - Nirbhay N Singh
- Medical College of Georgia, Georgia Regents University Augusta, GA, USA
| | - Mark F O'Reilly
- Department of Special Education, University of Texas at Austin Austin, TX, USA
| | - Jeff Sigafoos
- Department of Educational Psychology, Victoria University of Wellington Wellington, New Zealand
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Ferlisi G, Zullo V, Schirone S, Prisco R, Denitto F. A computer-aided program for helping patients with moderate Alzheimer's disease engage in verbal reminiscence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3026-3033. [PMID: 25124700 DOI: 10.1016/j.ridd.2014.07.047] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 07/22/2014] [Indexed: 06/03/2023]
Abstract
This study assessed a simple computer-aided program for helping patients with moderate Alzheimer's disease engage in verbal reminiscence. In practice, the program was aimed at fostering the patient's verbal engagement on a number of life experiences/topics previously selected for him or her and introduced in the sessions through a friendly female, who appeared on the computer screen. The female asked the patient about the aforementioned experiences/topics, and provided him or her with positive attention, and possibly verbal guidance (i.e., prompts/encouragements). Eight patients were involved in the study, which was carried out according to non-concurrent multiple baseline designs across participants. Seven of them showed clear improvement during the intervention phase (i.e., with the program). Their mean percentages of intervals with verbal engagement/reminiscence ranged from close to zero to about 15 during the baseline and from above 50 to above 75 during the intervention. The results were discussed in relation to previous literature on reminiscence therapy, with specific emphasis on the need for (a) replication studies and (b) the development of new versions of the technology-aided program to improve its impact and reach a wider number of patients.
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Affiliation(s)
| | - Nirbhay N Singh
- Medical College of Georgia, Georgia Regents University, Augusta, USA
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Renna C, Pinto K, De Vanna F, Caffò AO, Stasolla F. Persons with moderate Alzheimer's disease use simple technology aids to manage daily activities and leisure occupation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2117-2128. [PMID: 24881006 DOI: 10.1016/j.ridd.2014.05.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 05/05/2014] [Indexed: 06/03/2023]
Abstract
Two studies assessed technology-aided programs to support performance of daily activities and selection/activation of music items with patients with moderate Alzheimer's disease. In Study I, four patients were presented with activity-related pictorial instructions via a computer fitted with inexpensive, commercial software. In Study II, four patients were (a) presented with different music options and (b) allowed to select and activate the preferred option via a microswitch response. Study I showed that each patient learned to perform the two activities available with percentages of correct responses exceeding 85 by the end of the intervention. Study II showed that all patients learned to choose and activate music options. Psychology students, employed in a social validation check, scored the patients' behavior within the program better than their behavior in a control situation. The relevance and usability of simplified pictorial-instruction programs and music choice programs for patients with moderate Alzheimer's disease were discussed.
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Affiliation(s)
| | - Nirbhay N Singh
- Medical College of Georgia, Georgia Regents University, Augusta, USA
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Caffò AO, Hoogeveen F, Groenendaal M, Perilli AV, Picucci L, Lancioni GE, Bosco A. Intervention strategies for spatial orientation disorders in dementia: a selective review. Dev Neurorehabil 2014; 17:200-9. [PMID: 24102462 DOI: 10.3109/17518423.2012.749951] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This article provides a brief overview of the intervention strategies aimed at reducing spatial orientation disorders in elderly people with dementia. METHODS Eight experimental studies using spatial cues, assistive technology programs, reality orientation training, errorless learning technique, and backward chaining programs are described. They can be classified into two main approaches: restorative and compensatory, depending on whether they rely or not on residual learning ability, respectively. RESULTS A review of the efficacy of these intervention strategies is proposed. Results suggest that both compensatory and restorative approaches may be valuable in enhancing correct way-finding behavior, with various degrees of effectiveness. Some issues concerning (a) variability in participants' characteristics and experimental designs and (b) practicality of intervention strategies do not permit to draw a definite conclusion. CONCLUSIONS Future research should be aimed at a direct comparison between these two strategies, and should incorporate an extensive neuropsychological assessment of spatial domain.
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Affiliation(s)
- Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari , Bari , Italy
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Mazzei F, Gillan R, Cloutier D. Exploring the Influence of Environment on the Spatial Behavior of Older Adults in a Purpose-Built Acute Care Dementia Unit. Am J Alzheimers Dis Other Demen 2014; 29:311-9. [PMID: 24381136 PMCID: PMC10852605 DOI: 10.1177/1533317513517033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Limited research explores the experience of individuals with dementia in acute care geriatric psychiatry units. This observational case study examines the influence of the physical environment on behavior (wandering, pacing, door testing, congregation and seclusions) among residents in a traditional geriatric psychiatry unit who were then relocated to a purpose-built acute care unit. Purpose-built environments should be well suited to the needs of residents with dementia. Observed trends revealed differences in spatial behaviors in the pre- and post- environments attributable to the physical environment. Person-centred modifications to the current environment including concerted efforts to know residents are meaningful in fostering quality of life. Color coded environments (rooms vs dining areas etc.) to improve wayfinding and opportunities to personalize rooms that address the `hominess' of the setting also have potential. Future research could also seek the opinions of staff about the impact of the environment on them as well as residents.
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Affiliation(s)
- Francesco Mazzei
- Department of Geography, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | | | - Denise Cloutier
- Department of Geography and Centre on Aging, Victoria, BC, V8P 5C2, Canada
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Caffò AO, Hoogeveen F, Groenendaal M, Perilli VA, Damen M, Stasolla F, Lancioni GE, Bosco A. Comparing two different orientation strategies for promoting indoor traveling in people with Alzheimer's disease. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:572-580. [PMID: 24380786 DOI: 10.1016/j.ridd.2013.12.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 12/04/2013] [Indexed: 06/03/2023]
Abstract
The present study compared two different types of orientation strategies: an assistive technology program (AT, i.e., remotely controlled sound/light devices) and a backward chaining procedure (BC) for promoting indoor traveling in four persons with moderate to severe Alzheimer's disease (AD). A social validation assessment of the two strategies was also conducted employing undergraduate students as raters. For three out of four participants, AT intervention was more effective than the BC procedure, whilst for the fourth participant the two types of intervention had a comparably satisfying efficacy. A doubly Multivariate Analysis of Variance on social validation assessment data provided generally more positive scores for the AT intervention. These results suggest that AT programs (a) can be valuably employed for restoring and maintaining independence in indoor traveling in people with moderate to severe AD, and (b) might be perceived as preferable to conventional teaching strategies within daily contexts.
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Affiliation(s)
- Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Italy.
| | - Frans Hoogeveen
- Psychogeriatrics Lectorate, The Hague University of Applied Sciences, The Netherlands
| | - Mari Groenendaal
- Psychogeriatrics Lectorate, The Hague University of Applied Sciences, The Netherlands
| | - Viviana A Perilli
- Department of Educational Sciences, Psychology, Communication, University of Bari, Italy
| | | | | | - Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Italy
| | - Andrea Bosco
- Department of Educational Sciences, Psychology, Communication, University of Bari, Italy
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Tarnanas I, Tsolakis A, Tsolaki M. Assessing Virtual Reality Environments as Cognitive Stimulation Method for Patients with MCI. STUDIES IN COMPUTATIONAL INTELLIGENCE 2014. [DOI: 10.1007/978-3-642-45432-5_4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Renna C, Ventrella M, Pinto K, Minervini MG, Oliva D, Groeneweg J. Supporting daily activities and indoor travel of persons with moderate Alzheimer's disease through standard technology resources. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:2351-2359. [PMID: 23711628 DOI: 10.1016/j.ridd.2013.04.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 04/22/2013] [Indexed: 06/02/2023]
Abstract
These two studies were aimed at evaluating standard technology resources for supporting activity and travel among patients with moderate Alzheimer's disease. Specifically, Study I assessed a pictorial instruction program relying on the use of a portable computer and a commercially available and inexpensive video editing software for supporting the performance of daily activities with three patients. Study II assessed the indoor travel performance of four patients (i.e., the three involved in Study I and a fourth patient with no previous research exposure) using a commercially available, basic doorbell system with sound and light cues. The percentages of correct activity steps obtained with the instruction program used in Study I were relatively high and largely similar to the percentages reported in previous studies using more sophisticated technology. During Study II, the percentages of correct travels of two patients matched the data of the most successful patients involved in previous studies with more sophisticated technology. The percentages of the other two patients tended to be lower than those obtained previously, but were still practically relevant. The implications of the results of the two studies and a number of issues for new research are discussed.
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Perilli V, Lancioni GE, Hoogeveen F, Caffó A, Singh N, O'Reilly M, Sigafoos J, Cassano G, Oliva D. Video prompting versus other instruction strategies for persons with Alzheimer's disease. Am J Alzheimers Dis Other Demen 2013; 28:393-402. [PMID: 23687181 PMCID: PMC10852674 DOI: 10.1177/1533317513488913] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND/AIM Two studies assessed the effectiveness of video prompting as a strategy to support persons with mild and moderate Alzheimer's disease in performing daily activities. METHODS In study I, video prompting was compared to an existing strategy relying on verbal instructions. In study II, video prompting was compared to another existing strategy relying on static pictorial cues. Video prompting and the other strategies were counterbalanced across tasks and participants and compared within alternating treatments designs. RESULTS Video prompting was effective in all participants. Similarly effective were the other 2 strategies, and only occasional differences between the strategies were reported. Two social validation assessments showed that university psychology students and graduates rated the patients' performance with video prompting more favorably than their performance with the other strategies. CONCLUSION Video prompting may be considered a valuable alternative to the other strategies to support daily activities in persons with Alzheimer's disease.
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Affiliation(s)
- Viviana Perilli
- Department of Psychology and Pedagogical and Teaching Sciences, University of Bari, Italy
| | | | - Frans Hoogeveen
- The Hague University of Applied Sciences, The Hague, the Netherlands
| | - Alessandro Caffó
- Department of Psychology and Pedagogical and Teaching Sciences, University of Bari, Italy
| | - Nirbhay Singh
- American Health and Wellness Institute, Raleigh, NC, USA
| | - Mark O'Reilly
- Meadows Center for Preventing Educational Risk, University of Texas at Austin, TX, USA
| | - Jeff Sigafoos
- School of Educational Psychology and Pedagogy, Wellington Victoria University, New Zealand
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Perilli V, Lancioni GE, Laporta D, Paparella A, Caffò AO, Singh NN, O'Reilly MF, Sigafoos J, Oliva D. A computer-aided telephone system to enable five persons with Alzheimer's disease to make phone calls independently. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1991-1997. [PMID: 23584179 DOI: 10.1016/j.ridd.2013.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 03/14/2013] [Indexed: 06/02/2023]
Abstract
This study extended the assessment of a computer-aided telephone system to enable five patients with a diagnosis of Alzheimer's disease to make phone calls independently. The patients were divided into two groups and exposed to intervention according to a non-concurrent multiple baseline design across groups. All patients started with baseline in which the technology was not available, and continued with intervention in which the technology was used. The technology involved a net-book computer provided with specific software, a global system for mobile communication modem (GSM), a microswitch, and lists of partners to call with related photos. All the patients learned to use the system and made phone calls independently to a variety of partners, such as family members, friends, and caregivers. A social validation assessment, in which care and health professionals working with persons with dementia were asked to rate the patients' performance with the technology and with the help of a caregiver, provided generally more positive scores for the technology-assisted performance. The positive implications of the findings for daily programs of patients with Alzheimer's disease are discussed.
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Affiliation(s)
- Viviana Perilli
- Department of Neuroscience and Sense Organs, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy
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Picucci L, Gyselinck V, Piolino P, Nicolas S, Bosco A. Spatial Mental Models: The Interaction of Presentation Format, Task Requirements and Availability of Working Memory Components. APPLIED COGNITIVE PSYCHOLOGY 2013. [DOI: 10.1002/acp.2909] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | - Andrea Bosco
- Università degli Studi di Bari “Aldo Moro”; Italy
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Lancioni GE, Perilli V, O'Reilly MF, Singh NN, Sigafoos J, Bosco A, Caffò AO, Picucci L, Cassano G, Groeneweg J. Technology-based orientation programs to support indoor travel by persons with moderate Alzheimer's disease: impact assessment and social validation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:286-293. [PMID: 22982468 DOI: 10.1016/j.ridd.2012.08.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 08/20/2012] [Indexed: 06/01/2023]
Abstract
The present study (a) extended the assessment of an orientation program involving auditory cues (i.e., verbal messages automatically presented from the destinations) with five patients with Alzheimer's disease, (b) compared the effects of this program with those of a program with light cues (i.e., a program in which strobe lights were used instead of the verbal messages) with the same five patients, and (c) conducted a social validation assessment of the two programs with 70 university psychology students employed as social raters. Results confirmed the effectiveness of the program with auditory cues and showed an equally strong impact of the program with light cues with all five patients. The psychology students involved in the social validation assessment provided significantly higher scores for the program involving light cues on a six-item questionnaire. Those scores suggested that this program was perceived as a practically and socially preferable choice. The implications of the findings for daily contexts dealing with patients with Alzheimer's disease are discussed.
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Affiliation(s)
- Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Via Quintino Sella 268, 70100 Bari, Italy.
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