Cambridge and Peterborough Foundation Trust, Elizabeth House, Fulbourn Hospital Cambridge, Cambridge, UK.
ARC East of England, Douglas House, Cambridge, UK.
J Alzheimers Dis. 2020;75(1):23-43. doi: 10.3233/JAD-191218.
Immersive virtual reality (iVR) allows seamless interaction with simulated environments and is becoming an established tool in clinical research. It is unclear whether iVR is acceptable to people with Alzheimer's disease (AD) dementia or useful in their care. We explore whether iVR is a viable research tool that may aid the detection and treatment of AD.
This review examines the use of iVR in people with AD or mild cognitive impairment (MCI).
Medline, PsycINFO, Embase, CINAHL, and Web of Science databases were searched from inception. PRISMA guidelines were used with studies selected by at least two researchers.
Nine studies were eligible for inclusion. None reported any issues with iVR tolerability in participants with MCI and AD on assessment or treatment tasks. One study demonstrated capability for detecting prodromal AD and correlated with neuroanatomical substrates. Two studies showed iVR to have high accuracy in differentiating participants with AD from controls but were not hypothesis driven or with adequate controls measures. In a small validation study and two longitudinal case studies, iVR cognitive training was positively rated but did not demonstrate reliable benefit.
iVR is emerging as a viable method of assessing older adults and people with AD. Strongest benefits were seen when closely integrated with theoretical models of neurodegeneration and existing screening methods. Further randomized controlled trials integrated with clinical populations are required. This will consolidate the power of iVR for assessment of MCI and clarify treatment efficacy beyond current applications in physical rehabilitation.
沉浸式虚拟现实（iVR）允许与模拟环境无缝交互，并且正在成为临床研究中的一种既定工具。目前尚不清楚 iVR 是否被阿尔茨海默病（AD）痴呆患者接受，或者是否对他们的护理有用。我们探讨了 iVR 是否是一种可行的研究工具，可能有助于 AD 的检测和治疗。
本综述考察了 iVR 在 AD 或轻度认知障碍（MCI）患者中的应用。
从一开始就在 Medline、PsycINFO、Embase、CINAHL 和 Web of Science 数据库中进行了搜索。采用至少两名研究人员选择的 PRISMA 指南进行研究选择。
有 9 项研究符合纳入标准。在评估或治疗任务中，没有一项研究报告 MCI 和 AD 患者对 iVR 耐受性有任何问题。一项研究表明，iVR 具有检测前驱 AD 的能力，并与神经解剖学基础相关。两项研究表明，iVR 在区分 AD 患者和对照组方面具有很高的准确性，但没有假设驱动或有足够的对照措施。在一项小型验证研究和两项纵向病例研究中，iVR 认知训练得到了积极评价，但没有显示出可靠的益处。
iVR 正在成为评估老年人和 AD 患者的一种可行方法。当与神经退行性变的理论模型和现有的筛选方法紧密结合时，效果最强。需要进一步开展与临床人群相结合的随机对照试验，以巩固 iVR 在 MCI 评估中的作用，并澄清其治疗效果，超越目前在物理康复中的应用。
