Tan Ngiap Chuan, Lim Jie En, Allen John Carson, Wong Wei Teen, Quah Joanne Hui Min, Muthulakshmi Paulpandi, Teh Tuan Ann, Lim Soon Huat, Malhotra Rahul
Duke-NUS Medical School, Singapore, Singapore.
SingHealth Polyclinics, Singapore, Singapore.
Front Psychol. 2022 Mar 11;13:847590. doi: 10.3389/fpsyg.2022.847590. eCollection 2022.
Cognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. The rate of regression varies among the six cognitive domains (perceptual motor, executive function, complex attention, learning and memory, social cognition and language). Current modality of cognitive assessment using neuropsychological paper-and-pencil screening tools for cognitive impairment such as the Montreal Cognitive Assessment (MoCA) has limitations and is influenced by age. Virtual reality (VR) is considered as a potential alternative tool to assess cognition. A novel, fully immersive automated VR system (Cognitive Assessment using Virtual Reality, CAVIRE) has been developed to assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system.
This is a feasibility study to evaluate the VR performance of cognitively healthy adults aged between 35 and 74 years old, based on the performance score and completion time using the CAVIRE system.
Conducted in a public primary care clinic in Singapore, 25 multi-ethnic Asian adults were recruited in each of the four age groups in years: (1) 35-44; (2) 45-54; (3) 55-64, and (4) 65-74. The eligibility criteria included a MoCA score of 26 or higher to reflect normal cognition and understanding English instructions. They completed common daily activities ranging from brushing teething to shopping, across 13 VR segments. Their performances scores and completion time were automatically computed by the CAVIRE system. These VR performance indices were compared across the four age groups using one-way ANOVA, -test of the hypothesis, followed by pair-wise comparisons in the event of a significant -test ( < 0.05).
One participant dropped out from Group 1. The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups 1 and 2 attained higher VR performance scores and shorter completion time, compared to those in Groups 3 and 4, in all six cognitive domains (all < 0.05).
The CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices.
由于大脑的进行性退化，认知能力通常会随着时间的推移而逐渐下降，导致痴呆以及最终独立功能的丧失。六个认知领域（感知运动、执行功能、复杂注意力、学习和记忆、社会认知和语言）的衰退速度各不相同。目前使用神经心理学纸笔筛查工具（如蒙特利尔认知评估量表（MoCA））进行认知障碍评估的方式存在局限性，并且受年龄影响。虚拟现实（VR）被认为是评估认知的一种潜在替代工具。一种新型的、完全沉浸式的自动化VR系统（使用虚拟现实进行认知评估，CAVIRE）已被开发出来，用于评估这六个认知领域。由于认知与年龄相关，因此推测使用该系统时VR表现会随年龄而变化。
这是一项可行性研究，旨在根据使用CAVIRE系统的表现得分和完成时间，评估35至74岁认知健康成年人的VR表现。
在新加坡的一家公立基层医疗诊所进行，四个年龄组（以岁计）中每组招募25名多民族亚洲成年人：（1）35 - 44岁；（2）45 - 54岁；（3）55 - 64岁；（4）65 - 74岁。纳入标准包括MoCA得分26分或更高，以反映正常认知且能理解英文说明。他们完成了从刷牙到购物等常见日常活动，涵盖13个VR片段。他们的表现得分和完成时间由CAVIRE系统自动计算。使用单因素方差分析对这四个年龄组的这些VR表现指标进行比较，对假设进行检验，若检验结果显著（<0.05），则进行两两比较。
第一组有一名参与者退出。99名参与者的人口统计学特征在4个年龄组中相似。总体而言，在所有六个认知领域中，与第3组和第4组相比，第1组和第2组中较年轻的参与者获得了更高的VR表现得分且完成时间更短（均<0.05）。
认知正常的亚洲年轻和年长参与者之间，CAVIRE VR表现得分和完成时间存在显著差异。需要对该系统进行改进，以建立特定年龄组的正常表现指标。
