Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland.
Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland.
BMC Psychiatry. 2024 May 8;24(1):347. doi: 10.1186/s12888-024-05811-2.
BACKGROUND/AIMS: Older age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults.
Seventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65-85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups.
The users performed, on average, 39.8 sessions (range 1-100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants' sex, age, and years of education. The differences in CNS Vital Signs' global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant.
VR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size.
Clinicaltrials.gov ID NCT05369897.
背景/目的：年龄较大和认知不活跃与认知障碍有关，认知障碍反过来又会因护理成本高而给经济和社会带来负担，尤其是对于养老院和非正规护理而言。新兴的使用新技术的非药物干预措施，例如通过头戴式显示器（HMD）提供的虚拟现实（VR），可能是一种维持或改善认知能力的替代方法。本研究旨在评估基于 VR 的数字疗法应用程序在改善健康老年人认知功能方面的疗效和安全性。
72 名年龄在 65-85 岁的健康老年人（实验组 N=35，对照组 N=37）被罗兹医科大学（波兰）招募。参与者被随机分配到实验组（基于 VR 的认知训练，包括热身模块和三个任务，包括 1 回和双 N 回）或对照组（仅显示自然视频的常规 VR 头戴式设备应用程序）。练习在不同的 360 度自然环境中进行，同时听喜欢的音乐类型，并通过头戴式显示器（HMD）进行播放。为期 12 周的干预措施为 12 分钟，每周至少进行三次（36 次）。通过基于网络的应用程序跟踪依从性和表现。主要结局指标包括注意力和工作记忆（CNS-Vital Signs 计算机化认知电池）。次要结局指标包括其他认知领域。构建混合线性模型以阐明实验组和对照组在干预前后测量值之间的差异。
用户平均完成了 39.8 次会话（范围为 1-100），其中 60%的用户完成了超过 36 次会话。与对照组相比，实验组在视觉记忆模块（B=7.767，p=0.011）和 1 回连续反应测试（正确反应方面：B=2.057，p=0.003 和遗漏错误：B=-1.950，p=0.007）中获得了更高的分数。结果独立于参与者的性别、年龄和受教育年限。CNS Vital Signs 的全球评分、工作记忆、执行功能、反应时间、处理速度、简单和复杂注意力、言语记忆、认知灵活性、运动速度和运动速度方面的差异没有统计学意义。
基于 VR 的认知训练可能被证明是一种有价值、有效的工具，可用于改善健康老年人的视觉记忆和注意力的某些可持续性方面。这是基于到目前为止获得的部分结果的初步分析。在分析目标样本量后，将得出最终结论。
Clinicaltrials.gov ID NCT05369897。
