JMIR Publications

ABSTRACT

Background:

Dementia, which presents as cognitive decline in one or more cognitive domains affecting function, is becoming more prevalent. Traditional cognitive screening tools for dementia have their limitations, with emphasis on memory and to a lesser extent on the cognitive domain of executive function. The use of virtual reality (VR) in screening for cognitive function in older person is promising but evidence for its use is sparse.

Objective:

The primary aim is to examine the feasibility and acceptability of using VR for screening for cognitive impairment, through a VR module. The secondary aim is to assess the module’s ability to discriminate between cognitively normal and cognitively impaired participants.

Methods:

A comparative study was conducted at a public primary care clinic in Singapore, where 60 older persons were recruited based on a cut-off score of 26 using the Montreal Cognitive Assessment (MoCA) scale. They participated in the VR module to assess their learning and memory, perceptual-motor function and executive function. Each participant was evaluated by a total performance score (range: 0 – 700) upon completion. An assisted questionnaire was also administered to assess their perception of and attitude towards VR.

Results:

37 participants in Group 1 (cognitively normal; MoCA>26) and 23 participants in Group 2 (cognitively impaired; MoCA<26) were assessed. All participants completed the study with a mean total time of 19.1±3.6 minutes in Group 1 and 20.4±3.4 minutes in Group 2. Mean feedback scores ranged from 3.80 to 4.48 (max=5) in favour of VR. The total performance score in Group 1 (552.0±57.2) was higher than in Group 2 (476.1±61.9) (P<.001), and exhibited moderate positive correlation with scores from other cognitive screening tools: Abbreviated Mental Test (AMT) (0.312), Mini-Mental State Examination (MMSE) (0.373) and MoCA (0.427). A ROC curve analysis, relating total performance score to the presence of cognitive impairment, showed an area under curve of 0.821 (95% confidence interval: 0.714 to 0.928).

Conclusions:

We demonstrated the feasibility of using an VR-based screening tool for cognitive function in older persons in primary care, who were largely in favour of this tool.