JMIR Publications

ABSTRACT

Background:

Mild cognitive impairment (MCI) is often a precursor of dementia, and MCI patients develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence on the use of virtual supermarkets to screen for MCI.

Objective:

The objectives were to validate a VR game-based test, namely, the Virtual Supermarket Program (VSP), for differentiating MCI patients and healthy controls (HCs) and to identify cutoff scores for different age levels.

Methods:

Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into an HC group (N = 64) and an MCI group (N = 62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity and retest reliability of the VSP. We used the area under the curve (AUC) of the receiver operating characteristic to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively.

Results:

A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and a specificity of 79.0% for differentiating those with MCI and HCs, and the AUC was 0.870 (95% CI = 0.799~0.924). The median index of VSP score was 51.1, and the score range was 42.6 to 60.0. There was a moderate positive correlation between VSP total score and Mini-Mental State Examination score (r = 0.429, P < .001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r = 0.645, P < .001). The retest reliability of the VSP was feasible (r = 0.588, P = .048).

Conclusions:

The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. Clinical Trial: The study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2000040074).