BackgroundAspects of cognitive function decline with age. This phenomenon is referred to as age-related cognitive decline (ARCD). Improving the understanding of these changes that occur as part of the ageing process can serve to enhance the detection of the more incapacitating neurodegenerative disorders such as Alzheimer’s disease (AD). In this study, we employ novel methods to assess ARCD by exploring the utility of the alpha3/alpha2 electroencephalogram (EEG) power ratio – a marker of AD, and a novel virtual reality (VR) functional cognition task – VStore, in discriminating between young and ageing healthy adults.Materials and methodsTwenty young individuals aged 20–30, and 20 older adults aged 60–70 took part in the study. Participants underwent resting-state EEG and completed VStore and the Cogstate Computerised Cognitive Battery. The difference in alpha3/alpha2 power ratios between the age groups was tested using t-test. In addition, the discriminatory accuracy of VStore and Cogstate were compared using logistic regression and overlying receiver operating characteristic (ROC) curves. Youden’s J statistic was used to establish the optimal threshold for sensitivity and specificity and model performance was evaluated with the DeLong’s test. Finally, alpha3/alpha2 power ratios were correlated with VStote and Cogstate performance.ResultsThe difference in alpha3/alpha2 power ratios between age cohorts was not statistically significant. On the other hand, VStore discriminated between age groups with high sensitivity (94%) and specificity (95%) The Cogstate Pre-clinical Alzheimer’s Battery achieved a sensitivity of 89% and specificity of 60%, and Cogstate Composite Score achieved a sensitivity of 83% and specificity of 85%. The differences between the discriminatory accuracy of VStore and Cogstate models were statistically significant. Finally, high alpha3/alpha2 power ratios correlated strongly with VStore (r = 0.73), the Cogstate Pre-clinical Alzheimer’s Battery (r = -0.67), and Cogstate Composite Score (r = -0.76).ConclusionWhile we did not find evidence that the alpha3/alpha2 power ratio is elevated in healthy ageing individuals compared to young individuals, we demonstrated that VStore can classify age cohorts with high accuracy, supporting its utility in the assessment of ARCD. In addition, we found preliminary evidence that elevated alpha3/alpha2 power ratio may be linked to lower cognitive performance.

AimsTo compare the MATRICS Consensus Cognitive Battery (MCCB) and a novel Virtual Reality (VR) task, called VStore, in assessing cognition and functional capacity (FC) in schizophrenia. We hypothesise that VStore reliably discriminates between patients and controls, correlates with the MCCB, and is well-tolerated. Additionally, VStore is expected to strongly correlate with FC measures.BackgroundCognitive and functional deficits in schizophrenia have a major impact on everyday functioning of patients. The gold-standard cognitive assessment is the MCCB, while the USCD Performance-Based Skills Assessment (UPSA) is used to assess FC in this patient group. Neither of which are without limitations. For example, both take a long time to administer, and the MCCB alone cannot give clear indications of FC. We propose the use of a novel VR task to simultaneously measure cognition and FC in a single assessment. VStore is a shopping task, which involves a verbal learning task followed by buying items from a predetermined shopping list in a virtual minimarket.MethodTen patients with schizophrenia or schizoaffective disorder and ten age/gender-matched healthy controls recruited from South London, completed the following assessments: VStore, MCCB, UPSA & Global Assessment of Functioning (GAF), and VR-Symptom Questionnaire (VRSQ); while controls only completed the VR task. To test whether VStore can differentiate between patients and controls we employed unpaired t-test. To explore associations between VStore Total Time, MCCB composite score and FC measures Pearson's r was used. Finally, mean differences between pre/post-VR symptoms scores were tested using paired t-test.ResultThere was a significant difference between patients and controls on the verbal learning task (t16.38=−4.67,p < .001), and total time spent completing the VR task (t11.41 = 2.67, p = .023). In addition, VStore had a strong association with MCCB composite score (r=−.80,p = .010). While both VStore (r=−.82, p < 001) and MCCB (r = .77,p = .010) had significant correlation with the UPSA, only VStore had a significant association with the GAF (r=−.68,p = .030). Finally, VStore appears to be well-tolerated, causing no measurable side effects in the VRSQ (Pre-VR Mean =12.1[SD = 13.5], Post-VR Mean = 9.6[SD = 11.5],t9 = 0.49,p > .05).ConclusionResults suggest that VStore can discriminate between schizophrenia patients and healthy controls. In addition, VStore and MCCB seem to be strongly associated, suggesting that they tap into identical cognitive domains. VStore seems to be strongly correlated with FC, more so than the MCCB, and cause no measurable side effects. Taken together, this suggests that this novel VR task has the potential to reliably measure cognition and FC simultaneously.

Background It is widely accepted that neurocognitive performance is linked to functional outcomes in schizophrenia (Green, Kern, Braff, & Mintz, 2000). Research, however, shows that this relationship is likely to be mediated by other factors such as social competence (Brekke, Kay, Lee, & Green, 2005). Indeed, performance on cognitive tasks only explain 20% of the variance in work related skills (Bowie et al., 2008). Furthermore, the composite score generated by the gold standard neurocognitive measure, the MATRICS Consensus Cognitive Battery (MCCB), fails to predict work or education related functioning and independent living (August, Kiwanuka, McMahon, & Gold, 2012). To address these limitations, we developed a novel and ecologically valid virtual reality (VR) task with the aim to simultaneously measure cognition and functional capacity in schizophrenia. The assessment is set in a minimarket environment where participants are required to buy selected items from a shopping list. In this study, our objective was to establish the construct validity of the VR task in relation to the MCCB, and test whether it can predict functional outcomes. In addition, we tested whether app-based cognitive training can improve cognition and/or functional outcomes at follow-up as an exploratory objective. Methods Thirty patients with a diagnosis of schizophrenia or schizoaffective disorder were recruited from South London. At baseline, participants completed the VR task and MCCB, the Positive and Negative Syndrome Scale (PANSS), and various functional capacity/outcome measures including the Global Assessment of Functioning (GAF), Social and Occupational Functioning Assessment Scale (SOFAS), UCSD Performance-Based Skills Assessment-Brief (UPSA-B), and World Health Organization Disability Assessment Schedule II (WHODAS-II). A subset of participants was randomly allocated to receive a 4-week long, app-based training; either playing with an immersive or a 2D spatial memory training game. Those who completed the training were invited back for a follow-up visit. Construct validity of the VR task will be assessed through a series of bivariate correlations. The predictive ability of the VR task for functional outcomes will be tested through linear regression models. Finally, the efficacy of spatial memory training will be assessed using repeated measures ANOVA. Results Data analysis is currently ongoing, and results will be presented at the conference. Discussion This study will provide the first indication whether VR can be employed to test cognition and functional capacity simultaneously in patients with schizophrenia. Given the current lack of reliable and ecologically valid functional outcome measures, new assessments that are sensitive to clinically meaningful cognitive improvements are desperately needed.