Many people with cognitive disabilities avoid outside activities, apparently for fear of getting lost. However, little is known about the nature of the difficulties encountered and the ways in which these individuals deal with them. None of the few studies on wayfinding by people with cognitive disabilities have explored the various specific difficulties they meet in everyday life. Using both a qualitative and quantitative methodology, this study aimed at profiling the types of difficulties encountered in urban mobility and the associated problem-solving strategies. In order to provide more direct evidence from the field, we conducted semi-structured interviews using the critical incident technique (Flanagan, 1954). Among the 66 participants interviewed, 44 had cognitive disabilities and 22 were matched controls. The analysis of the transcripts showed in particular an overall reduced autonomy in problem-solving strategies for people with a cognitive disability. The multiple correspondence analysis highlighted three main types of complex situations, covering a comprehensive range of complex situations that are met in everyday life by these individuals. Results also indicated that people with cognitive disabilities request assistance from another person more frequently when a complex event occurs. These situations are discussed as potential cues for improvements in navigational aids. Conclusions and perspectives are provided to improve wayfinding among people with cognitive disabilities.

The rise of virtual reality has overcome many of the methodological challenges faced by researchers studying spatial navigation. Yet, the difficulty in developing life-like virtual settings still remains a substantial barrier to most studies when fidelity to the real world has to be achieved in order to ensure some psychological validity of the results. Moreover, the variety of the settings results in standardization issues across studies. Our argument is that widely available video games could represent a worthwhile alternative to laboratory-made virtual environments, while providing a satisfactory methodological quality. This study assessed a prototype of landmark-based navigational aid by administering wayfinding tasks in the video game Grand Theft Auto V. Our results provide evidence that this video game offers a transparent and adaptable way to investigate cognitive processes with high experimental control and psychological validity. Recommendations towards the use of video game-based methodologies for future research are discussed.

No abstract

Background Multiple sclerosis (MS) places a considerable financial burden on the society. However, data quantifying the contemporary cost burden in France are lacking. Objective This cost-of-illness study aimed to estimate the direct and indirect costs associated with MS in France. Methods Between October 2020-November 2020, 208 French adults with a confirmed diagnosis of MS were recruited via MSCopilot® (a new MS self-assessment digital solution) and several MS patient networks. Indirect costs were estimated using a combination of top-down and bottom-up approaches. Direct costs were retrieved from Assurance Maladie (i.e. national system of health insurance) publications. Out-of-pocket expenses (OOPEs) incurred by MS patients were also reported. All costs were expressed in €2020. Data from the survey were extrapolated to the overall French MS population. Results MS exerted an annual cost burden of €2.7 billion on the French society (indirect costs: €1.3 billion; direct costs: €1.4 billion). Mean annual costs were €27,164.7 per-patient, with indirect and direct costs accounting for 48.1% and 51.9% of the total annual costs, respectively. OOPEs contributed over €90 million to the total annual costs. Conclusions MS imposes a substantial cost burden on the French society, with approximately half of the total annual costs driven by indirect costs.