Predicting real world spatial disorientation in Alzheimer’s disease patients using virtual reality navigation tests

Abstract

Spatial navigation impairments in Alzheimer’s disease (AD) have been suggested to underlie patients experiencing spatial disorientation. Though many studies have highlighted navigation impairments for AD patients in virtual reality (VR) environments, the extent to which these impairments predict a patient’s risk for spatial disorientation in the real world is still poorly understood. The aims of this study were to (a) investigate the spatial navigation abilities of AD patients in VR environments as well as in a real world community setting and (b) explore whether we could predict patients at a high risk for spatial disorientation in the community based on their VR navigation. Sixteen community-dwelling AD patients and 21 age/gender matched controls were assessed on their egocentric and allocentric navigation abilities in VR environments using the Virtual Supermarket Test (VST) and Sea Hero Quest (SHQ) as well as in the community using the Detour Navigation Test (DNT). When compared to controls, AD patients exhibited impairments on the VST, SHQ, and DNT. For patients, only SHQ wayfinding distance and wayfinding duration significantly predicted composite disorientation score on the DNT (β = 0.422, p = 0.034, R2 = 0.299 and β = 0.357, p = 0.046, R2 = 0.27 respectively). However, these same VR measures could not reliably predict which patients were at highest risk of spatial disorientation in the community (p > 0.1). Future studies should focus on developing VR-based tests which can predict AD patients at high risk of getting spatially disorientated in the real world.

Early detection of diseases causing dementia using digital navigation and gait measures: A systematic review of evidence

“…One exception to the in‐person tools was Sea Hero Quest, a citizen science smartphone navigation game app with over 4 million global downloads that was remotely played by participants 71 . Initiatives such as this exemplify the potential power of remote collection of different navigation‐based metrics, which are independent of other cognitive abilities, 72 usable across multiple countries and cultures, 73 show sensitivity to preclinical genetic AD risk, 43 and can predict the real‐world navigation ability of both young 74 and older users 75 …”

“…71 Initiatives such as this exemplify the potential power of remote collection of different navigation-based metrics, which are independent of other cognitive abilities, 72 usable across multiple countries and cultures, 73 show sensitivity to preclinical genetic AD risk, 43 and can predict the real-world navigation ability of both young 74 and older users. 75 In contrast to the active metrics, all passive GPS driving metrics were collected remotely using loggers fitted in participant personal cars. Passive collection of GPS data provides a low-burden, scalable approach to collecting navigation-related metrics.…”

Spatial navigation questionnaires as a supportive diagnostic tool in early Alzheimer’s disease

“…In addition, the hMWM involves navigation in a small, open space and therefore may have limited ecological validity for human navigation. To address this limitation, spatial navigation tasks based on complex realistic indoor 7 , 56 , 60 and outdoor 60 , 61 , 62 , 63 , 64 , 65 environments have recently been designed and adapted to more comprehensively measure spatial navigation behavior, including route learning, wayfinding, cognitive mapping, perspective taking, path integration, and landmark placement. Future research should compare spatial navigation performance in these complex, realistic environments with spatial navigation questionnaire scores and specific questions to more accurately assess the associations between real-world navigation and reported navigation abilities.…”

At Crossroads in a Virtual City: Effect of Spatial Disorientation on Gait Variability and Psychophysiological Response among Healthy Older Adults

“…Firstly, results from this study provide a new insight in aging navigation research [ 3 , 4 , 21 ], by indicating that spatial disorientation can be successfully induced and evaluated among healthy older adults in an ambulatory VR setting, judging by the significantly higher instances observed among the experimental participants. Previous spatial disorientation studies involving healthy older adults and/or patients have mainly employed either computer-based VR tasks [ 39 ] or real-world wayfinding tasks [ 15 , 39 ]. Secondly, results showed a significant effect of spatial disorientation, most of which were observed at crossings, on gait variability and psychophysiological response.…”