Simultaneous Exercise and Cognitive Training in Virtual Reality Phase 2 Pilot Study: Impact on Brain Health and Cognition in Older Adults1

Abstract

Background: Aerobic exercise and environmental enrichment have been shown to enhance brain function. Virtual reality (VR) is a promising method for combining these activities in a meaningful and ecologically valid way. Objective: The purpose of this Phase 2 pilot study was to calculate relative change and effect sizes to assess the impact of simultaneous exercise and cognitive training in VR on brain health and cognition in older adults. Methods: Twelve cognitively normal older adults (64.7±8.8 years old, 8 female) participated in a 12-week intervention, 3 sessions/week for 25–50 minutes/session at 50–80%HRmax. Participants cycled on a custom-built stationary exercise bike while wearing a VR head-mounted display and navigating novel virtual environments to train spatial memory. Brain and cognitive changes were assessed using MRI imaging and a cognitive battery. Results: Medium effect size (ES) improvements in cerebral flow and brain structure were observed. Pulsatility, a measure of peripheral vascular resistance, decreased 10.5%(ES(d) = 0.47). Total grey matter volume increased 0.73%(ES(r) = 0.38), while thickness of the superior parietal lobule, a region associated with spatial orientation, increased 0.44%(ES(r) = 0.30). Visual memory discrimination related to pattern separation showed a large improvement of 68%(ES(ηp2) = 0.43). Cognitive flexibility (Trail Making Test B) (ES(r) = 0.42) and response inhibition (ES(W) = 0.54) showed medium improvements of 14%and 34%, respectively. Conclusions: Twelve weeks of simultaneous exercise and cognitive training in VR elicits positive changes in brain volume, vascular resistance, memory, and executive function with moderate-to-large effect sizes in our pilot study.

Artificial intelligence for dementia—Applied models and digital health

“…Technology can be developed to target cognitive processes anticipated to provide an early, pathology‐specific signal in an ecologically relevant context. For example, there is increasing study on the use of virtual reality to probe spatial navigation, 31 as well as cognitive training 86 . Altoida have produced an augmented reality object‐location task, with early evidence suggesting this tool can discriminate MCI, 87 and an ongoing collaboration with the Global Brain Health Institute set to collect longitudinal data from 10,000 individuals on this task 88 .…”

“…For example, there is increasing study on the use of virtual reality to probe spatial navigation, 31 as well as cognitive training. 86 Altoida have produced an augmented reality object‐location task, with early evidence suggesting this tool can discriminate MCI, 87 and an ongoing collaboration with the Global Brain Health Institute set to collect longitudinal data from 10,000 individuals on this task. 88 In addition, data from sensor streams (e.g., microphone, touch screen, accelerometer) can be collected alongside cognitive task data to give more nuanced, in‐depth measurement.…”