Smart Aging Platform for Evaluating Cognitive Functions in Aging: A Comparison with the MoCA in a Normal Population

Abstract

Background: Smart Aging is a Serious games (SGs) platform in a 3D virtual environment in which users perform a set of screening tests that address various cognitive skills. The tests are structured as 5 tasks of activities of daily life in a familiar environment. The main goal of the present study is to compare a cognitive evaluation made with Smart Aging with those of a classic standardized screening test, the Montreal Cognitive Assessment (MoCA).Methods: One thousand one-hundred thirty-one healthy adults aged between 50 and 80 (M = 64.3 ± 8.3) were enrolled in the study. They received a cognitive evaluation with the MoCA and the Smart Aging platform. Participants were grouped according to their MoCA global and specific cognitive domain (i.e., memory, executive functions, working memory, visual spatial elaboration, language, and orientation) scores and we explored differences among these groups in the Smart Aging indices.Results: One thousand eighty-six older adults (M = 64.0 ± 8.0) successfully completed the study and were stratified according to their MoCA score: Group 1 with MoCA < 27 (n = 360); Group 2 with 27 ≥ MoCA < 29 (n = 453); and Group 3 with MoCA ≥ 29 (n = 273). MoCA groups significantly differed in most of the Smart Aging indices considered, in particular as concerns accuracy (ps < 0.001) and time (ps < 0.001) for completing most of the platform tasks. Group 1 was outperformed by the other two Groups and was slower than them in these tasks, which were those supposed to assess memory and executive functions. In addition, significant differences across groups also emerged when considering the single cognitive domains of the MoCA and the corresponding performances in each Smart Aging task. In particular, this platform seems to be a good proxy for assessing memory, executive functions, working memory, and visual spatial processes.Conclusion: These findings demonstrate the validity of Smart Aging for assessing cognitive functions in normal aging. Future studies will validate this platform also in the clinical aging populations.

The Smart Aging Platform for Assessing Early Phases of Cognitive Impairment in Patients With Neurodegenerative Diseases

“…As described elsewhere (Pazzi et al, 2014 ; Tost et al, 2014 , 2015 ; Zucchella et al, 2014b ; Bottiroli et al, 2017 ), Smart Aging is an SG platform based on a first-person paradigm and administered in the presence of a neuropsychologist. The virtual 3D environment is a loft apartment that brings together, in a small space, the basic elements of the environmental interactions that occur in the setting of a private home: a kitchen corner, a bedroom corner, and a living room corner (see Figure 1 ).…”

“…Essentially, it integrates various games that reproduce, in 3D, different everyday life tasks. In a previous work (Bottiroli et al, 2017 ), we compared the results of cognitive screening performed by means of Smart Aging with the scores obtained on a traditional standardized screening test, i.e., the Montreal Overall Cognitive Assessment (MoCA), in a sample of 1,086 healthy older adults stratified by MoCA score. We found significant between-group differences in each Smart Aging task, and thus demonstrated the validity of this platform as a screening tool for cognitive functioning in normal aging.…”

Assessment of cognitive instrumental activities of daily living: a systematic review

“…In addition to virtual tasks, there were other methodologies used to evaluate ADLs by means of serious games platforms [70], combining game playing with a serious purpose such as that of assessing functional independence in older people through five ADL tasks in a family environment using the Smart Aging game [71]. Other types of assessments conducted with new technologies involve the use of sensors that collect data about participants' gestures, movements, location, interactions and actions [72].…”

A Fully-Immersive and Automated Virtual Reality System to Assess the Six Domains of Cognition: Protocol for a Feasibility Study

“…VR has also been used in screening for cognitive impairment. However, many existing VR tests rely on external controls such as a computer mouse or touchscreen to interact with a two-dimensional screen or augmented reality, instead of using a head-mounted device (HMD) with a three-dimensional environment (Bottiroli et al, 2017 ; Gamito et al, 2017 ; Zygouris et al, 2017 ; Chua et al, 2019 ). Without a three-dimensional environment, these VR systems are not be able to create a fully-immersive experience where the person has the sense of “being there,” thus being unable to simulate tasks that sufficiently mimic real life to assess a person's cognitive function (Strong, 2020 ).…”