Two Immersive Virtual Reality Tasks for the Assessment of Spatial Orientation in Older Adults with and Without Cognitive Impairment: Concurrent Validity, Group Comparison, and Accuracy Results

Abstract

Objective: Spatial disorientation is common in Alzheimer’s disease (AD), Mild Cognitive Impairment (MCI), and preclinical individuals with AD biomarkers. However, traditional neuropsychological tests lack ecological validity for the assessment of spatial orientation and to date, there is still no gold standard. The current study aimed to determine the validity and accuracy of two virtual reality tasks for the assessment of spatial orientation. Methods: We adapted two spatial orientation tasks to immersive virtual environments: a “survey to route” task in which participants had to transfer information from a map to their body position within a maze [Spatial Orientation in Immersive Virtual Environment Test (SOIVET) Maze], and an allocentric-type, route learning task, with well-established topographic landmarks (SOIVET Route). A total of 19 MCI patients and 29 cognitively healthy older adults aged 61–92 participated in this study. Regular neuropsychological assessments were used for correlation analysis and participant performances were compared between groups. Receiver Operating Characteristic (ROC) curve analysis was performed for accuracy. Results: The SOIVET Maze correlated with measures of visuoperception, mental rotation, and planning, and was not related to age, educational level, or technology use profile. The SOIVET Route immediate correlated with measures of mental rotation, memory, and visuoconstruction, and was influenced only by education. Both tasks significantly differentiated MCI and control groups, and demonstrated moderate accuracy for the MCI diagnosis. Conclusion: Traditional neuropsychological assessment presents limitations and immersive environments allow for the reproduction of complex cognitive processes. The two immersive virtual reality tasks are valid tools for the assessment of spatial orientation and should be considered for cognitive assessments of older adults.

Applicability of an immersive virtual reality system to assess egocentric orientation of older adults

“…In addition, participants reported high levels of immersion and presence; such finding is considered essential for the cognitive engagement capacity and for the test to be considered ecological. 17 Our results are in line with a study by Ijaz et al, 24 which evaluated the applicability and usability of an immersive VR platform to assess spatial navigation in older adults. Their results revealed that, despite the relative novelty of VR technology for this population, they made few navigation errors, identified challenging landmarks successfully and presented high levels of presence.…”

Short-term memory, attention, and temporal orientation as predictors of the cognitive impairment in older adults: A cross-sectional observational study

“…TO presents a greater difference between subjects with MCI or dementia and those without impairment [ 66 ]. Other studies, however, have observed that deterioration of SO in MCI is associated with a higher risk of progression to AD [ 67 ] and spatial disorientation is common in AD [ 68 ].…”

Application of novel technological solutions in the assessment of culturally diverse older adults.

“…The median VR study had 48 participants (range = 42–60) with a median age of 71.66 years (range of sample averages = 71.13–72.35). Race was reported for two studies, with one study reporting 100% Asian participants (Chua et al, 2019) and the other reporting 75% Hispanic White, 18.75% Hispanic Japanese, and 6.25% Hispanic Black participants (da Costa et al, 2022). One study required participants to speak Portuguese (da Costa et al, 2022), while the remaining two studies did not report a language requirement.…”