Virtual Reality and EEG-Based Intelligent Agent in Older Adults With Subjective Cognitive Decline: A Feasibility Study for Effects on Emotion and Cognition

Abstract

Objectives: Immersive virtual reality has tremendous potential to improve cognition in populations with cognitive impairment. We conducted a feasibility and proof-of-concept study to assess the potential of virtual reality and electroencephalography, with or without an intelligent agent, that adapts the presented material to the emotions elicited by the environment.Method: Older adults with subjective cognitive decline recruited from the community received a virtual reality-based intervention taking place in one of two virtual environments, a train (Part 1, N = 19) or a music theatre, complemented by the intelligent agent (Part 2, N = 19). A comparative control group (N = 19) receiving no intervention was also included. All participants completed measures of affect and cognition before and after the intervention. The intervention groups completed measures of cybersickness and user experience after the intervention.Results: Participants did not suffer from increased cybersickness following either intervention. They also reported a positive to highly positive user experience concerning the following aspects: attractivity, hedonic quality-identity and hedonic quality-stimulation. The measures of affect showed no pre-post change when comparing either intervention to the control condition. However, a reduction of negative affect was observed following the train intervention for participants with a high self-reported negative affect at baseline. Finally, there was a significant improvement in working memory when comparing either intervention group to the control condition.Conclusion: Our results support the feasibility and tolerability of the technology, and a positive impact on cognition, paving the way for a larger-scale randomized clinical trial to confirm efficacy.

In too deep? A systematic literature review of fully‐immersive virtual reality and cybersickness among older adults

“…Thus, 39 articles were selected for inclusion in this systematic literature review synthesis and appraisal. Of the 39 included studies, we determined that 11 studies [21][22][23][24][25][26][27][28][29][30][31] used "borderline" fully-immersive virtual reality technology. We defined "borderline" as: (1) studies that used a mobile phone as the display in the headset (e.g., Samsung Gear), (2) studies that had low player interaction with the virtual reality environment (e.g., viewing virtual reality videos), or (3) studies that provided only 3 degrees of freedom, allowing for head rotation but not translation within the virtual environment.…”

“…The studies generally had weak sample generalizability (e.g., selection bias) and methodological design, but strong data collection and sample retention. Using the Effective Public Health Practice Project Quality Assessment Tool, six studies received a rating of strong, 22,27,29,39,40,55 10 studies received a rating of moderate, 24,31,36,41,44,50,51,53,54,57 and 23 studies received a rating of weak. 21,23,25,26,28,30,[32][33][34][35]37,38,42,43,[45][46][47][48][49]52,56,58,59 Participants…”

“…21,23,25,26,28,30,33,38,43,[45][46][47][50][51][52]54,56,57,59 Most study samples were majority female, but the average age varied greatly between 63 years 42,44 to 92 years. 51 While many study samples consisted of community dwelling older adults, 34,35,38,41,44,45 other older adult subpopulations studied included those with cognitive impairment, 21,23,24,27,32,[53][54][55][56]58,59 those hospitalized 21,43,47 or living in an long term care community, 25,26,[28][29][30]48,50,51 and the ...…”

“…Across all studies, the most common study purpose was to assess the feasibility of fully-immersive virtual reality interventions for older adults. The majority of studies (23 studies) utilized a one-time session intervention, 22,24,28,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] whereas 16 studies 21,23,[25][26][27]29,[50][51][52][53][54][55][56][57][58][59] consisted of more than one session. The duration of the virtual reality intervention varied considerably from a one-time seven to 9 min session 38 to 20 min sessions per day for 4 weeks.…”

“…The duration of the virtual reality intervention varied considerably from a one-time seven to 9 min session 38 to 20 min sessions per day for 4 weeks. 27 Most studies' interventions included a virtual task that related to cognitive training or assessment, 22,24,[31][32][33][34]39,41,43,47,[53][54][55][56]58,59 activity or physical rehabilitation, 27,37,38,40,42,[49][50][51][52]57 exploration for purposes such as well-being or reminiscence, 21,23,25,[28][29][30]35,36,46,48 or a combination. 44,45 The most common virtual reality headsets used among the studies were the HTC Vive 32,35,37,[40][41][42]44,47,…”