Immersive Virtual Reality-Based Cognitive Intervention for the Improvement of Cognitive Function, Depression, and Perceived Stress in Older Adults With Mild Cognitive Impairment and Mild Dementia: Pilot Pre-Post Study.

Kaiyan Zhu,Hong Li,Rong Lin,Bingwei He,Meizhen Huang,Qiongyao Zhang

doi:10.2196/32117

Kaiyan Zhu, Hong Li + Show 4 more

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https://doi.org/10.2196/32117

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Abstract

BackgroundThe incidence of dementia is increasing annually, resulting in varying degrees of adverse effects for individuals, families, and society. With the continuous development of computer information technology, cognitive interventions are constantly evolving. The use of immersive virtual reality (IVR) as a cognitive intervention for older adults with mild cognitive impairment (MCI) and mild dementia (MD) is promising, although only few studies have focused on its use.ObjectiveThe Chinese virtual supermarket (CVSM) IVR system was developed to provide a comprehensive and individual cognitive intervention program for older patients with MCI and MD. The aim of this study was to explore the feasibility and clinical effectiveness of this 5-week IVR-based cognitive intervention.MethodsA pretest-posttest study design was conducted with 31 older adults with MCI and MD from August 2020 to January 2021. All participants participated in a 5-week immersive virtual cognitive training program using the CVSM system. Feasibility was assessed as the incidence and severity of cybersickness symptoms and participant satisfaction based on questionnaires conducted after the intervention. Clinical effectiveness was evaluated using neuropsychological assessments, including several commonly used measures of cognitive function, depression, perceived stress, and activities of daily living. Measurements were obtained at baseline and after the intervention period.ResultsA total of 18 patients with MCI (mean age 82.94 [SD 5.44] years; 12 females) and 13 patients with MD (mean age 85.7 [SD 4.67] years, 10 females) participated in this pilot study. Both groups showed significant improvements in all cognitive function measurements (P<.001). The MD group had a significantly greater improvement in general cognitive function compared to the MCI group in Montreal Cognitive Assessment Scale, Symbol Digit Modalities Test, Shape Trail Test, and Auditory Verbal Learning Test. Furthermore, an intervention effect was observed in the improvement of perceived stress (P=.048 for MD group, P=.03 for MCI group ).ConclusionsThe use of the CVSM system may be effective in enhancing the cognitive function of patients with MCI and MD, including general cognitive function, memory, executive function, and attention. IVR technology enriches cognitive intervention approaches and provides acceptable, professional, personalized, and interesting cognitive training for older adults with cognitive impairment.Trial RegistrationClinicalTrials ChiCTR2100043753; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2100043753

Highlights

China is rapidly transforming into an aging nation
The mild dementia (MD) group had a significantly greater improvement in general cognitive function compared to the mild cognitive impairment (MCI) group in Montreal Cognitive Assessment Scale, Symbol Digit Modalities Test, Shape Trail Test, and Auditory Verbal Learning Test
The use of the Chinese virtual supermarket (CVSM) system may be effective in enhancing the cognitive function of patients with MCI and MD, including general cognitive function, memory, executive function, and attention

Summary

Introduction

China is rapidly transforming into an aging nation. Based on the seventh national survey conducted by the National Bureau of Statistics, the number of older adults (aged ≥60 years) in China was 264.01 million (18.7% of the total population) at the end of 2020, including 190.63 million individuals aged ≥65 years (13.5% of the total population). Population aging is accompanied by an increased prevalence of mild cognitive impairment (MCI) and mild dementia (MD). In China, the prevalence of MCI in individuals ≥65 years is 10%-20%, and over 50% of these patients progress to dementia within 5 years. The incidence of dementia among individuals ≥60 years of age in China is predicted to increase from 14% in 2015 to 33% by 2050 [2,3]. The high prevalence of dementia in the older population is a significant social and economic burden on patients, patient families, and the existing health care system in China. The use of immersive virtual reality (IVR) as a cognitive intervention for older adults with mild cognitive impairment (MCI) and mild dementia (MD) is promising, only few studies have focused on its use

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