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.
Highlights
Aging is associated with an increased risk of cognitive impairment, for which early diagnosis becomes a critical aspect
Serious games (SGs) based on Virtual Reality (VR) are innovative computer games designed for purposes other than pure leisure (Charsky, 2010)
We have recently developed Smart Aging, a platform for the assessment of cognitive functions based on the SG technology (Pazzi et al, 2014; Tost et al, 2014, 2015)
Summary
Aging is associated with an increased risk of cognitive impairment, for which early diagnosis becomes a critical aspect. Neuropsychological tests are characterized by the limit of having a moderate level of ecological validity when predicting real-word cognitive performance, together with the fact of being too psychologically stressful with the risk of producing skewed results (Chaytor and Schmitter-Edgecombe, 2003). Serious games (SGs) based on Virtual Reality (VR) are innovative computer games designed for purposes other than pure leisure (Charsky, 2010) They usually consist in the presentation of 3D realistic scenarios where real-life situations can be simulated, allowing to enhance ecological validity with respect to traditional cognitive assessments. SGs can be self-administered or require little training, provide a pleasant experience and reduce the psychological stress caused by the traditional screening tools (Ismail et al, 2010) All these aspects are relevant for the diagnosis of the first phases of cognitive impairments. 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)
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