VStore: A Novel Virtual Reality Assessment of Functional Cognition

Abstract

Background: Cognitive deficits are present in a number of neuropsychiatric disorders including, Alzheimer’s disease, schizophrenia and depression. Assessments used to measure cognition in these disorders are time-consuming, burdensome, and lack ecological validity. To address these limitations, we developed a novel virtual reality shopping task – VStore. This study aims to establish the validity of VStore compared to the established computerised cognitive battery, Cogstate. Methods:104 healthy volunteers aged 20-79 completed the assessments. Main VStore outcomes included: 1) verbal recall of 12 grocery items, 2) time to collect items, 3) time to select items on a self-checkout machine, 4) time to make the payment, 5) time to order coffee, and 6) total completion time. To establish concurrent validity, bivariate correlations were performed between VStore outcomes and Cogstate tasks measuring attention, processing speed, verbal and visual learning, working memory, executive function, and paired associate learning. Construct validity analysis was also performed to examine which cognitive domains best predicted VStore performance. Finally, two ridge regression models were built using VStore outcomes in the first, and Cogstate outcomes in the second model as predictors of biological age to compare their sensitivity to age-related cognitive decline. Findings: We found moderate correlations between VStore and Cogstate outcomes. VStore Total Time was best explained by tasks measuring working memory and paired associate learning, in addition to age and technological familiarity, accounting for 46% of the variance. Finally, with λ = 5·16, the model fitting selected five parameters for VStore when predicting biological age (MSE = 185·8, SE= 19·34). With λ = 9·49 for Cogstate, the model fitting selected eight tasks (MSE = 226·8, SE = 23·48). Interpretation: These findings suggest that VStore is a promising assessment that engages standard cognitive domains and is sensitive to age-related cognitive decline. Funding Statement: Medical Research Council – Doctoral Training Partnership, King’s College London. Declaration of Interests: LP reports non-financial support from Vitae VR Ltd., during the conduct of the study. Authors SSS and EM created VStore, with contributions from LAP and technical development from VitaeVR Ltd. King’s College London has licensed its rights in VStore to VitaeVR Ltd. Authors LAP, EM, and SSS are entitled to a share of any revenues King’s College London may receive from commercialisation of VStore by VitaeVR Ltd. The other authors have no conflict of interest to declare. Ethics Approval Statement: Ethical approval was granted by the Psychiatry, Nursing and Midwifery Research Ethics Committee, King’s College London (LRS-16/17-4540). Informed consent was obtained.