Does practicing with a virtual reality driving simulator improve spatial cognition in older adults? A pilot study

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Date
2020-08-10
Authors
Masoumzadeh, Sogol
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Abstract

Many older adults experience memory, cognition and executive functioning impairments. A mild decline in cognition could be due to normal aging, while a moderate to advance decline could be due to dementia and in particular its Alzheimer’s disease subtype. One of the cognitive functions being impaired by Alzheimer’s is spatial cognition; an ability to navigate and orient in any new environment. Deficits in one’s spatial cognition have considerable negative impact on one’s quality of life and activities of daily living. Recently, the application of serious games as means for cognitive training to improve the brain’s lost functions has emerged significantly. The design of these serious programs is based on the neuroplasticity of the brain, with the purpose of targeting the brain’s impaired functions and improving them with repeated cognitive training. In this thesis, a driving simulator was designed in an immersive virtual reality environment (VRDS) with different levels of difficulty to be used as a serious game for improving older adults’ spatial cognition. We evaluated the effects of training with the VRDS on 11 volunteers with different cognitive status (range = 19, 21.1±5.9). Participants were trained with the VRDS for two weeks, every day except weekends (10 sessions of practice in total) and for 30 min/day. We used a virtual replica of the standard Morris water test as an independent assessment, to assess the participants’ spatial cognition before and after the two-week training intervention. Furthermore, through defining a spatial learning score, we evaluated the spatial performance of the participants and their progress in the game’s trials. Moreover, we evaluated the participants’ level of depression and their plausible simulation sickness using standard questionnaires at baseline and post-intervention. The results of the Morris water test demonstrated a significant improvement in participants’ spatial cognition; their normalized correct trajectory for finding the target of the test, improved significantly (+44.8%) at post-intervention in comparison to that at baseline. Furthermore, the participants had gradual progress in using higher (more challenging) levels of the game; their spatial learning score increased, with some participants reaching a marked improvement. The participants’ mood also improved after the two-week training program. Moreover, the repeated use of the VRDS, did not have any significant positive or negative effects on the participants’ experience of simulation sickness. Overall, the results hold promise for the designed VRDS as a serious game for mood-lifting and enhancing spatial skills of older adults if it is played regularly.

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Keywords
Serious game, Cognitive training program, Virtual reality, Driving simulator, Spatial cognition, Dementia, Alzheimer's disease
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