Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality
Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality
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DOI：
10.1212/01.wnl.0000326262.67613.fe
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发表时间：
2008-09-16
期刊：
影响因子：
9.9
通讯作者：
Duffy, Charles J.
中科院分区：
文献类型：
--
作者：
Cushman, Laura A.;Stein, Karen;Duffy, Charles J.
背景：老年人迷路，在许多情况下是因为公认的或早期的阿尔茨海默病（AD）。无论哪种情况，迷路都可能威胁到个人和公共安全，以及个人自主权和生活质量。在这里，我们比较我们以前描述的真实世界的导航测试与虚拟现实（VR）版本模拟相同的导航environment.Methods：量化现实世界的导航性能是困难和耗时的。VR测试是一种很有前途的替代方案，但它尚未与衰老和AD中密切对应的真实世界测试进行比较。我们在相同的受试者中研究了使用真实世界和虚拟环境的导航：年轻的正常对照组（YNC，n = 35），老年正常对照（ONC，n = 26），轻度认知障碍患者（MCI，n = 12）和早期AD患者（EAD，n = 14）。我们发现，从YNC到ONC，MCI和EAD，真实世界和虚拟导航缺陷之间存在密切相关性。子测试性能的分析显示，在所有四个受试者组中，真实世界和虚拟测试中的损伤情况相似。ONC、MCI和EAD受试者在自我定向和场景定位测试中都表现出最大的困难。MCI和EAD患者也表现出受损的口头回忆两个测试environment.Conclusions：虚拟环境测试提供了一个有效的评估导航技能。衰老和阿尔茨海默病（AD）在关联视觉场景和位置方面具有相同的困难模式，这在AD中由于伴随的口头介导的导航能力的丧失而变得复杂。我们的结论是，虚拟导航测试揭示了衰老和AD的缺陷，这些缺陷与我们的患者和社区的潜在严重风险有关。
Background: Older adults get lost, in many cases because of recognized or incipient Alzheimer disease (AD). In either case, getting lost can be a threat to individual and public safety, as well as to personal autonomy and quality of life. Here we compare our previously described real-world navigation test with a virtual reality (VR) version simulating the same navigational environment.Methods: Quantifying real-world navigational performance is difficult and time-consuming. VR testing is a promising alternative, but it has not been compared with closely corresponding real-world testing in aging and AD. We have studied navigation using both real-world and virtual environments in the same subjects: young normal controls (YNCs, n = 35), older normal controls (ONCs, n = 26), patients with mild cognitive impairment (MCI, n = 12), and patients with early AD (EAD, n = 14).Results: We found close correlations between real-world and virtual navigational deficits that increased across groups from YNC to ONC, to MCI, and to EAD. Analyses of subtest performance showed similar profiles of impairment in real-world and virtual testing in all four subject groups. The ONC, MCI, and EAD subjects all showed greatest difficulty in self-orientation and scene localization tests. MCI and EAD patients also showed impaired verbal recall about both test environments.Conclusions: Virtual environment testing provides a valid assessment of navigational skills. Aging and Alzheimer disease (AD) share the same patterns of difficulty in associating visual scenes and locations, which is complicated in AD by the accompanying loss of verbally mediated navigational capacities. We conclude that virtual navigation testing reveals deficits in aging and AD that are associated with potentially grave risks to our patients and the community.