Functional Assessment using a Virtual Environment

 描述（由申请人提供）：这个第一阶段的项目将开发一个基于计算机的工具，用于在虚拟环境（VE）中使用模拟活动对较高水平的工具性日常生活活动（IADL）进行功能评估。IADL是高级活动，如管理财务和复杂的药物治疗方案，并成功地谈判新的或新的情况，这些情况是完全独立生活所必需的，并且可能会受到老年人认知障碍的影响。事实上，能够进行一个人的日常和典型的日常生活能力是成功的老化的必要条件。它通常是确定老年人是否能够独立生活的基础，也是诊断痴呆症的核心标准。然而，IADL的有效和可靠的测量是困难的。许多现有的量表被设计用于已知认知障碍的患者，并专注于对痴呆诊断之前开始的高级行为下降不敏感的基本活动。大多数是基于线人或个人自己对自己能力的评价。这种方法的问题是，出于各种原因，个人和举报人可能高估或低估该人的技能。可能得分的范围也往往是有限的。使用计算机模拟环境的虚拟现实是一个明显的车辆可靠的评估范围内的功能活动。最终目标是使用虚拟环境技术开发一种工具，该工具将准确地测量具有非常轻微功能障碍的老年人在一系列高级功能任务中的表现。拟议的工具，功能评估使用虚拟环境（FAVE），将提供五个环境，在一系列的困难。最受欢迎的任务（电话使用，药物管理，管理财务，家庭活动和使用公共交通工具旅行）已在文献中被确定为对独立生活至关重要且易受轻微损害的活动。在第一阶段，我们将使用任务分析方法为每个场景准备脚本和故事板，将其提交给专家焦点小组进行评论，并在必要时进行修改。两个虚拟环境场景将使用Unity 3D跨平台游戏引擎实现。任务将在基于平板电脑的移动的设备（iPad、Galaxy Tab）上执行。参与者将通过手写笔或手指触摸与平板电脑进行交互，响应时间精确（毫秒）。眼动追踪和面部表情数据将在整个测试过程中收集和分析。完成的方案将由专家焦点小组进行审查，并在10名正常老年人和10名轻度认知障碍患者中进行试点，以确定FAVE检测IADL中细微困难的能力，并确定任何必要的变化。在II期，在最终产品中实施之前将进行任何最终变更，最终产品将在大量受试者中比较FAVE结果与实际性能的广泛研究中进行验证。

 DESCRIPTION (provided by applicant): This phase I project will develop a computer-based tool for the functional assessment of higher level instrumental activities of daily living (IADLs) using simulated activities in a virtual environment (VE). IADLs are the high level activities such as managing finances and complex medication regimens and successfully negotiating novel or new situations that are necessary for fully independent living and which can be compromised by cognitive impairment in older individuals. Indeed, ability to conduct one's usual and typical ADLs is the sine qua non of successful aging. It is frequently the basis for determining whether an older individual is able to live independently and is a core criterion for the diagnosis of dementi. However, valid and reliable measurement of IADLs is difficult. Many existing scales were designed for use with patients with known cognitive impairment and focus on basic activities that are not sensitive to the decline in higher level behaviors that begins well before a dementia diagnosis is made. Most are based on an informant's or the individual's own rating of their abilities. Such an approach has the problem that, for a variety of reasons, individuals and informants may over- or under-rate the person's skills. The range of possible scores is also often limited. Virtual reality using computer simulated environments is an obvious vehicle for the reliable assessment of a range of functional activities. The ultimate goal is to use virtual environment technology to develop a tool that will accurately measure performance across a range of high level functional tasks in older individuals with very mild dysfunction. The proposed tool, Functional Assessment using a Virtual Environment (FAVE), will offer five environments across a range of difficulty. The FAVE tasks (telephone use, medication management, managing finance, household activities and travel using public transportation) have been identified in the literature as activities that are both crucial for independent living and susceptble to subtle impairment. In Phase I, we will use a task analysis approach to prepare scripts and story boards for each scenario, submitting them to a focus group of experts for comments and, if necessary, modification. Two virtual environment scenarios will be implemented using the Unity 3D cross platform game engine. Tasks will be executed on tablet based mobile devices (iPad, Galaxy Tab). The participant will interact with the tablet via a stylus or finger touch with responses accurately time stamped (milliseconds). Eye-tracking and facial expression data will be collected and analyzed during the entire test session. The completed scenarios will be reviewed by expert focus groups and piloted on 10 normal older individuals and 10 persons with mild cognitive impairment to determine the ability of FAVE to detect subtle difficulties in IADLs and identify any necessary changes. In Phase II any final changes would be made before implementation in final product which will be validate in an extensive study comparing FAVE results against actual performance in a large number of subjects.