Assessing Everyday Function in Older Adults with the Virtual Kitchen

使用虚拟厨房评估老年人的日常功能

• 批准号: 9884370
• 负责人: Tania Giovannetti
• 金额: $ 36.91万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9884370
• 关键词: Activities of Daily Living; Address; Adult; Age; Aging; Alzheimer' s Disease; Alzheimer' s disease related dementia; Assessment tool; Behavior; Belief; Benchmarking; Characteristics; Clinical; Cognition; Cognitive; Cognitive aging; Computers; Consumption; Data; Dementia; Economics; Education; Educational Background; Elderly; Ethnic Origin; Future; Goals; Guidelines; Impaired cognition; Impairment; Individual; Intervention; Investigation; Longitudinal Studies; Masks; Measurement; Measures; Methods; Nature; Neuropsychology; Output; Participant; Performance; Pharmaceutical Preparations; Population; Property; Psychometrics; Publishing; Questionnaires; Race; Regression Analysis; Reporting; Research; Risk; Sampling; Socioeconomic Status; Standardization; Testing; Time; Validity and Reliability; Woman; aged; base; clinical application; clinical decision-making; cognitive ability; cognitive testing; computer science; demographics; design; disability; expectation; functional status; healthy aging; human old age (65+); individual variation; informant; men; mild cognitive impairment; novel; portability; pre-clinical; recruit; sex; standard measure; tool; touchscreen; virtual; virtual reality

PROJECT SUMMARY/ABSTRACT The goal of this proposal is to develop an objective, standardized, and efficient alternative to current methods of functional assessment for older adults across the spectrum of cognitive aging, from healthy cognition to mild cognitive impairment (MCI), and preclinical and clinical Alzheimer’s disease and Alzheimer’s Disease Related Dementias (AD/ADRD). Mild functional difficulties are a strong predictor of future cognitive decline in healthy older adults and individuals with preclinical AD/ADRD or MCI and may precede impairment on traditional cognitive tests. Functional ability level is a criterion that distinguishes preclinical AD/ADRD and MCI from clinical AD/ADRD, and unlike tests of cognitive abilities, functional status generally is not as strongly influenced by race/ethnicity and socioeconomic status (SES). Consequently, information on functional status is useful for determining the validity of low cognitive test scores in non-majority older adults or older adults with low educational attainment/SES. The current benchmark standard method of functional assessment is informant report, which is subjective in nature, may be biased by cultural beliefs about aging and AD/ADRD, and requires an available and knowledgeable partner. Performance-based assessments offer advantages over informant reports but are time consuming to administer and score. Aim 1 of this proposal will evaluate the validity and reliability of a novel, portable, non-immersive, virtual-reality paradigm, the Virtual Kitchen Challenge (VKC). The VKC requires participants to complete two everyday tasks in a virtual kitchen using a touch-screen interface to select objects and sequence steps. A detailed automated score report reflecting time to completion, task accomplishment and performance efficiency is generated immediately after task completion. 180 individuals aged 65 and older with a range of cognitive abilities (healthy n = 60, MCI n = 60, mild, clinical AD/ADRD n = 60) will be administered the VKC as well as traditional cognitive tests (yielding demographically adjusted scores) and validated performance-based tasks with real objects. Informants also will be asked to complete questionnaires of functional status. We predict that the automated VKC score output will yield valid, reliable, and detailed characterizations of everyday function for participants at all levels of cognitive ability. Aim 2 will test the hypothesis that because of its practical, ecologically valid nature and objectivity, performance-based assessment of functioning (i.e., VKC) will be less influenced by race/ethnicity, education, and SES than standard measures of cognition and informant report of function. However, if our hypothesis is not supported, demographic adjustments for interpreting VKC scores will be identified and applied. This proposal will yield an efficient and sensitive measure of everyday function for diverse older adults that may be used clinically when informants are unavailable or potentially unreliable, and may be scalable for large longitudinal studies of cognitive aging, MCI, and preclinical and clinical AD/ADRD.

项目总结/摘要 该提案的目标是开发一种客观、标准化和有效的替代方法，以替代目前对老年人进行认知老化的功能评估方法，从健康认知到轻度认知障碍（MCI），以及临床前和临床阿尔茨海默病和阿尔茨海默病相关痴呆（AD/ADRD）。轻度功能障碍是健康老年人和临床前AD/ADRD或MCI患者未来认知功能下降的强有力预测因素，可能先于传统认知测试的损害。功能能力水平是区分临床前AD/ADRD和MCI与临床AD/ADRD的标准，与认知能力测试不同，功能状态通常不受种族/民族和社会经济地位（SES）的强烈影响。因此，有关功能状态的信息有助于确定非多数老年人或教育程度低/SES的老年人的低认知测试分数的有效性。目前的基准标准方法的功能评估是线人报告，这是主观的性质，可能会受到偏见的文化信仰有关老化和AD/ADRD，并需要一个可用的和知识渊博的合作伙伴。基于绩效的评估提供了优于线人报告的优势，但管理和评分耗时。本提案的目标1将评估一种新颖的、便携式的、非沉浸式的虚拟现实范例--虚拟厨房挑战赛（VKC）的有效性和可靠性。VKC要求参与者在虚拟厨房中完成两项日常任务，使用触摸屏界面选择对象和顺序步骤。一个详细的自动评分报告，反映完成时间，任务完成和性能效率后，立即生成任务完成。将对180名年龄在65岁及以上、具有一系列认知能力（健康n = 60，MCI n = 60，轻度，临床AD/ADRD n = 60）的个体进行VKC以及传统认知测试（产生人口统计学调整的评分）和使用真实的物体的经验证的基于表现的任务。还将要求举报人填写功能状态问卷。我们预测，自动化的VKC评分输出将为所有认知能力水平的参与者提供有效，可靠和详细的日常功能特征。 目标2将检验这一假设，即由于其实用性、生态有效性和客观性，基于绩效的功能评估（即，VKC）受种族/民族，教育和SES的影响要小于认知的标准测量和功能的线人报告。然而，如果我们的假设不被支持，将确定并应用人口统计学调整来解释VKC评分。该建议将产生一个有效的和敏感的措施，日常功能的不同老年人，可用于临床时，线人不可用或潜在的不可靠，并可能是可扩展的认知老化，MCI，临床前和临床AD/ADRD的大型纵向研究。