Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality

Charles J. Duffy, Laura A. Cushman, Karen Stein

Research output: Contribution to journalArticle

167 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)888-895
Number of pages8
JournalNeurology
Volume71
Issue number12
DOIs
StatePublished - Sep 16 2008

Fingerprint

Alzheimer Disease
Reality Testing
Personal Autonomy
Cognitive Aging
Quality of Life
Safety

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

Duffy, Charles J. ; Cushman, Laura A. ; Stein, Karen. / Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality. In: Neurology. 2008 ; Vol. 71, No. 12. pp. 888-895.
@article{95f39428517c412399b70dea1037ad1d,
title = "Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality",
abstract = "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.",
author = "Duffy, {Charles J.} and Cushman, {Laura A.} and Karen Stein",
year = "2008",
month = "9",
day = "16",
doi = "10.1212/01.wnl.0000326262.67613.fe",
language = "English (US)",
volume = "71",
pages = "888--895",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality. / Duffy, Charles J.; Cushman, Laura A.; Stein, Karen.

In: Neurology, Vol. 71, No. 12, 16.09.2008, p. 888-895.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality

AU - Duffy, Charles J.

AU - Cushman, Laura A.

AU - Stein, Karen

PY - 2008/9/16

Y1 - 2008/9/16

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=54049098494&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=54049098494&partnerID=8YFLogxK

U2 - 10.1212/01.wnl.0000326262.67613.fe

DO - 10.1212/01.wnl.0000326262.67613.fe

M3 - Article

C2 - 18794491

AN - SCOPUS:54049098494

VL - 71

SP - 888

EP - 895

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 12

ER -