Virtual reality‐based cognitive‐motor training for middle‐aged adults at high Alzheimer's disease risk: A randomized controlled trial

Abstract

IntroductionUbiquity of Alzheimer's disease (AD) coupled with relatively ineffectual pharmacologic treatments has spurred interest in nonpharmacologic lifestyle interventions for prevention or risk reduction. However, evidence of neuroplasticity notwithstanding, there are few scientifically rigorous, ecologically relevant brain training studies focused on building cognitive reserve in middle age to protect against cognitive decline. This pilot study will examine the ability of virtual reality (VR) cognitive training to improve cognition and cerebral blood flow (CBF) in middle-aged individuals at high AD risk due to parental history.MethodsThe design is an assessor-blind, parallel group, randomized controlled trial of VR cognitive-motor training in middle-aged adults with AD family history. The experimental group will be trained with adaptive “real-world” VR tasks targeting sustained and selective attention, working memory, covert rule deduction, and planning, while walking on a treadmill. One active control group will perform the VR tasks without treadmill walking; another will walk on a treadmill while watching scientific documentaries (nonspecific cognitive stimulation). A passive (waitlist) control group will not receive training. Training sessions will be 45 minutes, twice/week for 12 weeks. Primary outcomes are global cognition and CBF (from arterial spin labeling [ASL]) at baseline, immediately after training (training gain), and 3 months post-training (maintenance gain). We aim to recruit 125 participants, including 20 passive controls and 35 in the other groups.DiscussionCurrent pharmacologic therapies are for symptomatic AD patients, whereas nonpharmacologic training is administrable before symptom onset. Emerging evidence suggests that cognitive training improves cognitive function. However, a more ecologically valid cognitive-motor VR setting that better mimics complex daily activities may augment transfer of trained skills. VR training has benefited clinical cohorts, but benefit in asymptomatic high-risk individuals is unknown. If effective, this trial may help define a prophylactic regimen for AD, adaptable for home-based application in high-risk individuals.

Virtual Reality in Non-Communicable diseases

“…Future, progressively controlled investigations should endeavor to unravel which parts of the VR task made it all the more fascinating (e.g., the character's liveliness, the 3D representation, the wide screen, and so forth. ), with the goal that the present outcomes can be repeated in various trainings [1,3]. Strikingly, while investigating the evaluations and time played for emotionless and non-impassive members, results demonstrated that unresponsive members were as intrigued by the two attentional assignments as non-passionless members.…”

“…Notwithstanding a proceeded with absence of codification in the human services framework, 2018 could be an achievement year for 3D printing administrations, pending a fruitful application for a CPT Category III assignment. [1,13] Different choices are accessible for the treatment of mitral valve inadequacy, including reconstructive methodologies, for example, annulus redress through ring inserts. The right decision of general treatment and embed is significant for an ideal result.…”

Measuring the Use of the Active and Assisted Living Prototype CARIMO for Home Care Service Users: Evaluation Framework and Results

“…CARIMO differed from other AAL physical training prototypes for older people in three areas: intention for use, devices used, and the size and duration of the trial. First, a low-threshold exercise program developed for care-dependent people living at home offered a multi-component training program to improve coordination, strength, balance, and endurance [27] rather than training selected parts of the body, such as training using a treadmill [28] or ergometer [29,30]. Second, it applied two commercially available, comparatively low-cost components (with prices expected to fall over time) and thus did not require expensive fitness equipment, sensors, or computing hardware [28][29][30][31].…”

“…First, a low-threshold exercise program developed for care-dependent people living at home offered a multi-component training program to improve coordination, strength, balance, and endurance [27] rather than training selected parts of the body, such as training using a treadmill [28] or ergometer [29,30]. Second, it applied two commercially available, comparatively low-cost components (with prices expected to fall over time) and thus did not require expensive fitness equipment, sensors, or computing hardware [28][29][30][31]. Finally, compared to most of the previous work reporting on short-term tests and small sample sizes [29][30][31], CARIMO was tested in an eight-month field trial with about 100 participants.…”

Virtual reality-based cognitive healthcare interventions: User-centered design considerations, guidelines and framework

“…One example would be the use of odorant delivery devices coordinated with a VR platform for olfactory dysfunction testing, a promising biomarker for detection and diagnosis of preclinical MCI and AD (Lafaille-Magnan et al, 2017;Woodward et al, 2018). Other examples include the combination of VR cognitive interventions to be used concurrently with other types of interventions, such as the preservation of vascular health by VR-driven physical exercise (Doniger et al, 2018). Another possibility is the development of novel mixed modality interventions by integrating into the VR platform any of several existing or emerging minimally invasive neurotechnological procedures, e.g.…”