Age-related performance in using a fully-immersive and automated virtual reality system to assess cognitive function (Preprint)

2021 ◽  
Author(s):  
Ngiap Chuan Tan ◽  
Jie En Lim ◽  
John Carson Allen Jr ◽  
Wei Teen Wong ◽  
Maksim Lai Wern Shen ◽  
...  
Keyword(s):  
Social Cognition ◽  
Learning And Memory ◽  
Cognitive Assessment ◽  
Completion Time ◽  
Age Groups ◽  
Cognitive Domain ◽  
Performance Indices ◽  
Normal Cognition ◽  
Complex Attention ◽  
Group 1

BACKGROUND Cognition generally declines gradually over time due to progressive degeneration of the brain, leading to dementia and eventual loss of independent functions. Cognition in the six domains (perceptual motor, executive function, complex attention, learning and memory, social cognition and language) varies in their rate of regression. Current modality of cognitive assessment using neuropsychological, questionnaire-based such as the Montreal Cognitive Assessment (MoCA) has its limitations and is influenced by age. Virtual reality (VR) has been introduced as a potential alternative tool to assess cognition. A novel fully immersive automated VR system (CAVIRE) has been developed to assess the six cognitive domains. As cognition is associated with age, VR performance is postulated to vary with age using this system. OBJECTIVE This study aimed to evaluate the VR performance of cognitively healthy adults using the CAVIRE system based on its automated scoring matrix and completion time. METHODS Conducted in a public primary care clinic in Singapore, the study recruited 25 multi-ethnic Asian adults in each of the age groups in years: (1) 35-44; (2) 45-54; (3) 55-64 and (4) 65-74. Their eligibility included a MoCA score of 26 or higher to reflect normal cognition and understanding the automated English instructions in the CAVIRE system. They completed common daily activities from brushing teething to shopping across 13 virtual segments. Their performances were automatically evaluated and computed using cognitive domain score matrix and completion time of the VR tasks. These VR performance indices were compared across the age groups using a one-way ANOVA, F-test of the hypothesis, followed by pair-wise comparisons in the event of a significant F-test (p<0.05). RESULTS One participant dropped out from Group (1). The demographic characteristics of 99 participants were similar across the 4 age groups. Overall, younger participants in Groups (1) and (2) attained higher VR performance scores and shorter completion time using the CAVIRE system, compared to those in Groups (3] and (4) in every cognitive domain (all p<0.05). Significant differences in performance scores are noted in sequential age groups from (1) to (3) in “Executive Functions”; Group (1) and those in Groups (3) and (4) in “perceptual motor; Group (1) and those in Groups (2), (3) and (4) in “complex attention” and “social cognition”; Group (1) and (4) In “learning and memory”; Groups (1) and (2) and those in Groups (3) and (4) in language. Significant differences in completion time are noted between Groups (1) and (3) except for “social cognition”; and between Groups (2) and (3), except for “learning and memory”. CONCLUSIONS The CAVIRE VR performance scores and completion time significantly differ between the younger and older Asian participants with normal cognition. Enhancements to the system are needed to establish the age-group specific normal performance indices.

scholarly journals Comparison of Time Taken to Assess Cognitive Function Using a Fully Immersive and Automated Virtual Reality System vs. the Montreal Cognitive Assessment

2021 ◽  
Vol 13 ◽  
Author(s):  
Wei Teen Wong ◽  
Ngiap Chuan Tan ◽  
Jie En Lim ◽  
John Carson Allen ◽  
Wan Sian Lee ◽  
...  
Keyword(s):  
Primary Care ◽  
Virtual Reality ◽  
Cognitive Function ◽  
Cognitive Assessment ◽  
Completion Time ◽  
Age Groups ◽  
Age Group ◽  
Virtual Reality System ◽  
Cognitive Domains ◽  
Completion Times

Introduction: Dementia is increasingly prevalent globally. Existing questionnaire-based cognitive assessment tools may not comprehensively assess cognitive function and real-time task-performance across all cognitive domains. CAVIRE (Cognitive Assessment by VIrtual REality), a fully immersive virtual reality system incorporating automated audio-visual instructions and a scoring matrix was developed to assess the six cognitive domains, with potential to maintain consistency in execution of the testing environment and possibly time-saving in busy primary care practice.Aims: This is a feasibility study to compare the completion times of the questionnaire-based Montreal Cognitive Assessment (MoCA) and the CAVIRE in cognitively-healthy Asian adults aged between 35 and 74 years, overall, and in and across each 10-year age group (35–44; 45–54; 55–64; 65–74).Methods: A total of 100 participants with a MoCA score of 26 or more were recruited equally into the four 10-year age groups at a primary care clinic in Singapore. Completion time for the MoCA assessment for each participant was recorded. They were assessed using the CAVIRE, comprising 13 segments featuring common everyday activities assessing all six cognitive domains, and the completion time was also recorded through the embedded automated scoring and timing framework.Results: Completion time for CAVIRE as compared to MoCA was significantly (p &lt; 0.01) shorter, overall (mean difference: 74.9 (SD) seconds) and in each age group. Younger, vs. older, participants completed both the MoCA and CAVIRE tasks in a shorter time. There was a greater variability in the completion time for the MoCA, most markedly in the oldest group, whereas completion time was less variable for the CAVIRE tasks in all age groups, with most consistency in the 45–54 year-age group.Conclusion: We demonstrate almost equivalent completion times for a VR and a questionnaire-based cognition assessment, with inter-age group variation in VR completion time synonymous to that in conventional screening methods. The CAVIRE has the potential to be an alternative screening modality for cognition in the primary care setting.

scholarly journals A Fully-Immersive and Automated Virtual Reality System to Assess the Six Domains of Cognition: Protocol for a Feasibility Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie En Lim ◽  
Wei Teen Wong ◽  
Tuan Ann Teh ◽  
Soon Huat Lim ◽  
John Carson Allen ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Cognitive Function ◽  
Activities Of Daily Living ◽  
Feasibility Study ◽  
Cognitive Assessment ◽  
Daily Living ◽  
Age Groups ◽  
Performance Indices ◽  
Cognitive Assessments ◽  
Cognitive Domains

Introduction: Dementia is increasing in prevalence in aging populations. Current questionnaire-based cognitive assessments may not comprehensively assess cognitive function and real-time task-performance. Virtual reality (VR) technology has been used in cognitive assessments but existing systems have limited scope in evaluating all cognitive domains. We have developed a novel, fully-immersive VR system (CAVIRE: Cognitive Assessment by VIrtual REality), which incorporates automated audio-visual instructions. An automated scoring matrix to assess the six cognitive domains—perceptual-motor function, executive function, complex attention, social cognition, learning and memory, and language—is embedded in the CAVIRE system.Aims: The primary aim is to evaluate the feasibility of using the CAVIRE system to assess cognitive function of participants across different age groups from 35 to 84 years old. The secondary aims are to determine the CAVIRE performance-indices (completion time and scores) of the participants and to assess their acceptability toward the use of CAVIRE as a modality for cognitive assessment.Methods: One hundred and seventy-five participants will be assessed by CAVIRE at a primary care clinic in Singapore. They will be first assessed using questionnaires: Montreal Cognitive Assessment (MoCA), Abbreviated Mental Test (AMT), Mini-Mental State Examination (MMSE), Basic Activities of Daily Living (BADLs), Instrumental Activities of Daily Living (IADLs). Those aged 65–84 years will be grouped into cognitively intact (n = 50, MoCA score ≥ 26) and cognitively impaired (n = 50, MoCA &lt; 26). The CAVIRE performance-indices of cognitively healthy younger participants aged 35–64 years (n = 75) will serve as benchmark references. CAVIRE auto-computes the participant's performance-indices in 13 different segments. The tasks include domestic chores, memory, shopping, and social interactions. The proportion of participants who complete the entire VR assessment in each age group will be evaluated as feasibility indicators. The CAVIRE performance-indices will be compared across the different age groups. Feedback on the acceptability of the CAVIRE system will be collated and compared among the participants across the age groups.Significance: CAVIRE is designed to assess the six domains of cognitive function using VR. The results of this feasibility study will provide insights for the implementation of the CAVIRE system as an alternative modality of cognitive assessment in the community.

CLINICAL AND LABORATORY PECULIARITIES OF WHOOPING COUGH IN CHILDREN OF DIFFERENT AGE GROUPS

2020 ◽  
Vol 99 (6) ◽  
pp. 98-104
Author(s):  
I.V. Babachenko ◽  
◽  
Y.V. Nesterova ◽  
N.V. Skripchenko ◽  
◽  
...  
Keyword(s):  
Whooping Cough ◽  
Severe Disease ◽  
Respiratory Rhythm ◽  
Age Groups ◽  
Low Frequency ◽  
Pertussis Infection ◽  
Group 2 ◽  
Sick Children ◽  
Hematological Changes ◽  
Group 1

Objective of the research: to present the clinical and laboratory peculiarities of modern whooping cough in hospitalized children of different ages. Materials and methods: сlinical and laboratory characteristics of whooping cough were analyzed in 88 hospitalized sick children aged 1 month to 18 years in groups of children: group 1 – children under 1 year old; group 2 – children 1–6 years old; group 3 – children 7–17 years old. DNA of causative agents of pertussis infection was isolated by PCR in nasopharyngeal swabs using a commercial kit AmpliSens®Bordetella multi-FL (Moscow). Results: children of group 1 in 90% (n=43) of cases were not vaccinated against whooping cough, severe forms were recorded in 17% (n=8) of children of the 1st year of life, and in 15% (n=7) – due to respiratory rhythm disturbances. The diagnosis was confirmed by PCR in 94% (n=45) of children, leukocytosis with lymphocytosis was detected in 81,5% (n=101). Along with hematological changes typical for whooping cough, 79% (n=38) of patients in the first year of life had thrombocytosis (>400×109/l), which was most pronounced in severe disease course 511,5 [425; 568,5]×109/l vs 421 [347; 505,5]×109/l; p<0,05, which has no tendency to decrease throughout the entire observation period and correlates with the level of leukocytes (rs=0,69; p<0,001). Patients over 7 years old in 88% (n=21) of cases were vaccinated against whooping cough, but 79% (n=27) hemograms had no characteristic changes, which, along with a low frequency of confirmation of the diagnosis by PCR 22% (n=4), made it difficult to diagnose whooping cough. Conclusion: children over 7 years of age may not have characteristic hematological changes and PCR diagnostics are insufficiently effective, which contributes to the spread of whooping cough in family foci.

Validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in the Russian Population

2021 ◽  
pp. 1-8
Author(s):  
Evgeniy Evdoshenko ◽  
Kristina Laskova ◽  
Maria Shumilina ◽  
Ekaterina Nekrashevich ◽  
Maria Andreeva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Assessment ◽  
Verbal Learning ◽  
Cognitive Status ◽  
Russian Population ◽  
Cognitive Domain ◽  
Control Group ◽  
Retest Reliability ◽  
Valid Instrument ◽  
Test Retest Reliability

Abstract Objective: Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. Methods: Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test – Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test–retest reliability. Results: MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test–retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT–II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. Conclusion: This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.

Evaluation of a Telephone Version for the Montreal Cognitive Assessment: Establishing a Cutoff for Normative Data From a Cross-Sectional Study

2021 ◽  
pp. 089198872110026
Author(s):  
Sivan Klil-Drori ◽  
Natalie Phillips ◽  
Alita Fernandez ◽  
Shelley Solomon ◽  
Adi J. Klil-Drori ◽  
...  
Keyword(s):  
Cognitive Assessment ◽  
Cross Sectional Study ◽  
Montreal Cognitive Assessment ◽  
Cutoff Score ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
A Prospective Study ◽  
Sectional Analysis ◽  
State Examination ◽  
Normal Cognition

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P = .003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P < .001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity.

Optimal Propofol Plasma Concentration during Upper Gastrointestinal Endoscopy in Young, Middle-aged, and Elderly Patients

2000 ◽  
Vol 93 (3) ◽  
pp. 662-669 ◽  
Author(s):  
Tomiei Kazama ◽  
Ken Takeuchi ◽  
Kazuyuki Ikeda ◽  
Takehiko Ikeda ◽  
Mutsuhito Kikura ◽  
...  
Keyword(s):  
Plasma Concentrations ◽  
Age Groups ◽  
Young Patients ◽  
Upper Gastrointestinal Endoscopy ◽  
Hemodynamic Responses ◽  
Verbal Command ◽  
Group 3 ◽  
Group 2 ◽  
Somatic Response ◽  
Group 1

Background Suitable propofol plasma concentrations during gastroscopy have not been determined for suppressing somatic and hemodynamic responses in different age groups. Methods Propofol sedation at target plasma concentrations from 0.5 to 4.0 microgram/ml were performed randomly in three groups of patients (23 per group) who were undergoing elective outpatient gastroscopy: ages 17-49 yr (group 1), 50-69 yr (group 2), and 70-89 yr (group 3). Plasma propofol concentration in which 50% of patients do not respond to these different stimuli were determined by logistic regression: verbal command (Cp50ls), somatic response to gastroscopy (Cp50endo), and gag response to gastroscopy (Cp50gag). Hemodynamic responses were also investigated in the different age groups. Results Cp50ls concentrations were 2.23 microgram/ml (group 1), 1.75 microgram/ml (group 2), and 1.40 microgram/ml (group 3). The Cp50endo values in groups 1 and 2 were 2.87 and 2.34 microgram/ml, respectively, which were significantly higher than their respective Cp50ls values. Cp50endo value in group 3 was 1.64 microgram/ml, which was close to its Cp50ls value. Because of a high degree of interpatient variability, Cp50gag could not be defined. Systolic blood pressure response decreased with increasing propofol concentrations. Conclusions The authors determined the propofol concentration necessary for gastroscopy and showed that increasing age reduces it. Propofol concentration that suppresses somatic response induces loss of consciousness in almost all young patients.

scholarly journals Linking Social Cognition to Learning and Memory

2020 ◽  
Vol 40 (46) ◽  
pp. 8782-8798
Author(s):  
Heloise Leblanc ◽  
Steve Ramirez
Keyword(s):  
Social Cognition ◽  
Learning And Memory

scholarly journals THE DYNAMICS OF BLOOD PRESSURE OF DIFFERENT AGE PATIENTS GROUPS WITH HYPERTENSION AND DIABETES TYPE II AFTER CORRECTION OF CAROTID STENOSIS

2019 ◽  
Vol 72 (5) ◽  
pp. 1007-1011
Author(s):  
Igor I. Kobza ◽  
Oksana Z. Didenko ◽  
Ostap G. Yavorskyi ◽  
Тaras I. Kobza
Keyword(s):  
Blood Pressure ◽  
Carotid Stenosis ◽  
Blood Pressure Monitoring ◽  
Age Groups ◽  
Diabetes Type ◽  
Type Ii ◽  
Diabetes Type Ii ◽  
Group 2 ◽  
Two Age Groups ◽  
Group 1

Introduction: hypertension and diabetes remain the main risk factors for stroke, which leads to premature disability and mortality. The aim: To study the dynamics of blood pressure (BP) in patients of different age groups with hypertension and diabetes type II before and after carotid endarterectomy. Materials and methods: 90 patients with hypertension and diabetes type II were selected for CE. Patients are divided into two age groups: up to 65 years (group 1) and after 65 years (group 2). We assessed the dynamics of ambulatory blood pressure monitoring (ABPM). The examination was carried out 2 days before and 6 months after surgery. CE was conducted under local anaesthesia. Results: Before operation in patients in group 2, there was a significantly higher level of average systolic BP per 24 hours (p <0.02), per day (p <0.01), per night (p <0.01) and diastolic BP per night (p <0,01). At the preoperative stage, there was a significant increase in the parameters of the variability of BP, but the increase in the variability of BP with age was not fixed. After surgery, patients with Group 1 observed a more significant positive dynamics of ABPM indices than patients in Group 2. In two age groups, the percentage of patients with an insufficient reduction of BP at night was prevalent. Conclusions: Surgical treatment of carotid stenosis is associated with a steady decrease in BP in the distant period after CE. Significant regression of BP is characteristic for patients of the younger age group.

Assessment of cognitive impairment with the cognitive assessment interview (CAI) was useful for identifying poor psychosocial functioning outcome in patients with psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S106-S107
Author(s):  
A. Sánchez-Torres ◽  
M.R. Elosúa ◽  
R. Lorente-Omeñaca ◽  
L. Moreno-Izco ◽  
V. Peralta ◽  
...  
Keyword(s):  
Social Cognition ◽  
Cognitive Functioning ◽  
Verbal Memory ◽  
Psychosocial Functioning ◽  
Cognitive Assessment ◽  
Daily Functioning ◽  
Everyday Functioning ◽  
Cognitive Domains ◽  
Assessment Interview ◽  
Competing Interest

IntroductionCognitive impairments clearly impact the daily functioning of patients with psychosis.ObjectivesTo assess cross-sectionally whether there are differences in the cognitive domains assessed with the CAI, for considering the real-world functioning of a sample of patients with psychosis.MethodsThe sample consisted of 76 patients with a DSM-IV psychotic disorder. Patients were assessed with the cognitive assessment interview (CAI), which is an interview-based measure of cognitive functioning that is intermediate between cognitive functioning and daily functioning, and three subscales of the specific levels of functioning (SLOF), an informant-rated measure of functioning. The CAI was used to assess the patient and an informant, and these scores were integrated into a rater composite score. We divided the sample by a median-split procedure for each of the three functional domains, and then applied ANOVAs to compare the two groups (impaired/not impaired) in the six cognitive domains of the CAI: working memory, attention, verbal memory, problem solving, processing speed, and social cognition.ResultsWe found significant differences between the impaired vs. non-impaired groups in most of the cognitive domains assessed with the CAI (Fig. 1).ConclusionsInterview-based assessment of cognition with the CAI allows for the prediction of everyday functioning in patients with psychosis. Impairment in almost all CAI cognitive domains, except for social cognition, was associated with poorer psychosocial functioning.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Association between plasma homocysteine levels and cognitive deficits in Han Chinese patients with schizophrenia across age groups

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sumiao Zhou ◽  
Yuanyuan Huang ◽  
Yangdong Feng ◽  
Hehua Li ◽  
Kai Wu ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Function ◽  
Learning And Memory ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Verbal Learning ◽  
Age Groups ◽  
Speed Of Processing ◽  
Function Score ◽  
Cognitive Function Score

AbstractIt was still unclear how homocysteine (Hcy) levels and cognitive deficits change in patients with schizophrenia of various ages. The present article attempts to assess the relationship between Hcy levels and cognitive deficits in patients with schizophrenia across age groups, especially in young people. Totals of 103 patients and 122 healthy controls were included. All participants were stratified into four groups according to their age: 18–29 years, 30–39 years, 40–49 years, and 50–59 years. Clinical data, plasma Hcy levels, and cognitive function score were collected. Cognitive function was evaluated using the MATRICS Consensus Cognitive Battery of tests assessing speed of processing, verbal learning and memory, visual learning and memory, working memory, and attention/vigilance. Compared with the healthy group, Hcy levels increased significantly, and all the measured cognitive function score were significantly lower in all age groups of patients with schizophrenia (p < 0.001). Hcy levels were negatively associated with speed of processing (SoP), working memory (WM), and visual learning and memory (Vis Lrng) score in 18–29 years. Further multiple regression analysis showed that SoP were independently associated with Hcy levels in patients with schizophrenia aged 18–29 years (B = 0.74, t = 3.12, p = 0.008). Based on our results, patients with schizophrenia performed worse on cognitive assessments and Hcy levels were more closely related to cognition in young patients.

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