Exploring Possibilities: Virtual Reality in Nursing Research

This paper describes the use of virtual reality (VR) as a method of measurement in nursing research. VR refers to the use of computerized displays to display a life-like environment in which the user interacts. Although many disciplines are beginning to use VR environments in research, nursing has yet to embrace this technology. Nursing, as a profession which values the interaction between the environment, individual, and health, can benefit from the use of VR in research. Establishing reliability and validity of the VR tool selected for research is important and requires special consideration. VR testing can produce side effects, such as vertigo and discomfort, which must be anticipated in the research protocol

Virtual enactment effect on memory in young and aged populations: a systematic review

Background: Spatial cognition is a critical aspect of episodic memory, as it provides the scaffold for events and enables successful retrieval. Virtual enactment (sensorimotor and cognitive interaction) by means of input devices within virtual environments provides an excellent opportunity to enhance encoding and to support memory retrieval with useful traces in the brain compared to passive observation. Methods: We conducted a systematic review with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines concerning the virtual enactment effect on spatial and episodic memory in young and aged populations. We aim at giving guidelines for virtual enactment studies, especially in the context of aging, where spatial and episodic memory decline. Results: Our findings reveal a positive effect on spatial and episodic memory in the young population and promising outcomes in aging. Several cognitive factors (e.g., executive function, decision-making, and visual components) mediate memory performances. Findings should be taken into account for future interventions in aging. Conclusions: The present review sheds light on the key role of the sensorimotor and cognitive systems for memory rehabilitation by means of a more ecological tool such as virtual reality and stresses the importance of the body for cognition, endorsing the view of an embodied mind

Measurement of allocentric processing in mild cognitive impairment and early Alzheimer’s disease using a virtual reality object location paradigm

Aim: Mild cognitive impairment (MCI) and Alzheimer’s Disease (AD) are major contributors to disability in old age and defined in the early stages by spatial memory deficits associated with hippocampal (HC) and entorhinal (EC) atrophy. Currently diagnosis occurs late in the process which limits efficacy of interventions. This study investigated the neural correlates of a novel object location task (OLT) in immersive virtual reality (iVR). Methods: Twenty amnestic MCI (aMCI) patients and twenty two healthy controls were tested on the iVR OLT, underwent neuropsychological testing and structural MRI scanning. OLT performance and HC, EC subfield volumetric data were compared between groups, and correlational analyses of HC/EC volumes and performance were conducted. Results: Participants with aMCI were significantly impaired in object location recall and object recognition compared to controls. They had significantly smaller total HC, subiculum, CA1, EC and perirhinal volumes. There was a significant interaction of group in analysis of neural correlates: OLT performance was strongly predicted by total HC and subiculum volumes in patients only. EC subfields were not significant predictors of performance. Conclusion: Performance on the novel OLT in immersive VR is a good indicator of HC integrity in older adults with amnestic MCI and can improve the diagnostic process for people with MCI and AD in the future

Predicting real world spatial disorientation in Alzheimer's disease patients using virtual reality navigation tests

Spatial navigation impairments in Alzheimer's disease (AD) have been suggested to underlie patients experiencing spatial disorientation. Though many studies have highlighted navigation impairments for AD patients in virtual reality (VR) environments, the extent to which these impairments predict a patient's risk for spatial disorientation in the real world is still poorly understood. The aims of this study were to (a) investigate the spatial navigation abilities of AD patients in VR environments as well as in a real world community setting and (b) explore whether we could predict patients at a high risk for spatial disorientation in the community based on their VR navigation. Sixteen community-dwelling AD patients and 21 age/gender matched controls were assessed on their egocentric and allocentric navigation abilities in VR environments using the Virtual Supermarket Test (VST) and Sea Hero Quest (SHQ) as well as in the community using the Detour Navigation Test (DNT). When compared to controls, AD patients exhibited impairments on the VST, SHQ, and DNT. For patients, only SHQ wayfinding distance and wayfinding duration significantly predicted composite disorientation score on the DNT (β = 0.422, p = 0.034, R2 = 0.299 and β = 0.357, p = 0.046, R2 = 0.27 respectively). However, these same VR measures could not reliably predict which patients were at highest risk of spatial disorientation in the community (p > 0.1). Future studies should focus on developing VR-based tests which can predict AD patients at high risk of getting spatially disorientated in the real world

Automatic detection of disorientation among people with dementia

Ageing is characterized by decline in cognition including visuospatial function, necessary for independently executing instrumental activities of daily living. The onset of Alzheimer’s disease dementia exacerbates this decline, leading to major challenges for patients and increased burden for caregivers. An important function affected by this decline is spatial orientation. This work provides insight into substrates of real-world wayfinding challenges among older adults, with emphasis on viable features aiding the detection of spatial disorientation and design of possible interventions

Identifying new concepts for innovative lighting-based interventions to influence movement and behaviours in train stations

The disorderly and disrupted movement of passengers within train stations are key concerns in rail transport, especially where there are increasing numbers of passengers, coupled with often out-dated, adapted station spaces. With careful planning and design, different characteristics of lighting can be employed to address problems relating to the movement and behaviour of passengers in railway environments. This study aims to offer an approach to identifying new concepts for lighting-based interventions, to influence passenger movement behaviours within train stations. Behaviourally-orientated lighting literature was reviewed, providing the knowledge base to inform a series of engagement activities with transport stakeholders and lighting technologists, to understand problematic behaviours and how these might be resolved through targeted lighting design. In combining findings from the literature with insights from rail and transport related industry stakeholders and lighting specialists, a number of potential opportunities for novel applications of lighting have been identified. Six scenarios are developed that illustrate these opportunities for potential lighting-based interventions to influence train passenger movement and behaviour. These scenarios can be used to inform the direction of further research and consideration of how different lighting characteristics can affect rail passenger behaviours

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia