22nd Alzheimer Europe Conference“Changing perceptions, practice and policy”Vienna (4-6 October 2012)
Assistive Technology (AT) is a broad term covering a widerange of technology solutionsfrom simple low technologyto more complicated applications
Defining Technologies in DementiaCategorizing TechnologiesThe Person and the Dementia JourneyTechnology can be helpful on an individual basis at specific needsRememberingEatingTaking a walkSpeakingWalkingCommunicatingAvoiding accidents (for example cut off the electricity supply)
Virtual environments (VE) have been developed since 1996 (Hodges et al., 1996), and now demonstrate effectiveness in the areas of clinical psychology and neuropsychology.
VRComputer simulations that create perceivable information for humansenses, such asvisual andaudio stimuli,and that maintain known aspects of the real world, such as space andtime
Virtual model: thanks to its dynamism, it allows thevalidating of hypotheses:1.architectural solutions2.reconstruction of fragmented objects3.transformation of an element over time, etc..
In the specific area of museums there are great advantages.
Figure 1. Stills from the virtual museum route showing a toy placed at a non-decision point (A) and a non-toy at a decision point (B), and schematic overview of the recognition trials (C). Kessels RPC, van Doormaal A, Janzen G (2011) Landmark Recognition in Alzheimer’s Dementia: Spared Implicit Memory for Objects Relevant for Navigation. PLoS ONE 6(4): e18611. doi:10.1371/journal.pone.0018611 http://www.plosone.org/article/info:doi/10.1371/journal.pone.0018611
VR has the opportunity to provide new approaches to thetreatment of memory deficits among elders (Optale et al.,2009).
The virtual reality museum is designed tospeed up auditory processing,improve working memory,improve the accuracy and the speed with which the brainprocesses cognitive information and reengage theneuromodulatory systems that gate learning and memory.
LiteratureWerner et al., (2009) Use of the Virtual Action Planning Supermarket for the Diagnosis of Mild Cognitive ImpairmentKlinger, Chemin, Lebreton and A Virtual Supermarket to Assess Cognitive PlanningMarié (2004)Josman, Klinger and Kizony Performance within the virtual action planning supermarket(2008) (VAP-S): an executive function profile of three different populations suffering from deficits in the central nervous systemGadler, Grassi, Rive (2009) A Rehabilitation Protocol for Empowering Spatial Orientation in MCI. A Pilot StudyMan, Chung, Lee (2012) Evaluation of a virtual reality-based memory training programme for Hong Kong Chinese older adults with q uestionable dementia: a pilot studyFranco-Martín, Palau, Usability of a cognitive (Gradior) and physical trainingRuiz,Vargas, Solis, Mellado, program based in new software technologies in patients withToribio, Losada, Gómez, Bueno, mild dementia, mild cognitive impairment and healthyBartolomé (2011) elderly people: Long Lasting Memories preliminary findings
In our study, the virtualreality museum wasdesigned to1.enhance auditoryprocessing, (ERPs P300)2.working memory, (Digitspan)3.improve speed ofinformation processing(Trail B, Stroop EffectTest)4.Improve visuospatialability (Rey Figure)
To reverse cognitive disuse and drive brain plasticity, theprogram strongly engages the brain withdemanding exercises andan adaptive and reward-based daily training schedule.
We embrace the philosophy of ecological thinking for theVirtual reality applications, interpreting virtual worlds suchecosystems.
Participants:30 patients with amnestic Mild Cognitive Impairment (aMCI) (experimental group) and30 control group with aMCIAge: 65-80Duration: 2010-2012.The experimental group attended the “vrmuseum” program.The control group had been placed on a waiting list.
Non parametric sampleStatistical analyses were carried out using x2 and Mann-Whitney methods.To evaluate auditory processing, working memory, speed of informationprocessing and visuospatial ability we used: ERPs, MMSE, Trail MakingB, FRSSD, Digit Span, Stroop test and Rey-Osterrieth complex figure.
Cognitive exercises are divided into three interrelatedcategories, that, in aggregate, span the cognitive functions ofseniors :• Listen & Plan:• Storyteller:• Exer-gaming:
Intent-to-treat analyses, controlling for age, education, andcluster randomization were adopted.There was a significant improvement of visuospatial memoryperformance (p= .042 immediate recall and p = .036 laterrecall),ERPsThere have not been observed any changes in general mentaland functional performance between the two groups.
Improvement in trained tasks: Spatial syllable Speed of Visuospatial Working match memory Processing memory memory Persons with 93% 77% 91% 80% improvements Average 41% 10% 18% 13% improvement Generalization: Improvement in global auditory memory in the experimental group Stability: Effect stable also at 3 months follow-up
In conclusion, aMCI patients who participated in theVrmuseum program outperformed the control groupregarding visuospatial memory, suggesting that the presentform of virtual reality training improves neuropsychologicalperformance selectively on task related abilities.Reported pre-post training effect sizes for intervention groupsranged from 0.19 to 7.14 for the total of 16 session Vmuseuminterventions.
Overall, computerized training findings are comparable orbetter than those from reviews of more traditional, paper-and-pencil cognitive training approaches, suggesting that consistan effective and less labor intensive alternative.Main et al., 2004
Age-related cognitive decline can be through the selection ofproper cognitive intervention programs.However, most existing softwares fail to demonstratesignificant transfer of learning from the trained tasks toeveryday activities.
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