Application of VR-based Working Memory Screening Test to Facilitate Early Detection of Dementia in Community

Background: Timely detection of the early signs of cognitive deterioration can facilitate access to social support and improve preparation for the future by older adults and their family. This VR-based working memory test (VRWMT) is a translational adaptation of the delayed matching-to-place paradigm developed for rodents in a water-maze. The water-maze task requires the animals to escape from water by climbing onto an escape platform hidden just beneath the surface. Efficient escape depends on memory of the platform location as defined by stable landmarks outside the otherwise uniform maze (extra-maze cues). Method: This is a prospective study designed to provide a stringently controlled, quantitative evaluation of the accuracy, specificity, and sensitivity of the VRWMT, and to determine its suitability as a cost-effective method for screening early neuro-cognitive disorders. This study aims to promote a change in evidence-based practice that will be conducive to timely detection and will create opportunities for early interventions. The VRWMT and cognitive assessment by Montreal Cognitive Assessment - Hong Kong Version (MoCA-HK) will be collected for correlation analyses. Result: A pilot study has been commencing for 20 subjects. Significant correlation noted in functional performance as reflected in VRWMT and MoCA-HK. Age-dependent deterioration was evident in all measures, regardless of whether they were calculated based on time or path length: (i) Trial 1 to 2 improvement or saving; (ii) preference for the target zone in probe test 1, and (iii) preference for the target zone in probe test 1. The association was significant (at p<0.05) for the probe tests but was weaker (at p=0.14) in terms of improvement from Trial 1 to 2. These preliminary data suggest that this behavioral test is sufficient to detect age-related cognitive impairment. Conclusion: Timely detection of the early signs of cognitive deterioration facilitates access to social support and improves preparedness for the future in patients and their families. The availability of such an easily accessible screening tool could become a potential game-changer in the cognitive screening of older adults and in the care provided by their caregivers as well as service providers.