With a huge number of 70,000 New Zealanders with dementia (and growing), and also 4 out 5 of people being aware of someone they know being affected by dementia, it is a obviously an important healthcare issue to focus on for New Zealand (Alzheimers New Zealand, 2022). 

The tools that are used in VR can rehabilitate and help sufferers and their caregivers in a safe and comfortable environment. VR also gives caregivers and families the opportunity to be’ confronted’ with what a dementia patient is going through, which is useful for empathy and understanding from the families that are supporting their family members going through dementia. 

 

•            Gaming technologies – gaming technologies can be very realistic and help the patient with connection and see the world, without leaving their house

 

·       Communication devices – such as Talking Mat, let people with dementia have an app and select a feeling picture/ emotion to communicate how they feel (Bushak, 2019)

 

Patients getting a diagnosis of dementia should not mean their independence is gone or the choice to live in their own homes is gone (Alzheimer's Society, 2022). Therefore, technology tools and innovations are extremely valuable, that can help patients with dementia have their independence, and be supported and as comfortable as possible in their homes and lives.

 

Alzheimers Society. (2022). 5-tech-innovations-for-people-living-home-dementia. Retrieved from Alzheimers Society: https://www.alzheimers.org.uk/blog/5-tech-innovations-for-people-living-home-dementia

Bushak, L. (2019). Dementia Virtual Reality. Retrieved from Being Patient: https://www.beingpatient.com/dementia-virtual-reality/

Henderson, E. (2022). Artificial-intelligence-could-help-fast-track-dementia-diagnosi. Retrieved from News Medical News: https://www.news-medical.net/news/20220921/Artificial-intelligence-could-help-fast-track-dementia-diagnosis.aspx

Sauerr, A. (2019). Alzheimers. Retrieved from 7 Technologies for Alzheimers: https://www.alzheimers.net/9-22-14-technology-for-dementia#:~:text=10%20Technological%20Innovations%20for%20Caregivers%20and%20Those%20Living,...%208%208.%20Medication%20management.%20...%20More%20items

 

 

 

 

 

Through my research about VR and dementia, I found that there was a game created to help researchers find out more about dementia working towards a potential cure. Although it is still in the research and development stage, working towards the greater good always proves to be advantageous, especially for those members who live with whānau with dementia. 

In conclusion having a better understanding of dementia enables us to work as a community to better care for out whānau with dementia. 

“Recent studies have shown that Alzheimer’s disease begins to develop long before any symptoms become noticeable, but it’s very difficult to detect such changes,” said co-first author Andrea Castegnaro, PhD student in UCL Institute of Cognitive Neuroscience and UCL Electronic & Electrical Engineering.

“Virtual reality tests could be a valuable way to identify Alzheimer’s early on, and provides a powerful tool for investigating cognition,” said Professor Neil Burgess, Director of the UCL Institute of Cognitive Neuroscience.

In 2014, Professor John O’Keefe (UCL Cell & Developmental Biology, Director of the Sainsbury Wellcome Centre) was jointly awarded the Nobel Prize in Physiology or Medicine for ‘discoveries of cells that constitute a positioning system in the brain’. Essentially, this means that the brain contains a mental ‘satnav’ of where we are, where we have been, and how to find our way around.

A key component of this internal satnav is a region of the brain known as the entorhinal cortex. This is one of the first regions to be damaged in Alzheimer’s disease, which may explain why ‘getting lost’ is one of the first symptoms of the disease. However, the pen-and-paper cognitive tests used in clinic to diagnose the condition are unable to test for navigation difficulties.

A team of researchers at UCL and Cambridge have now developed and trialled a VR navigation test in patients at risk of developing dementia.

In the test, a patient dons a VR headset and undertakes a test of navigation while walking within a simulated environment. Successful completion of the task requires intact functioning of the entorhinal cortex, so the team hypothesised that patients with early Alzheimer’s disease would be disproportionately affected on the test.

The team recruited 45 patients with mild cognitive impairment (MCI) from the Cambridge University Hospitals NHS Trust Mild Cognitive Impairment and Memory Clinics. Patients with MCI typically exhibit memory impairment, but while MCI can indicate early Alzheimer’s, it can also be caused by other conditions such as anxiety and even normal aging. As such, establishing the cause of MCI is crucial for determining whether affected individuals are at risk of developing dementia in the future.  

The researchers took samples of cerebrospinal fluid (CSF) to look for biomarkers of underlying Alzheimer’s disease in their MCI patients, with 12 testing positive. The researchers also recruited 41 age-matched healthy controls for comparison.

All of the patients with MCI performed worse on the navigation task than the healthy controls. However, the study yielded two crucial additional observations. First, MCI patients with positive CSF markers – indicating the presence of Alzheimer’s disease, thus placing them at risk of developing dementia – performed worse than those with negative CSF markers at low risk of future dementia.

Secondly, the VR navigation task was better at differentiating between these low and high risk MCI patients than a battery of currently-used tests considered to be gold standard for the diagnosis of early Alzheimer’s.

“These results suggest a VR test of navigation may be better at identifying early Alzheimer’s disease than tests we use at present in clinic and in research studies,” said the study’s lead author Dr Dennis Chan (University of Cambridge), who previously completely a PhD in Professor O’Keefe’s lab.

VR could also help clinical trials of future drugs aimed at slowing down, or even halting, progression of Alzheimer’s disease. Lack of comparability of memory tests between animal models and human participants represents a major problem for current clinical trials.

“The brain cells underpinning navigation are similar in rodents and humans, so testing navigation may allow us to overcome this roadblock in Alzheimer’s drug trials and help translate basic science discoveries into clinical use,” said Dr Chan.

The VR research was funded by the Medical Research Council and the Cambridge NIHR Biomedical Research Centre. The app-based research is funded by the Wellcome, the European Research Council and the Alan Turing Institute.

The study also involved researchers in UCL Psychology & Language Sciences and the UCL Institute of Communications and Connected Systems

Some apps have also been developed to support care partners developed Story-Call, a multimedia app for mobile devices that provides support for care partners of people with dementia.

AR apps aid people who have dementia with routine tasks that a care partner might normally do. Existing apps for this purpose are either aimed at accomplishing one particular task or lack flexibility. These are two ideas that assist a person with dementia with completing a specific task and one idea for completing tasks in general.

The cARe [app is intended to assist people who have dementia with tasks around the house, such as cooking. The app was specifically designed to allow care partners to customize the cooking instructions in the form of text and images without any programming knowledge. The user can customize the location where the instructions appear in the world. However, the customization process was not as refined as a care partner may require. The customization process involved using a GUI that exported an XML file with instructions and images, which then had to be copied to the HoloLens. The cARe app has arrows that direct the person to where they should be looking. Drawing constant attention to where the user should be looking or having content follow them is valuable, because people with dementia tend to forget what they were doing and look away. According to the creators of the cARe app, a problem resulted from the presentation of the step-by-step instructions that have to be followed, which required manual input to move to the next or previous step. As found in this study, sometimes the users became confused if they skipped a step or went back to a previous step. It may be that following these steps is too mentally demanding for someone who has dementia. Thus, it may be preferable to have audio or video instructions recorded by their care partners to guide them in using the app.

Another developed AR app called the Therapy Lens, which displays holograms to guide people with Alzheimer's through the process of making tea. The researchers observed no statistically noticeable difference between making tea with normal instructions and making tea with HoloLens’ AR instructions. Nonetheless, some people struggled with using the device, depending on the current severity of the disease. People who have had the disease longer and were in worse condition, made approximately the same number of errors with or without using the HoloLens app. Therefore, it is preferable if the person with dementia does not have to interact with the device. Additionally, the researchers found that most people could use the voice commands to go to the next step, but some people found the process confusing and wanted more information. The big clear text and soothing voice were highly appreciated by the participants because of their vision or hearing problems. However, the researchers also mentioned that allowing more personalization options for the individual might reduce information overload from hologram visuals, text, and audio. Clear text, soothing voice, and detailed personalization are desirable for any apps for people with dementia.

The KLCLL app, is intended for patients and their care partners. The location and orientation of the patient will be tracked, and when the patient looks at an object or image, a reminder will be displayed along with GPS location information. If an object is in view of the camera, the app could display a customized textual and audio reminder. If a question is asked, the app could also respond with a textual and audio answer. It is unclear whether the audio responses were pre-recorded or were generated using an automated text-to-speech process. The KLCLL app showed the value of customized reminders and relative positioning of displayed content for people with dementia.

References:

Alzheimer's Association 2020. Alzheimer's Disease Facts and Figures. Alzheimer's Association, Chicago. 

Alzheimer's Association 2020. Dementia vs. Alzheimer's Disease: What is the Difference?Alzheimer's Association. https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s. 

B. Aruanno, F. Garzotto, and M.C. Rodriguez. 2017. HoloLens-based Mixed Reality Experiences for Subjects with Alzheimer's Disease. In 12th Biannual Conference on Italian SIGCHI Chapter (Cagilari). Association for Computing Machinery, New York, 15:1–9. 

C. Boletsis and S. McCallum. 2016. Augmented Reality Cubes for Cognitive Gaming: Preliminary Usability and Game Experience Testing. International Journal of Serious Games 3, 1 (2016), 3–18. 

B Davis, M Nies, M Shehab, D Shenk, and P Alfonzo. 2014. Developing a pilot e-mobile app for dementia caregiver support: Lessons learned. Online Journal of Nursing Informatics (OJNI) 18, 1 (2014).