There are very few effective interventions that promote functional independence in people with Alzheimer's disease (AD) and related dementias. This R21 project is the first step in our laboratory's long-term goal of developing an effective, enjoyable, portable, and inexpensive non-immersive virtual reality (VR) training intervention for improving the performance of everyday tasks. Our VR training approach is built upon the results of past studies that show 1) when people with AD repeatedly practice daily tasks they subsequently perform them more completely and without error; and 2) healthy people are able to transfer skills learned in VR-contexts to tasks in the real world. This R21 study will obtain preliminary data to inform a future randomized clinical trial through three aims:
Aim 1) To test the hypothesis that individuals with mild- moderate AD will show improved performance on an everyday task after repeatedly practicing the task in a non-immersive VR setting;
Aim 2) To test the hypothesis that participants demonstrate greater benefit from VR training when VR (training) objects are perceptually identical to objects used later in real-life;
and Aim 3) To explore associations between individual differences variables (e.g., cognitive abilities, demographics) and training effects. To test Aim 1, 40 participants with mild to moderate AD will be recruited to complete daily VR Training sessions for one week. VR Training will include repeated practice of a single, everyday task in a non- immersive VR-context (VR Breakfast or VR Lunch; counterbalanced across participants). The primary outcome measure is performance of the real-life version of the trained task, which will be collected before and at two time points after training, compared to performance of an untrained, control task of comparable difficulty, and scored from video by coders blinded to training task/condition. To evaluate Aim 2, participants will be randomly assigned to complete VR training with either VR objects that perceptually match the test objects (e.g., same color, shape, size; Matched Objects, n = 20) or VR objects that are not perceptually similar to the test objects (e.g., different color, shape, size; Different Objects, n = 20). To evaluate Aim 3, all participants and an informant will complete interviews and questionnaires and participants will complete tests of cognitive abilities. Associations between participant variables and VR Training results will be explored. If our hypothesis is supported and results show that training effects generalize from virtual to real tasks in our sample, then VR training of custom and individualized tasks will be investigated in a future randomized, controlled clinical trial for maintaining and improving functional abilities in people with mild to moderate AD.

Public Health Relevance

Functional disability is one of the core diagnostic criteria for clinical dementia/Alzheimer's disease and contributes to the exorbitant cost of care and caregiver burden associated with dementia. Effective interventions that improve everyday function in people with dementia are greatly needed. This project will evaluate the efficacy of low-cost, non-immersive virtual reality training for improving the performance of everyday tasks in people with dementia. !

National Institute of Health (NIH)
National Institute on Aging (NIA)
Exploratory/Developmental Grants (R21)
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Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
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Plude, Dana Jeffrey
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Temple University
Schools of Arts and Sciences
United States
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