Mixed Reality Prototype of Multimodal Screening for Early Detection of Cognitive Impairments in Older Adults: Protocol Development and Usability Study

Monica Christova; Robert Strohmaier; Bianca Fuchs-Neuhold; Bernhard Guggenberger; Brigitte Loder-Fink; Theresa Draxler; Christoph Palli; Helmut Simi; Sandra Schadenbauer; Alexander Nischelwitzer; Gerhard Sprung; René Pilz; Robert Darkow; Wolfgang Staubmann

doi:10.2196/39513

Mixed Reality Prototype of Multimodal Screening for Early Detection of Cognitive Impairments in Older Adults: Protocol Development and Usability Study

JMIR Res Protoc. 2022 Oct 14;11(10):e39513. doi: 10.2196/39513.

Authors

Monica Christova^{1

2}, Robert Strohmaier³, Bianca Fuchs-Neuhold^{4

5}, Bernhard Guggenberger^{1

6}, Brigitte Loder-Fink⁷, Theresa Draxler⁴, Christoph Palli⁸, Helmut Simi⁵, Sandra Schadenbauer³, Alexander Nischelwitzer³, Gerhard Sprung³, René Pilz⁹, Robert Darkow¹⁰, Wolfgang Staubmann⁴

Affiliations

¹ Institute of Physiotherapy, University of Applied Sciences FH JOANNEUM, Graz, Austria.
² Section of Physiology, Otto Loewi Research Center, Medical University of Graz, Graz, Austria.
³ Institute of Business Informatics and Data Science, University of Applied Sciences FH JOANNEUM, Graz, Austria.
⁴ Institute of Dietetics and Nutrition, University of Applied Sciences FH JOANNEUM, Graz, Austria.
⁵ Institute of Health and Tourism Management, University of Applied Sciences FH JOANNEUM, Bad Gleichenberg, Austria.
⁶ Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria.
⁷ Institute of Occupational Therapy, University of Applied Sciences FH JOANNEUM, Graz, Austria.
⁸ Institute of Health Care and Nursing, University of Applied Sciences FH JOANNEUM, Graz, Austria.
⁹ Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
¹⁰ Institute of Logopedics, University of Applied Sciences FH JOANNEUM, Graz, Austria.

PMID: 36239994
PMCID: PMC9617182
DOI: 10.2196/39513

Abstract

Background: The early diagnosis of cognitive impairments is an important step in the adequate management of dementia. The project "Smart Cognition & Behaviour Screening powered by Augmented Reality" (SCOBES-AR) aims to develop a multimodal screening tool (MST) for the early detection of cognitive impairments using augmented and virtual reality. The first project phase selected validated assessments for combination with the MST and tested it in 300 healthy older adults.

Objective: This study established a protocol for the implementation and usability of a mixed reality (MR)-enhanced multidisciplinary screening tool for the early detection of cognitive impairments in older adults. The developed MST will be partially enhanced by MR, which is a combination of augmented reality (AR) and virtual reality (VR). This MR-enhanced prototype of the screening tool (MR-MST) will be tested and compared to the previously developed MST. The usability of the prototype will also be examined.

Methods: This single-center observational crossover design study screens 100 healthy participants (aged 60-75 years) for cognitive decline using a specially developed MST (assessment of cognitive functions, olfactory sensitivity, nutritional preferences, gait parameters, reaction times, and activities of daily living) and an MR-enhanced MST in which the assessments of cognitive functions, reaction time, activities of daily living, and gait will be performed using tailor-made software and AR and VR hardware. The results of the MR-enhanced MST will be compared to those without MR. The usability of the developed MR-enhanced MST will be tested on 10 investigators and 10 test participants using observed summative evaluation and the codiscovery method, and on 2 usability experts using the codiscovery and cognitive walkthrough methods.

Results: This study was funded by the Austrian Research Promotion Agency (grant 866873) and received approval from the ethics committee of the Medical University of Graz. The MR-MST and the experimental protocol for this study were developed. All participants gave written informed consent. As of July 15, 2022, a total of 70 participants have been screened. Data analysis and dissemination are scheduled for completion by September 2023.

Conclusions: The development and testing of the MR-MST is an important step toward the establishment of the best practice procedure for the implementation of AR and VR in the screening of cognitive declines in older adults. It will help improve our knowledge of the usability and applicability of the developed prototype and promote further advancement in AR and VR technologies to be used in therapeutic settings.

International registered report identifier (irrid): DERR1-10.2196/39513.

Keywords: aging; augmented reality; cognitive impairment; dementia; digital health; digital health intervention; elderly; multimodal screening; screening tool; smart cognition; usability; virtual reality.

©Monica Christova, Robert Strohmaier, Bianca Fuchs-Neuhold, Bernhard Guggenberger, Brigitte Loder-Fink, Theresa Draxler, Christoph Palli, Helmut Simi, Sandra Schadenbauer, Alexander Nischelwitzer, Gerhard Sprung, René Pilz, Robert Darkow, Wolfgang Staubmann. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.10.2022.