Application of VR-based Working Memory Screening Test

Study Overview
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Brief Summary
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We propose to validate an interactive, immersive spatial memory test from the laboratory test. This VR-based working memory test (VRWMT) is a first-person, self-pacing game embedded within a virtual reality environment, the program is easily implemented with minimal instructions and no supervision that can be community-users friendly. It is specifically designed to assess rapid spatial working memory - a common deficit in all NCD subtypes. Its ability to detect pathological models of dementia, age-related deterioration, and hippocampal dysfunction are well established in literature

Detailed Description
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The proposed research aims to study the ability of VRWMT to discriminate between older adults with known mild NCD, healthy age-matched older adults and participants with non-communicable diseases and to predict their deterioration in cognitive function over a period of 12 months. Moreover, this study is to characterize and evaluate any concurrent validity between emergence of deterioration in the VRWMT and clinical tools of functional performance in older adults. Additionally, the potential of inflammatory and metabolic dysregulation biomarkers to increase our ability to detect early NCD risk over and above the predictive validity of the VRWMT. The study findings will bring both social and clinical significance to ageing and NCD research. The combination of behavioural and biomarkers of pathological significance offers an innovative approach that potentially addresses the limitations intrinsic to either measure alone.

Official Title
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Application of VR-based Working Memory Screening Test to Facilitate Early Detection of Dementia

Conditions
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Older Adults With Mild Neurocognitive Disorders, Older Adults With Non-communicable Diseases, Healthy Age-matched Older Adults

Intervention / Treatment
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* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: the ability to understand verbal and written Chinese instructions the ability and willingness to provide informed consent and sign the relevant document. Exclusion Criteria: a history of substance abuse including alcohol, drugs, or any medication/substances indicative of chronic abuse; participants with major NCD.

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| older adults with known mild NCD<br>Older adults with known mild neuro-cognitive disorders | Other: no intervention<br>* no interventioni<br>|
| older adults with non-communicable diseases<br>older adults with non-communicable diseases such as diabetics, hypertension and chronic obstructive airway diseases | Other: no intervention<br>* no interventioni<br>|
| Older adults with healthy condition<br>Older adults who are free from neuro-cognitive disorders and non-communicable diseases | Other: no intervention<br>* no interventioni<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delayed matching-to-place (DMP) | a prototypical working memory test implemented in a virtual reality environment of the VRWMT | 20 mins | 
| The Montreal Cognitive Assessment - Hong Kong Version | The MoCA-HK is an examiner-rated cognitive screening test that evaluates visuospatial functions, naming, attention and working memory, language, abstraction, and orientation, commonly affected in NCD including Alzheimer's disease, stroke, and vascular dementia. It is a validated tool for detecting cognitive impairment in Chinese Hong Kong population at early stages. It is a common tool in practical practice that can be under 15 minutes. MoCA scores range from 0 to 30. Subjects with a score of above 21 will be classified as healthy controls, while 21 or below will be included in the mild NCD group in the present study. | 15 mins | 
| The Chinese Multiple Errands Test | A functional performance measure of executive function that identifies abnormalities known for its ecological validity through assessment of real-world daily living activities. The proposed study will evaluate the ability of working memory (as a component to executive function) from VRWMT to predict executive functions (globally) across the six scores obtained from the Chinese Multiple Errands Test | 20 mins | 
| Biological biomarkers for older adults with NCDs and Healthy Control | The panel of biomarkers covers five immune cytokines and two metabolic markers (including serum IL-1B,Interleukin 6, Interleukin 10, Interleukin 33, Tumor Necrosis Factor alpha, Leptin and Glycosylated haemoglobin A1c (HbA1c) | 5 mins | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognitive function screening