Recent advances in the quality of Virtual Reality (VR) technology present new and exciting opportunities for its application in healthcare settings. The three-dimensional computer-generated worlds in VR can be navigated using specialised devices such as head-mounted displays and hand-held controllers, providing users with an interactive and immersive experience.
The use of VR has been explored in the assessment, treatment and rehabilitation of cognitive functioning, psychiatric disorders (e.g. anxiety, trauma, psychosis), motor impairments (e.g. gait, balance, fall prevention) and pain management, to name a few. At Changi General Hospital (CGH), our multi-disciplinary team, comprising psychologists, geriatricians, clinical coordinators and a research analyst, is studying the application of VR on the prevention of worsening cognition among older adults.
CGH psychologists (from left: Louisa Tan, Senior Clinical Psychologist; Zaylea Kua, Clinical Psychologist and the study’s Principal Investigator (PI); and Nicole Chen, Clinical Neuropsychologist and Co-PI) work with the Department of Geriatric Medicine, Clinical Trials & Research Unit and Health Services Research on the ongoing study.
"As the Caring General Hospital, we believe in thinking out of the box, scaling up successful pilots, innovating and re-envisioning the role that smart technologies can play to deepen excellence in clinical care. Our pilot study recently received the SingHealth Allied Health Innovation Practice — Ground Up and Emerging Award in recognition of ongoing innovative projects that have the potential to achieve significant impact and outcomes."
Bridging the Deficit
Mild Cognitive Impairment (MCI) is a symptomatic transitional stage between normal ageing and dementia, where individuals display cognitive deficits (e.g. problems in memory, attention, planning, judgement etc.) but are still able to maintain social and functional independence. Given the disability and distress associated with worsening cognition, growing global efforts are being undertaken to prevent or delay the progression of MCI to dementia. Promoting cognitive resilience by means of intellectual stimulation is among the recommended preventive approaches that may help to reduce the risk of dementia.
While cognitive interventions and rehabilitation are utilised in clinical practice, they are mainly targeted at dementia patients with lower cognitive abilities. The same interventions do not seem to benefit patients with MCI as they find the activities too easy, thereby losing motivation and reducing engagement.
Patients look forward to weekly sessions where they experience different scenarios and tasks in the VR environment.
In a bid to address this absence of suitable cognitive activities, our CGH care team adopted a novel intervention approach to meet the cognitive and motivational needs of patients with MCI. Computerised Cognitive Training through VR offers a viable solution as it involves guided repetitive practice of standardised tasks designed to target specific cognitive skills or processes — such as memory encoding, selective attention and inhibitory control — with the aim of improving cognition via strengthening of neural pathways. Preliminary results of the pilot study show promise, garnering positive patient feedback thus far.
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