These tests are also dependent on age, language and literacy status of the person. These neuropsychological tests are rigorous and over-emphasize learning and memory dysfunction over other cognitive domains, such as executive function ( Cullen et al., 2007) and perceptual-motor function ( Alegret et al., 2009), which are more evident in early stages of dementia ( Gauthier et al., 2006). Screening tests commonly used in clinical practice include neuropsychological questionnaire-based assessments such as the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) ( Abd Razak et al., 2019). No single cognitive screening tool is universally recommended for use worldwide. Identifying the early stages of cognitive decline remains challenging. Early detection of cognitive impairment becomes imperative to initiate management, and also to prepare caregivers in handling the syndrome. This translates to almost 82,000 people in 2018 and is expected to exceed 187,000 by 2050 ( Alzheimer’s Disease Association Singapore, 2020). According to the Well-being of the Singapore Elderly (WiSE) study ( Subramaniam et al., 2015), one in ten people aged 60 years and above may have dementia.
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Singapore faces increasing prevalence of dementia in an aging population. The number of people with dementia is expected to triple by 2050 ( World Health Organisation, 2020). The World Health Organization projects that 50 million people worldwide live with dementia, with nearly 10 million cases diagnosed each year. The CAVIRE has the potential to be an alternative screening modality for cognition in the primary care setting.ĭementia is a syndrome of one’s cognitive function deterioration, leading to increasing difficulties in coping with everyday activities. There was a greater variability in the completion time for the MoCA, most markedly in the oldest group, whereas completion time was less variable for the CAVIRE tasks in all age groups, with most consistency in the 45–54 year-age group.Ĭonclusion: We demonstrate almost equivalent completion times for a VR and a questionnaire-based cognition assessment, with inter-age group variation in VR completion time synonymous to that in conventional screening methods.
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older, participants completed both the MoCA and CAVIRE tasks in a shorter time. Results: Completion time for CAVIRE as compared to MoCA was significantly ( p < 0.01) shorter, overall (mean difference: 74.9 (SD) seconds) and in each age group. They were assessed using the CAVIRE, comprising 13 segments featuring common everyday activities assessing all six cognitive domains, and the completion time was also recorded through the embedded automated scoring and timing framework. Completion time for the MoCA assessment for each participant was recorded. Methods: A total of 100 participants with a MoCA score of 26 or more were recruited equally into the four 10-year age groups at a primary care clinic in Singapore. CAVIRE (Cognitive Assessment by VIrtual REality), a fully immersive virtual reality system incorporating automated audio-visual instructions and a scoring matrix was developed to assess the six cognitive domains, with potential to maintain consistency in execution of the testing environment and possibly time-saving in busy primary care practice.Īims: This is a feasibility study to compare the completion times of the questionnaire-based Montreal Cognitive Assessment (MoCA) and the CAVIRE in cognitively-healthy Asian adults aged between 35 and 74 years, overall, and in and across each 10-year age group (35–44 45–54 55–64 65–74). Existing questionnaire-based cognitive assessment tools may not comprehensively assess cognitive function and real-time task-performance across all cognitive domains. Introduction: Dementia is increasingly prevalent globally. 8Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.7Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.
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6Technology Development Centre, Institute of Technical Education College West, Singapore, Singapore.5Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore.4Head Office, SingHealth Polyclinics, Singapore, Singapore.3SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.2Duke-NUS Medical School, Singapore, Singapore.1SingHealth Polyclinics-Outram, SingHealth Polyclinics, Singapore, Singapore.5 Wan Sian Lee 1 Joanne Hui Min Quah 2,3,4 Muthulakshmi Paulpandi 4 Tuan Ann Teh 6 Soon Huat Lim 6 Rahul Malhotra 7,8 Wei Teen Wong 1,2,3* Ngiap Chuan Tan 2,3,4 Jie En Lim 2 John Carson Allen Jr.