Utilization of Immersive Virtual Reality in Cognitive Stimulation Therapy (IVR-CST) for elderly with mild cognitive impairment : a randomized controlled pilot study protocol

Abstract

Objectives: Mild cognitive impairment (MCI) affects about 11.4% of the elderly population in Hong Kong. This study mainly investigates the feasibility and efficacy of immersive virtual reality-based cognitive stimulation therapy (IVR-CST) on MCI, and the use of eye-tracking technology in studying treatment outcome. Hypothesis to be tested: 1) Whether IVR-CST is a feasible intervention for the elderly with MCI. 2) Whether IVR-CST is efficacious (and more efficacious than conventional CST) in improving cognition. 3) Whether changes in eye movements across therapy and treatment outcome are associated. Design and subjects: An open-label, two-armed, assessor-blinded, randomized controlled trial will be conducted. Sixty-six elderly individuals with MCI will be recruited and randomly allocated to either the IVR-CST or the conventional CST group. Their cognition will be measured before and immediately after therapy and 4 weeks post-therapy. Interventions: A 14-session IVR-CST or conventional CST, with content adapted from the Chinese-translated manual of CST, will be carried out twice per week in groups of three to four individuals. Outcome measures and data analysis: The Hong Kong Montreal Cognitive Assessment and measures on executive functions/working memory will serve as primary outcomes. The within-subject (before and after therapy) and between-subject (IVR-CST vs. conventional CST) differences will be examined. Besides, eye movements during therapy in the IVR-CST group will be collected and its correlation with primary outcomes will be studied. Expected results: Positive changes in cognition are expected after therapy in both treatment groups, which may be maintained four weeks post-therapy.