AUTHOR=Lewis Morgan McGrath , Waltz Colin , Scelina Kathryn , Scelina Logan , Owen Kelsey , Hastilow Karissa , Miller Koop Mandy , Rosenfeldt Anson B. , Alberts Jay L. TITLE=Older adults exhibit declines in instrumental activities of daily living during a virtual grocery shopping task JOURNAL=Frontiers in Virtual Reality VOLUME=4 YEAR=2023 URL=https://www.frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2023.1261096 DOI=10.3389/frvir.2023.1261096 ISSN=2673-4192 ABSTRACT=

Introduction: The successful performance of instrumental activities of daily living (IADLs) is critical in maintaining independence for older adults. Traditional IADL questionnaires and performance-based assessments are time consuming, potentially unreliable, and fail to adequately consider the interplay between cognitive and motor performance in completing IADLs. The Cleveland Clinic Virtual Reality Shopping (CC-VRS) platform was developed to objectively quantify IADL performance through the characterization of cognitive, motor, and cognitive-motor function. The CC-VRS combines an immersive virtual grocery store with an omnidirectional treadmill to create a scenario in which the user physically navigates through a virtual environment. The primary aim of this project was to determine the known-group validity of the CC-VRS platform to characterize IADL performance in healthy older adults and young adults.

Methods: Twenty healthy young (n = 10) and older (n = 10) adults completed the Basic and Complex CC-VRS scenarios. Position data from VR trackers on the hands, waist, and feet were used to quantify motor performance. Cognitive and dual-task performance were automatically calculated by the application during specific shopping sub-tasks.

Results: Older adults exhibited significantly worse performance on multiple cognitive, motor, and dual-task outcomes of the CC-VRS (e. g., average walking speed, number of list activations, and stopping frequency).

Discussion: The CC-VRS successfully discriminated IADL performance between young and healthy older adults. The complex realistic environment of the CC-VRS, combined with simultaneous evaluation of motor and cognitive performance, has the potential to more accurately characterize IADL performance by identifying subtle functional deficits that may precede neurological disease.