Using a Virtual Reality Serious Game to Assess the Performance of Older Adults with Frailty

Objectives: The comparison of cognitive performance of older adults with frailty and non-frail ones (according to Fried's criteria) was investigated.

Methods/design: The differences in performance between people with frailty and individuals without frailty according to Fried were tested using a Virtual Reality (VR) application. The Fried criteria for frailty were used to categorize users into study groups, while standardized batteries were used for a Comprehensive Geriatric Assessment, including Activities of Daily Living (ADL), lifestyle, cognition, and depression screening. A group of 80 elders (78.08 years old in average) played the VR game entitled Virtual Supermarket (VSM). From those, 39 were healthy controls and 30 were categorized as pre-frail and 11 as frail. The VSM application presented users with a virtual shopping experience where users had to locate and purchase items displayed in a shopping list. This application was designed to test player's ability to reproduce a typical customer behavior in a simulated environment which requires spatial orientation, short-term memory, selective attention, and cognition speed. The performance, duration, and error rate were used as measurements.

Results: The analysis showed that there was a statistically significant difference in game performance between the different user groups with X² (2) = 9.929, p = 0.007. Moreover, the multinomial logistic regression model generated, which based on game performance metrics, was found to be statistically significant with X² (4) = 15.662, p = 0.004.

Conclusions: Results shed more light toward the possible use of VR for distant self-administered evaluation of the frail status.