Telerehabilitation Combining Virtual Reality Adaptable Games and Drug Therapy for Early Alzheimer's Disease

PROJECT SUMMARY Objectives: The first objective is to develop a computer-based cognitive training system for individuals in the early stages of Alzheimer?s Disease. The product, a home-based custom Virtual Reality (VR) system will be developed, targeting cognitive domains (processing speed, executive functions, attention, language, memory) as well as depression. The system will incorporate a novel low-cost biosensor device. Usability and feasibility studies of the product will determine technology ease of use, acceptance and clinical benefit. Specific Aims: 1) Development, validation and usability evaluation of an integrative therapy system; 2) RCT Feasibility study on individuals with cognitive impairments due to Alzheimer?s Disease, who may also be depressed. Methods: 1) Develop a system to detect cognitive load variation during computer interaction; 2) Develop VR-based therapeutic games with focus on cognitive intervention; 3) Develop communication software to allow remote management of the game system with training data transfer; 4) Conduct validation on n=2, and a usability study n=4 (2 healthy and 2 with AD); 5) Conduct an RCT feasibility trial with cross-over design, n=28 participants with AD and their 28 caregivers. Participants will be randomized equally into experimental and wait-list controls. Caregivers will log training issues and perceived value of training; 6) Sample standardized outcome measures at baseline, mod- and post-therapy. 7) Analyze adherence to protocol and outcome data using descriptive and multivariate regression analysis to determine cognitive benefits and group changes, when combined with customary care. NIH Relevance: Current medication treatments for cognitive impairments subsequent to AD benefit from addition of physical exercise. The proposed home-based cognitive intervention is an innovative approach, provided in the convenience of home. This increases access to care with less caregiver burden.