OBJECTIVE: Everyday tasks, such as meal preparation and bill paying, require the coordination of multiple cognitive processes and are essential for independent living. In dementia, cognitive impairment disrupts the ability to perform everyday tasks, though subtle difficulties occur prior to the onset of a frank dementia and predict risk of further decline. Current clinical methods of assessing everyday functioning fail to elucidate the reasons people experience mild functional difficulties, but new sensitive and objective measures of mild functional difficulties may advance our understanding of the cognitive mechanisms associated with very early functional decline. In separate paradigms, prior work has identified two markers of mild functional difficulties that distinguish healthy older adults from younger adults: (1) micro errors, inefficient reaching movements (e.g., reaching for but not using a distractor object) and (2) inefficient eye movements during verbal description of common everyday activities (e.g., making coffee). The present study used a novel single, streamlined paradigm that integrates analysis of inefficient eye movements with inefficient reaching to increase sensitivity for early detection and advance our understanding of mild functional difficulties. METHODS: Thirty-four older adults with healthy cognition (n = 28) or mild cognitive impairment (n = 6) completed a novel, non-immersive virtual reality (VR) test involving two everyday tasks (Breakfast and Lunch) during which both eye movements and reaching movements were measured. Participants also completed clinical questionnaires and a performance-based test (with real objects) of everyday functioning as well as cognitive testing. Analyses examined whether eye movements are (1) associated with precision of reaching movements during the VR task (Aim 1); (2) associated with clinical measures of everyday function (Aim 2); and (3) show meaningful patterns across the VR tasks (beginning vs. end; between vs. within subtask) that are differentially associated with cognitive measures (Aim 3).
RESULTS: Within the VR task, participants spent the highest proportion of time viewing objects necessary for completion of the current task step (target objects) compared to distractor objects or objects not needed at the current task step. Relations between efficiency of eye movements and reaching movements during the VR task were not statistically significant (Aim1). Time spent viewing non-target objects in the VR task was moderately correlated with errors on the performance-based test, but not with clinical questionnaires of everyday functioning (Aim 2). Participants spent a greater proportion of time viewing non-target objects at the beginning of the task sequence compared to later in the task sequence, as well as between sub-tasks compared to within sub-tasks, but correlation coefficients between these viewing patterns and cognitive tests failed to reach statistical significance (Aim 3).
CONCLUSIONS: Results provide preliminary evidence that eye movements during execution of a VR task of everyday functioning involving reaching movements may be a reliable and sensitive measure of subtle, real-world functional difficulties. Eye movement patterns suggest premature decay of task goals and interference from competing task goals are mechanisms that may contribute to early functional decline in older adults. Further study is required to demonstrate the utility of eye movements in predicting cognitive and functional decline in older adults. / Psychology
| Identifer | oai:union.ndltd.org:TEMPLE/oai:scholarshare.temple.edu:20.500.12613/9540 |
| Date | 12 1900 |
| Creators | Mis, Rachel Elizabeth |
| Contributors | Giovannetti, Tania, Drabick, Deborah A., Reilly, Jamie, Shipley, Thomas F., Smith, David V., Mechanic-Hamilton, Dawn |
| Publisher | Temple University. Libraries |
| Source Sets | Temple University |
| Language | English |
| Detected Language | English |
| Type | Thesis/Dissertation, Text |
| Format | 89 pages |
| Rights | IN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available., http://rightsstatements.org/vocab/InC/1.0/ |
| Relation | http://dx.doi.org/10.34944/dspace/9502, Theses and Dissertations |
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