Functional Living Skills: A Non-Immersive Virtual Reality Training for Individuals with Major Neurocognitive Disorders

The loss of functional living skills (FLS) is an essential feature of major neurocognitive disorders (M-NCD); virtual reality training (VRT) offers many possibilities for improving FLS in people with M-NCD. The aim of our study was to verify the effectiveness of a non-immersive VRT on FLS for patients with M-NCD. VRT was carried out for 10 to 20 sessions, by means of four 3D apps developed in our institute and installed on a large touch screen. The experimental group (EG) and the control group (CG) included 24 and 18 patients with M-NCD, respectively. They were administered the in vivo test (in specific hospital places reproducing the natural environments) at T1 (pre-training) and T3 (post-training); at T2, only EG was administered VRT. Statistically significant differences between EG and CG in all the in vivo tests were found in the number of correct responses; during VRT, the number of correct responses increased, while the execution times and the number of clues decreased. The improvement in the in vivo tests appeared to be related to the specific VRT applied. The satisfaction of participants with the VRT was moderate to high.

Acute Regression in Down Syndrome

Background: Acute regression has been reported in some individuals with Down syndrome (DS), typically occurring between the teenage years and mid to late 20s. Characterized by sudden, and often unexplained, reductions in language skills, functional living skills and reduced psychomotor activity, some individuals have been incorrectly diagnosed with Alzheimer’s disease (AD). Methods: This paper compares five individuals with DS who previously experienced acute regression with a matched group of 15 unaffected individuals with DS using a set of AD biomarkers. Results: While the sample was too small to conduct statistical analyses, findings suggest there are possible meaningful differences between the groups on proteomics biomarkers (e.g., NfL, total tau). Hippocampal, caudate and putamen volumes were slightly larger in the regression group, the opposite of what was hypothesized. A slightly lower amyloid load was found on the PET scans for the regression group, but no differences were noted on tau PET. Conclusions: Some proteomics biomarker findings suggest that individuals with DS who experience acute regression may be at increased risk for AD at an earlier age in comparison to unaffected adults with DS. However, due to the age of the group (mean 38 years), it may be too early to observe meaningful group differences on image-based biomarkers.

A-120 Practice Effects on Repeat Neuropsychological Assessment of Adults with Chronic Severe TBI

Objective This study examined whether practice effects caused by repeated exposure to test materials during serial assessment significantly impacts the performance of adults with chronic severe traumatic brain injury (sTBI), given the severe memory impairment typical of this population. This study sought to describe the pattern of practice effects on repeat neuropsychological testing for this population. It was hypothesized that practice effects would be diminished for individuals with chronic sTBI. Method This study utilized longitudinal archival data collected as part of an annual neuropsychological assessment battery administered to 43 individuals receiving post-acute rehabilitation services at a structured multisite day treatment program. Each participant was tested at two time points which differed by an average of 13 months. The battery consisted of the Texas Functional Living Scale (TFLS), Trail Making Test (TMT), Brief Mood Survey, Neuropsychological Assessment Battery (NAB) Screening Module (NAB-SN), and Judgment subtest from the NAB Executive Functions Module (NAB Judgment). Results Practice effects were determined based on reliable improvement (p < .05) in scores across test administrations. A Reliable Change Index (RCI) was calculated for each test based on the method proposed by Jacobson and Truax (1991). Results revealed reliable improvements in performance for the NAB-SN Attention domain (RCI = 3.69), NAB Judgment subtest (RCI = 10.14), and TFLS Total Score (RCI = 4.38). Conclusion This study indicates that adults with chronic sTBI demonstrate significant practice effects primarily on measures associated with functional living skills. These findings suggest that repeat testing in this population may be less susceptible to the influence of practice effects.