A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> Augmented reality (AR) refers to the introduction of virtual elements in the real world. That is, the person is seeing an image composed of a visualization of the real world, and a series of virtual elements that, at that same moment, are super-imposed on the real world. The most important aspect of AR is that the virtual elements supply to the person relevant and useful information that is not contained in the real world. AR has notable potential, and has already been used in diverse fields, such as medicine, the army, coaching, engineering, design, and robotics. Until now, AR has never been used in the scope of psychological treatment. Nevertheless, AR presents various advantages. Just like in the classical systems of virtual reality, it is possible to have total control over the virtual elements that are super-imposed on the real world, and how one interacts with those elements. AR could involve additional advantages; on one side it could be less expensive since it also uses the real world (this does not need to be modeled), and it could facilitate the feeling of presence (the sensation of being there), and reality judgment (the fact of judging the experience as real) of the person since the environment he or she is in, and what he or she is seeing is, in fact the "reality." In this paper, we present the data of the first case study in which AR has been used for the treatment of a specific phobia, cockroaches phobia. It addresses a system of AR that permits exposure to virtual cockroaches super-imposed on the real world. In order to carry out the exposure, the guidelines of Ost with respect to "one-session treatment" were followed. The results are promising. The participant demonstrated notable fear and avoidance in the behavioral avoidance test before the treatment, and not only was an important decrease in the scores of fear and avoidance observed after the treatment, but also the participant was capable of approaching, interacting, and killing live cockroaches immediately following the treatment. The results are maintained in a follow-up conducted 1 month after the termination of the treatment. <s> BIB001 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> Electronic games have been used to stimulate cognitive functions such as attention, concentration and memory. This paper presents GenVirtual, which is an augmented reality musical game and is proposed to help people with learning disabilities. The intention is to help the patient in the following skills: creativity, attention, memory (storage and retrieval), planning, concentration, ready-response, hearing and visual perception, and motor coordination. The therapist has flexibility to place the musical and visual elements, allowing him to create different scenarios to each patient. GenVirtual uses Augmented Reality technology to allow people with physical disorders to interact with the game. Patients with no fingers can also play this game. GenVirtual was evaluated by a music therapist who considered it as a facilitating and motivating game to the learning process and that it has the potential to improve the life of the people with special needs. <s> BIB002 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> Autobiographical memory comprises memories of one's own past that are characterized by a sense of subjective time and autonoetic awareness. Although autobiographical memory deficits are among the major complaints of patients with dementia, they have rarely been systematically assessed in mild cognitive impairment and Alzheimer's disease. We therefore investigated semantic and episodic aspects of autobiographical memory for remote and recent life periods in a sample of 239 nursing home residents (165 in different stages of Alzheimer's disease, 33 with mild cognitive impairment, and 41 cognitively unimpaired) with respect to potential confounders. Episodic autobiographical memories, especially the richness of details, were impaired early in the course of Alzheimer's disease or even in the preclinical phase, while semantic memories were spared until moderate stages, indicating a dissociation between both memory systems. The examination of autobiographic memory loss can facilitate the clinical diagnosis of Alzheimer's disease. <s> BIB003 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> Persons with Alzheimer's disease (AD) and their caregivers implement diverse strategies to cope with memory loss. A common strategy involves placing tags on drawers or removing cabinet doors to make their contents visible. This study describes the Ambient aNnotation System (ANS), aimed at assisting people suffering from AD and their caregivers with this task. The system has two main modules: The tagging subsystem allows caregivers to create and manage ambient annotations in order to assist people with memory problems. The second subsystem allows people with AD to use a mobile phone to recognize tags in the environment and to receive relevant information in the form of audio, text, or images. The identification of these tags is performed in real time by uploading images from the mobile phone to a server, which uses the SURF algorithm for object recognition. We describe the design and implementation of the system as well as results of the evaluation of its performance and efficiency. ANS can process query images approximately every 2 s and is able to locate users in their homes with a precision of 0.93. A usability study conducted with six subjects determined that audio notifications are more effective than vibrating notifications to alert the user about tags in the environment. <s> BIB004 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> This paper reviews the move from virtual reality exposure-based therapy (VRET) to augmented reality exposure-based therapy (ARET). Unlike virtual reality (VR), which entails a complete virtual environment (VE), augmented reality (AR) limits itself to producing certain virtual elements to then merge them into the view of the physical world. Although the general public may only have become aware of AR in the last few years, AR type applications have been around since beginning of the 20th century. Since, then, technological developments have enabled an ever increasing level of seamless integration of virtual and physical elements into one view. Like VR, AR allows the exposure to stimuli which, due to various reasons, may not be suitable for real-life scenarios. As such, AR has proven itself to be a medium through which individuals suffering from specific phobia can be exposed “safely” to the object(s) of their fear, without the costs associated with programming complete virtual environments. Thus, ARET can offer an efficacious alternative to some less advantageous exposure-based therapies. Above and beyond presenting what has been accomplished in ARET, this paper also raises some ARET related issues, and proposes potential avenues to be followed. These include the definition of an AR related term, the type of measures to be used to qualify the user’s experience in an augmented reality environment (ARE), the development of alternative geospatial referencing systems, as well as the potential use of ARET to treat social phobia. Overall, it may be said that the use of ARET, although promising, is still in its infancy but that, given a continued cooperation between clinical and technical teams, ARET has the potential of going well beyond the treatment of small animal phobia. <s> BIB005 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> This study presents Catch Me game, a therapeutic game for teaching patients how to confront to their feared animals during spider and cockroach phobia treatment, and evaluates whether inclusion of gaming elements into therapeutic protocol does have an added value for the treatment. The Catch Me game was designed in order to help patients learn about their feared animals and to learn how to apply adapted confrontation strategies and techniques with the lowest possible anxiety level. In this study, Catch Me game was evaluated in terms of knowledge acquisition, anxiety level, self-efficacy belief acquisition, and appeal to both participants and therapists. Data collection consisted of quantitative measures on a sample of 14 non-clinical population. The results showed that the game significantly improved knowledge and self-efficacy belief regarding the feared animal, and significantly decreased the anxiety level of participants. Moreover, both participants and the therapists were highly satisfied with the game. <s> BIB006 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> There is the potential that cognitive activity may delay cognitive decline in people with mild cognitive impairment. Games provide both cognitive challenge and motivation for repeated use, a prerequisite for long lasting effect. Recent advances in technology introduce several new interaction methods, potentially leading to more efficient, personalized cognitive gaming experiences. In this paper, we present an Augmented Reality (AR) cognitive training game, utilizing cubes as input tools, and we test the cube interaction with a pilot study. The results of the study revealed the marker occlusion problem, and that novice AR users can adjust to the developed AR environment after a small number of sessions. <s> BIB007 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Interaction Techniques <s> Background: Virtual reality (VR) opens up a vast number of possibilities in many domains of therapy. The primary objective of the present study was to evaluate the acceptability for elderly subjects of a VR experience using the image-based rendering virtual environment (IBVE) approach and secondly to test the hypothesis that visual cues using VR may enhance the generation of autobiographical memories. ::: Methods: Eighteen healthy volunteers (mean age 68.2 years) presenting memory complaints with a Mini-Mental State Examination score higher than 27 and no history of neuropsychiatric disease were included. Participants were asked to perform an autobiographical fluency task in four conditions. The first condition was a baseline grey screen, the second was a photograph of a well-known location in the participant’s home city (FamPhoto), and the last two conditions displayed VR, ie, a familiar image-based virtual environment (FamIBVE) consisting of an image-based representation of a known landmark square in the center of the city of experimentation (Nice) and an unknown image-based virtual environment (UnknoIBVE), which was captured in a public housing neighborhood containing unrecognizable building fronts. After each of the four experimental conditions, participants filled in self-report questionnaires to assess the task acceptability (levels of emotion, motivation, security, fatigue, and familiarity). CyberSickness and Presence questionnaires were also assessed after the two VR conditions. Autobiographical memory was assessed using a verbal fluency task and quality of the recollection was assessed using the “remember/know” procedure. ::: Results: All subjects completed the experiment. Sense of security and fatigue were not significantly different between the conditions with and without VR. The FamPhoto condition yielded a higher emotion score than the other conditions (P,0.05). The CyberSickness questionnaire showed that participants did not experience sickness during the experiment across the VR conditions. VR stimulates autobiographical memory, as demonstrated by the increased total number of responses on the autobiographical fluency task and the increased number of conscious recollections of memories for familiar versus unknown scenes (P,0.01). ::: Conclusion: The study indicates that VR using the FamIBVE system is well tolerated by the elderly. VR can also stimulate recollections of autobiographical memory and convey familiarity of a given scene, which is an essential requirement for use of VR during reminiscence therapy. <s> BIB008
User interaction with VEs and scenarios might involve several methodological modalities. It could consist of playing serious games or performing different tasks or activities (e.g., IADL). Here, we refer to "tasks" and "activities" in reference to VR systems for AD, the term "task" specifically means a particular action that is intended, designed, and established to improve a specific cognitive function, while "activities" involve performing high-level sustained cognitive actions and processes such as: eating, bathing, dressing, shopping, etc. Furthermore, the term "game" refers to activities that are defined by rules and any type of user engagement. Most current VR systems for assessment and diagnosis of AD are based on performing tasks, such as navigation or memorization. Moreover, current VR systems for cognitive training concentrate on performing activities that are related to IADL, such as: cooking, driving, shopping, etc. It has been recently demonstrated that the use of a familiar image-based VE can stimulate recollections of autobiographical memory in healthy elderly subjects BIB008 . The fact that episodic autobiographical memory is impaired in early stages of AD BIB003 , suggests that using such type of VR systems may be helpful for reminiscence rehabilitation of AD patients. Table 1 classifies the reviewed VR systems in terms of the methodology utilized for user interaction. Recent progress in augmented reality (AR) indicates that this technology will probably become another useful ICT tool for AD. This form of mixed reality enhances a non-synthetic real environment by superimposing some synthetic elements into the users' perception of that reality BIB005 . In contrast to VR system users, who are exposed to VEs (immersive or not), users of AR applications face real physical locations, upon which AR systems introduce additional virtual elements. Some AR applications have been developed in recent years for medically related purposes, such as phobia therapy BIB001 BIB006 , and for assessment and treatment of psychological disorders  . A few researchers have conducted appraisals of AR applications for cognitive training and rehabilitation of AD patients BIB004 . Some examples are the GenVirtual BIB002 , BuildAR (AlKhafaji et al., 2013) , and ARCube BIB007 .