A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Categorization of VR Applications Used in AD <s> Background: Virtual reality (VR) is an evolving technology that has been applied in various aspects of medicine, including the treatment of phobia disorders, pain distraction interventions, surgical training, and medical education. These applications have served to demonstrate the various assets offered through the use of VR. Objective: To provide a background and rationale for the application of VR to neuropsychological assessment. Methods: A brief introduction to VR technology and a review of current ongoing neuropsychological research that integrates the use of this technology. Conclusions: VR offers numerous assets that may enhance current neuropsychological assessment protocols and address many of the <s> BIB001 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Categorization of VR Applications Used in AD <s> BACKGROUND ::: Several virtual reality (VR) applications for the understanding, assessment and treatment of mental health problems have been developed in the last 10 years. The purpose of this review is to outline the current state of virtual reality research in the treatment of mental health problems. ::: ::: ::: METHODS ::: PubMed and PsycINFO were searched for all articles containing the words "virtual reality". In addition a manual search of the references contained in the papers resulting from this search was conducted and relevant periodicals were searched. Studies reporting the results of treatment utilizing VR in the mental health field and involving at least one patient were identified. ::: ::: ::: RESULTS ::: More than 50 studies using VR were identified, the majority of which were case studies. Seventeen employed a between groups design: 4 involved patients with fear of flying; 3 involved patients with fear of heights; 3 involved patients with social phobia/public speaking anxiety; 2 involved people with spider phobia; 2 involved patients with agoraphobia; 2 involved patients with body image disturbance and 1 involved obese patients. There are both advantages in terms of delivery and disadvantages in terms of side effects to using VR. Although virtual reality based therapy appears to be superior to no treatment the effectiveness of VR therapy over traditional therapeutic approaches is not supported by the research currently available. ::: ::: ::: CONCLUSIONS ::: There is a lack of good quality research on the effectiveness of VR therapy. Before clinicians will be able to make effective use of this emerging technology greater emphasis must be placed on controlled trials with clinically identified populations. <s> BIB002 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Categorization of VR Applications Used in AD <s> Non-pharmacological intervention of memory difficulties in healthy older adults, as well as those with brain damage and neurodegenerative disorders, has gained much attention in recent years. The two main reasons that explain this growing interest in memory rehabilitation are the limited efficacy of current drug therapies and the plasticity of the human central nervous and the discovery that during aging, the connections in the brain are not fixed but retain the capacity to change with learning. Moreover, several studies have reported enhanced cognitive performance in patients with neurological disease, following non-invasive brain stimulation [i.e., repetitive transcranial magnetic stimulation and transcranial direct current stimulation to specific cortical areas]. The present review provides an overview of memory rehabilitation in individuals with mild cognitive impairment and in patients with Alzheimer’s disease with particular regard to cognitive rehabilitation interventions focused on memory and non-invasive brain stimulation. Reviewed data suggest that in patients with memory deficits, memory intervention therapy could lead to performance improvements in memory, nevertheless further studies need to be conducted in order to establish the real value of this approach. <s> BIB003 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Categorization of VR Applications Used in AD <s> Background ::: ::: Older adults with questionable dementia are at risk of progressing to dementia, and early intervention is considered important. The present study investigated the effectiveness of a virtual reality (VR)-based memory training for older adults with questionable dementia. ::: ::: ::: ::: Methods ::: ::: A pre-test and post-test design was adopted. Twenty and 24 older adults with questionable dementia were randomly assigned to a VR-based and a therapist-led memory training group, respectively. Primary outcome measures included the Multifactorial Memory Questionnaire and Fuld Object Memory Evaluation. ::: ::: ::: ::: Results ::: ::: Both groups demonstrated positive training effects, with the VR group showing greater improvement in objective memory performance and the non-VR group showing better subjective memory subtest results in the Multifactorial Memory Questionnaire. ::: ::: ::: ::: Conclusion ::: ::: The use of VR seems to be acceptable for older adults with questionable dementia. Further study on the effect of educational background and memory training modality (visual, auditory) is warranted. Copyright © 2011 John Wiley & Sons, Ltd. <s> BIB004 </s> A Succinct Overview of Virtual Reality Technology Use in Alzheimer’s Disease <s> Categorization of VR Applications Used in AD <s> Everyday action impairment is one of the diagnostic criteria of Alzheimer's disease and is associated with many serious consequences, including loss of functional autonomy and independence. It has been shown that the (re)learning of everyday activities is possible in Alzheimer's disease by using error reduction teaching approaches in naturalistic clinical settings. The purpose of this study is to develop a dual-modal virtual reality platform for training in everyday cooking activities in Alzheimer's disease and to establish its value as a training tool for everyday activities in these patients. Two everyday tasks and two error reduction learning methods were implemented within a virtual kitchen. Two patients with Alzheimer's disease and two healthy elderly controls were tested. All subjects were trained in two learning sessions on two comparable cooking tasks. Within each group (i.e., patients and controls), the order of the training methods was counterbalanced. Repeated measure analysis before and after learning was performed. A questionnaire of presence and a verbal interview were used to obtain information about the subjective responses of the participants to the VR experience. The results in terms of errors, omissions, and perseverations (i.e., repetitive behaviors) indicate that the patients performed worse than the controls before learning, but that they reached a level of performance similar to that of the controls after a short learning session, regardless of the learning method employed. This finding provides preliminary support for the value of the dual-modal virtual reality platform for training in everyday cooking activities in Alzheimer's disease. However, further work is needed before it is ready for clinical application. <s> BIB005
The potential usefulness and exceptional opportunities of VR systems as valuable ICT tools to assess and train patients in the early stages of AD has been already ascertained by several studies BIB001 BIB002  BIB003 BIB004 BIB005 . For analytical purposes, it seems convenient to classify VR systems according to some functional criteria, as follows: (1) intended purpose (e.g., assessment and diagnosis, cognitive training, patient education, caregivers' training, etc.); (2) impairment feature it is focused on (e.g., spatial impairment, memory deficit, etc.); (3) methodology employed (e.g., tasks, games, or activities); (4) kind of VE (e.g., desktop, goggles-and-gloves, large screen, virtual room, etc.); and (5) type of interaction technique (e.g., fullimmersive, semi-immersive, non-immersive, and passive or active interaction, etc.). Figure 1 presents the schematic representation of such classification. The pursuit of future advances beyond current VR applications for AD state of the art will benefit from a broad awareness of recent and ongoing VR developments. Such understanding essentially consists of scrutinizing and comparing design and operation specificities that aim to fulfill the intended purpose of particular AD applications, such as the techniques of patient interaction. A useful starting point, particularly regarding design methodology type and immersion level, is Table 1 , which lists representative current VR applications for AD and briefly classifies them according to their intended purpose and interaction technique.