The Virtual Kitchen Challenge: preliminary data from a novel virtual reality test of mild difficulties in everyday functioning.

Background: Efficient, objective measures of mild functional difficulties are lacking. Preliminary data from a novel, non-immersive virtual reality, performance-based task (Virtual Kitchen Challenge; VKC) were obtained to address this gap. Methods: 14 older and 21 younger adults completed cognitive tests and two everyday tasks (breakfast, lunch) in the VKC with virtual objects and a touch-screen and in the Real Kitchen with real objects (order counterbalanced). Automated performance measures were obtained from the VKC program and human coders scored VKC and Real Kitchen videos for errors. Results: Older adults made more errors than younger adults on the VKC and Real Kitchen, with similar error patterns across measures. VKC automated measures were significantly related to measures from human coders, performance on the Real Kitchen, and cognitive test scores. Conclusion: The VKC is a valid and highly efficient performance-based measure of subtle functional difficulties with great potential for future clinical and research applications.

Windows to functional decline: Naturalistic eye movements in older and younger adults.

Subtle changes in everyday tasks precede and predict future disability in older adults. Eye tracking may provide a sensitive tool for detecting subtle disruption of everyday task performance and informing the mechanism(s) of breakdown. We tracked eye movements of healthy older adults (OA, n = 24) and younger adults (YA, n = 25) while they passively viewed a naturalistic scene (Passive Viewing condition) and then verbally reported the necessary steps for achieving a task goal (e.g., pack a lunch; Verbalize Goal condition). Participants also completed a performance-based task of packing a lunch using real objects as well as neuropsychological tests. Group (young vs. old) by Condition (Passive Viewing vs. Verbalize Goal) ANOVAs were conducted to analyze eye tracking variables (i.e., fixation rate, number/duration of fixations to target/distractor objects and off objects). Both the younger and older adults made significantly fewer fixations to distractors during Verbalize Goal than Passive Viewing. Also, significant Group × Condition interactions were observed, indicating that younger adults, but not older adults, spent significantly more time viewing targets and less time off-objects in the goal driven, Verbalize Goal condition than the Passive Viewing condition. Goal-directed eye movements correlated with everyday action errors and tests of executive functioning. Taken together, results support theories of age-related decline in top-down cognitive control and indicate the potential utility of this eye tracking paradigm in detecting subtle age-related functional changes. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sensitive performance-based assessment of everyday action in older and younger adults.

Everyday function is compromised by mild cognitive changes in aging. These changes predict risk for future decline and dementia but remain poorly characterized, largely due to a scarcity of sensitive, objective measures.Twenty-seven younger adults and 25 non-demented older adults completed the Naturalistic Action Test (NAT), a performance-based measure of everyday action involving simple and complex tasks. Performance was coded for overt errors and subtle inefficiencies. Participants also completed self-report functional measures and cognitive tests. Mixed ANOVAs revealed that older adults made more subtle NAT errors with high task demands; groups did not differ in overt errors. Correlations did not reveal significant relations between self-report and NAT errors, but NAT performance was correlated with learning and recall.The NAT provides a promising tool for detecting subtle age-related changes and examining decline across levels of impairment. Self-report may lack sensitivity to subtle changes, and episodic memory changes underlie early functional disruption.