Acceptance and Usability of Immersive Virtual Reality in Older Adults with Objective and Subjective Cognitive Decline.

BACKGROUND: Virtual reality (VR) has recently emerged as a promising means for the administration of cognitive training of seniors at risk of dementia. Immersive VR could result in increased engagement and performances; however, its acceptance in older adults with cognitive deficits still has to be assessed. OBJECTIVE: To assess acceptance and usability of an immersive VR environment requiring real walking and active participants' interaction. METHODS: 58 seniors with mild cognitive impairment (MCI, n = 24) or subjective cognitive decline (SCD, n = 31) performed a shopping task in a virtual supermarket displayed through a head-mounted display. Subjective and objective outcomes were evaluated. RESULTS: Immersive VR was well-accepted by all but one participant (TAM3 positive subscales > 5.33), irrespective of the extent of cognitive decline. Participants enjoyed the experience (spatial presence 3.51±0.50, engagement 3.85±0.68, naturalness 3.85±0.82) and reported negligible side-effects (SSQ: 3.74; q1-q3:0-16.83). The environment was considered extremely realistic, such as to induce potentially harmful behaviors: one participant fell while trying to lean on a virtual shelf. Older participants needed more time to conclude trials. Participants with MCI committed more errors in grocery items' selection and experienced less "perceived control" over the environment. CONCLUSION: Immersive VR was acceptable and enjoyable for older adults in both groups. Cognitive deficits could induce risky behaviors, and cause issues in the interactions with virtual items. Further studies are needed to confirm acceptance of immersive VR in individuals at risk of dementia, and to extend the results to people with more severe symptoms.

The Effects of COVID-19 and Quarantine Measures on the Lifestyles and Mental Health of People Over 60 at Increased Risk of Dementia.

Background: The lockdown strategies adopted to limit the spread of COVID-19 infection may lead to adopt unhealthy lifestyles which may impact on the mental well-being and future risk of dementia. Older adults with mild cognitive impairment (MCI) or subjective cognitive decline (SCD) may suffer important mental health consequences from measures of quarantine and confinement. Aims: The study aimed to explore the effects of COVID-19 and quarantine measures on lifestyles and mental health of elderly at increased risk of dementia. Methods: One hundred and twenty six community-dwelling seniors with MCI or SCD were phone-interviewed and assessed with questions regarding variables related to COVID-19 pandemic, lifestyle changes and scales validated for the assessment of depression, anxiety, and apathy. Results: The sample included 55.6% patients with MCI and 56 people with SCD. Over 1/3 of the sample reduced their physical activity and nearly 70% reported an increase in idle time. Adherence to the Mediterranean diet decreased in almost 1/3 of respondents and over 35% reported weight gain. Social activities were abolished and 1/6 of participants also decreased productive and mental-stimulating activities. 19.8% were depressed, 9.5% anxious, and 9.5% apathetic. A significant association existed between depression and living alone or having a poor relation with cohabitants and between anxiety and SCD, cold or flu symptoms, and reduction in productive leisure activities. Conclusions: Seniors with SCD and MCI underwent lifestyle changes that are potentially harmful to their future cognitive decline, even if, with the exception of leisure activities, they do not appear to be cross-sectionally associated with psychiatric symptoms.

Sedentary Behaviors and Physical Activity Habits Independently Affect Fat Oxidation in Fasting Conditions and Capillary Glucose Levels After Standardized Glucose-Rich Meal in Healthy Females.

PURPOSE: Sedentary behaviors and muscle inactivity are being growingly recognized as important risk factors for health, adjunctively and independently from a scarce physical activity (PA), although the metabolic mechanism underneath is barely clear. To explore the relation between sedentary behaviors (SBs) and metabolism, we measured the metabolic profile in fasting condition and after oral glucose overload in a group of women, along with objective monitoring of their PA/sedentary lifestyle habits. SUBJECTS AND METHODS: Thirteen women (age: 32.5 ± 16.1 years; BMI: 24.0 ± 3.3 kg/m2), recruited among university students and research staff, underwent indirect calorimetry to assess fat and carbohydrate contribution to energy metabolism, in fasting conditions and after a glucose-rich standard meal (about 45 g of glucose). Glucose concentration in capillary blood was determined in fasting state and 15 and 30 min after meal. Habitual PA and SBs in the previous week were continuously monitored with Actigraph accelerometers. RESULTS: After adjustment for age, the contribution of fat oxidation to metabolic energy sources, normalized for fat-free mass, in fasting conditions was significantly correlated with time spent in sitting/lying position during wake hours (p < 0.001), independent from PA habits, whereas capillary blood peak and change of glucose concentration after the meal were significantly and inversely correlated with average daily moderate to vigorous PA (p = 0.025 and p = 0.019, respectively), independent from average daily sitting/lying time. CONCLUSIONS: Here, we report for the first time a direct effect of muscle inactivity on increased fat oxidation in fasting conditions, which can be hypothesized as a preliminary condition for the development of insulin resistance. We also report the direct independent effect of PA on the capacity to respond to a glycemic load, so that SBs and reduced PA appear to concur, although independently, to the increased health risk, as elsewhere observed on an epidemiological ground.