SALT LAKE CITY — With a virtual reality headset, you can pilot a spaceship, hunt zombies and fight crime as Batman. Now, you can also find out if you are at risk for developing Alzheimer's disease.
A recent study from the University of Cambridge in the United Kingdom found that early signs of Alzheimer's can be detected by measuring how well a person navigates a virtual world.
The brain's entorhinal cortex is used for navigation and is one of the first regions to be damaged by the disease, according to the study, which was published in Brain, a journal of neurology, on May 28. That's why getting lost is often one of the first symptoms. Patients typically don't develop significant memory loss until years after the disease has set in and a substantial portion of brain cells have degenerated.
"We know that Alzheimer's affects the brain long before symptoms become apparent," Dennis Chan, the neuroscientist who led the experiment, told Science Daily. "We're getting to the point where everyday tech can be used to spot the warning signs of the disease well before we become aware of them."
In the future, common technology like mobile phone apps and virtual reality headsets could be used to diagnose Alzheimer's at a much lower cost than brain scanning and other current diagnostic methods, Chan added. Low-cost yet accurate tests will help more people receive an early diagnosis, which could improve the effectiveness of future treatments.
Alzheimer's is the world's fifth leading cause of death, according to the World Health Organization, and there is no cure. Symptoms include memory loss, difficulty communicating, confusion, depression and paranoia. In 2019, Alzheimer's and other forms of dementia will cost the nation $290 billion, according to the Alzheimer's Association.
The University of Cambridge study is a look at just one of many ways technology is being used to try and detect Alzheimer's or help people suffering from the disease. Virtual reality has also been used to stimulate Alzheimer's patients' memories and help family members and caretakers understand what it's like to have dementia by letting them see the world through a patient's eyes.
Lucy Johnston wrote in Wired about caring for her grandmother and her hope that companies like U.K.-based Virtue Health, which produces virtual reality content to help patients remember their own past experiences, will bring relief to people suffering from Alzheimer's.
"The disease took hold gradually, with just small signals of confusion and memory loss to begin with — such as getting lost on her 50-meter walk home from the bus stop," Johnston wrote of her grandmother. "But it became more brutal as time went on."
"I am hopeful for a world where — until a preventative treatment is found — facing dementia will not be such a truly terrible and isolating experience," she added.
Virtue's LookBack app has virtual scenes arranged by destination, theme, activity and decade to spur memories and prompt conversations. For example, users might choose to visit Brighton Beach in the 1970's.
“It’s only now that the phone in your pocket is advanced enough and virtual reality headsets are reducing in price that we can really democratise access to this type of impactful therapy,” Virtue's co-founder and chief technology officer Scott Gorman told Wired.
Early signs of Alzheimer's
Participants in the University of Cambridge study were asked to don a virtual reality headset like the ones used by computer gamers.
They found themselves in a variety of virtual environments with different landscapes and were asked to walk in an L-shaped path to three different locations. The locations were marked by cones at eye level numbered one, two and three.
Upon reaching cone three, a message prompted the participants to walk back to the location of cone one, now unmarked. When they reached what they thought was the right spot, participants pressed a trigger on a hand-held controller that logged their location and ended the experiment.
“You just place the headset on your face like a pair of goggles, and you are immediately placed in your virtual environment," Coco Newton, a PhD student who worked on the study, told the NIHR Cambridge Biomedical Research Institute. "Ultimately we want to find out if those who do worse in the tests will develop Alzheimer's disease in later life.”
Forty-five patients with mild cognitive impairment were recruited from the Cambridge University Hospitals for the study, in addition to 41 healthy control subjects. Some of the subjects with slight cognitive impairment underwent genetic testing to see if they had a biomarker for Alzheimer's.
The study found that not only did the healthy participants navigate the virtual world better than the others, but among the mildly impaired participants, those with the biomarker for Alzheimer's performed the task with the least accuracy.
"These results suggest a virtual reality test of navigation may be better at identifying early Alzheimer's disease than tests we use at present in the clinic and in research studies," Chan told Medical News Today.
Altoida, a biotech company with its U.S. headquarters in Houston, has developed similar virtual and augmented reality tools to predict the onset of Alzheimer's. Their method involves asking people to place virtual objects in different places and then collect them. Right now, the company’s technology is only available as a clinically supervised test in a doctor’s office, according to TechCrunch.
“As the world’s effort to introduce meaningful therapies for Alzheimer’s disease inches closer and closer to success, it is clear that the greatest benefit will come to those whose disease is detected at a very early stage,” Jonathan L. Liss, director at Columbus Memory Center, who has been using Altoida’s technology since September 2018, told TechCruch.
Beyond diagnosis, virtual reality can help Alzheimer's patients find healing and help family and caretakers find empathy.
Another U.K. study from the University of Kent found that virtual reality therapy helped people with dementia recall memories, reduced their aggression and improved their interactions with caregivers.
In that study, researchers allowed patients to visit five therapeutic virtual settings — a cathedral, a countryside, a forest, a sandy beach and a rocky beach — and then monitored them over the course of 16 sessions.
“Virtual reality can clearly have positive benefits for patients with dementia, their families, and caregivers. It provides a richer and more satisfying quality of life than is otherwise available, with many positive outcomes,” Kent senior lecturer in multimedia and digital systems Jim Ang, one of the study’s researchers, told Being Patient.
Other virtual reality programs are designed to help people who don't have Alzheimer's understand what it's like. Dementia Australia offers a virtual reality program that immerses users in a life with dementia. Alzheimer's Research U.K. created an app called A Walk Through Dementia that does the same.
A virtual reality program from Los Angeles-based Embodied Labs lets users see the world through the eyes of a woman named Beatriz as she navigates everyday scenarios at different stages of Alzheimer's disease, the Chicago Tribune reported.
When she tries to go grocery shopping, the lights are blinding and the food labels are fuzzy. When people speak, their words are muffled. Her virtual family members shoot her frustrated glances because they don't understand why she keeps forgetting things. Later, at a park, Beatriz becomes paranoid because she thinks her daughter has stolen her purse. And in the later stages of the disease, she cries out for help when she hears a load roar and sees a dark figure moving erratically, which turns out to be a shadow and the sound of a fan, the Chicago Tribune reported.
“You are there and you are observing this and you have a deep sense of feeling of what’s happening,” Neelum Aggarwal of the Rush Alzheimer’s Disease Center told the Chicago Tribune. Aggarwal worked as an advisor for Embodied Labs to develop Beatriz's story.
“We know when there’s an emotional connection to something, that whole experience is enhanced, and virtual reality seems to be able to do this.”