Current Alzheimer Research - Volume 21, Issue 11, 2024

In recent years, Virtual Reality (VR) has emerged as a promising tool to improve the well-being and functional capabilities of older adults. Although VR applications have shown positive results, their impact on user experience and therapeutic outcomes still needs to be evaluated.

This scoping review aims to analyze existing studies on VR use in older adults with neurodegenerative disorders, focusing on the factors that influence usability, satisfaction, and immersion, as well as the effects on emotional and cognitive well-being.

Empirical studies in English were included on VR applications applied to older adults with cognitive impairment without study design restrictions. The search was conducted in IEEE Xplore, PubMed, Scopus, and Web of Science, identifying a total of 650 initial results. After screening, 14 studies met the inclusion criteria.

Immersive VR tends to generate a greater sense of presence, which contributes to improving emotional well-being and reducing neuropsychiatric symptoms, such as apathy and depression. However, its impact on cognitive functions, including memory and executive skills, varied depending on the level of immersion and participant characteristics. Despite these positive findings, significant heterogeneity was evident in study designs, measurement instruments, and user experience indicators.

Virtual environments have great potential as a therapeutic tool for older adults, but their success depends on the personalization of applications and the adaptation of technology to the specific needs of this population. Future research should focus on developing standardized protocols, incorporating adaptive technologies such as artificial intelligence, and evaluating the long-term effects of VR to maximize its benefits and minimize its risks. This review was registered in Open Science Framework (OSF).

10.17605/OSF.IO/PNU36.

Alzheimer's disease is a chronic, neurodegenerative condition that leads to a significant cognitive decline. One of the symptoms that greatly reduces the quality of daily functioning is the deterioration of spatial orientation abilities. A non-pharmacological treatment option for Alzheimer's disease, which is also employed to improve the cognitive functioning of individuals with mild cognitive impairment, is virtual reality training.

To the best of the authors' knowledge, there is no existing systematic review on the use of virtual reality training to enhance spatial orientation in individuals with Alzheimer’s disease or mild cognitive impairment. The review was therefore conducted to fill this gap. The findings of this review may support the efficacy of virtual reality in enhancing spatial orientation.

Five databases were searched. The primary inclusion criteria were study participants aged over 60 years with a diagnosis of Alzheimer's disease or mild cognitive impairment and the use of virtual reality for improving spatial orientation. Six studies meeting these criteria were ultimately included in the review.

All included studies demonstrated an improvement in the spatial orientation of individuals with Alzheimer's disease or mild cognitive impairment following virtual reality training. This indicates the effectiveness of virtual reality technology in cognitive rehabilitation.

As virtual reality cognitive training has proven effective, its use should be more widely adopted. Further research on the application of virtual reality for enhancing spatial orientation in individuals with dementia is recommended.

The potential therapeutic role of nicotine in Alzheimer's disease (AD) remains controversial, particularly regarding its age-dependent effects and underlying mechanisms.

This study investigated the impact of chronic nicotine administration on cognitive function and molecular pathways in Presenilin 1/2 double knockout (DKO) mice, an amyloid-β (Aβ)-independent model of AD. Three-month-old and eight-month-old DKO and wild-type (WT) mice received oral nicotine treatment (100 μg/ml) for three months. Behavioral assessments revealed that while the 6-month-old cohort showed no significant differences between nicotine-treated and control groups regardless of genotype, nicotine improved contextual fear memory in 11-month-old DKO mice but impaired nest-building ability and cued fear memory in age-matched WT controls. Transcriptome analysis of the prefrontal cortex identified distinct molecular responses to nicotine between genotypes.

In DKO mice, nicotine modulated neuropeptide signaling and reduced astrocyte activation, while in WT mice, it disrupted cytokine-cytokine receptor interaction and neuroactive ligand-receptor interaction pathways. Western blot analysis revealed that nicotine treatment significantly reduced tau hyperphosphorylation and Glial Fibrillary Acidic Protein (GFAP) expression in 11-month-old DKO mice, which was further confirmed by immunohistochemistry showing decreased astrocyte activation in multiple brain regions.

These findings demonstrate that nicotine's effects on cognition and molecular pathways are both age- and genotype-dependent, suggesting its therapeutic potential may be limited to specific stages of neurodegeneration while potentially having adverse effects in healthy aging brains.