Virtual reality-based cognitive assessment tools for mild cognitive impairment screening: Comparison with traditional paper and pencil-based cognitive assessment tools

Abstract Background and Objectives Dementia is becoming increasingly prevalent, highlighting the need for early detection of mild cognitive impairment (MCI), a risk state for dementia. Traditional cognitive assessments often require trained examiners and lack ecological validity. This study examined the diagnostic accuracy of a virtual reality (VR)–based cognitive assessment tool, VARABOM.D, by comparing it with three standard tests: Seoul Neuropsychological Screening Battery (SNSB), Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE). Research Design and Methods Seventy-seven participants, divided into normal (n = 44) and MCI (n = 33) groups based on their Clinical Dementia Rating scores, completed the VARABOM.D program, in addition to SNSB, MoCA, and MMSE. Correlation analyses were performed on the test results, and the specificity, sensitivity, and area under the curve (AUC) of VARABOM.D were compared to those of the other assessments. To monitor for any adverse reactions to the VR environment, the Simulator Sickness Questionnaire (SSQ) was administered both before and after the VR sessions. Results VARABOM.D scores showed significant positive associations with established cognitive assessments. Its AUC values were comparable to those of the MoCA, MMSE, and most SNSB subdomains except for attention, where VARABOM.D demonstrated greater discriminative ability. SSQ scores remained stable across pre- and post-VR sessions in both study groups, underscoring the VR platform’s safety and feasibility. Discussion and Implications VARABOM.D demonstrated accuracy comparable to traditional cognitive assessments and even outperformed the attention subdomain of SNSB. Additionally, no adverse reactions were observed in the normal or MCI groups, further emphasizing the safety and stability of VARABOM.D.