VeraSci developed the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) to assess proficiency in performing real-world tasks in a realistic environment. The VRFCAT, a digital tablet-based instrument, has been accepted into the FDA clinical outcome assessment (COA) qualification program and has been validated for use in schizophrenia and older adults with subjective cognitive decline. To demonstrate the feasibility and utility of the VRFCAT as a meaningful measure of functional improvement, we conducted a study using the VRFCAT to evaluate function in patients with mild to moderate Parkinson’s disease (PD).  Results of the study were presented by Dr. Travis Turner at Advances in Alzheimer’s and Parkinson’s Therapies: An AAT-AD/PD Focus Meeting April 2020 (held virtually due to COVID-19).

Methods

Our clinical scientists examined VRFCAT performances in 30 patients aged 54 to 79 with idiopathic PD through a retrospective chart review. The study examined the association of VRFCAT performance with cognitive status, disease progression, standard neuropsychological tests and a self-report scale for impact of cognition on instrumental Activities of Daily Living (iADLs).

Results

We found that PD-MCI patients took longer and made more errors on the VRFCAT than PD patients with normal cognition. There were no significant gender differences on VRFCAT performance. Relationships between VRFCAT performance and age and education were not statistically significant. The self-reported scale (the Parkinson‘s Disease Cognitive Function Rating Scale (PD-CFRS) 4) assessed patients‘ subjective sense of diminished efficiency in instrumental ADLS due to cognition. No statistically significant relationships were observed between VRFCAT performance outcomes and PD-CFRS score. Notably, PD-CFRS scores (lower is better) were not significantly different between cognitive status groups.

Conclusion

As expected, PD-MCI patients performed worse than PD normal cognition patients, and those with more advanced disease performed more slowly. Demographic and other clinical factors did not confound performance. Failure of PD-MCI patients to recognize impact of cognition on efficiency for iADLs indicates that self-report measures are not well-suited for this purpose in PD. Taken together, results support use of the VRFCAT as an objective measure of functional capacity for iADLs in Parkinson‘s disease.