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Validation of an online innovative virtual reality-based test for early detection of cognitive impairment in community-dwelling older adults. (Ref: RDF22/HLS/SWECW/HO-YINLAI)

   Faculty of Health and Life Sciences

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  Dr Frank Ho-yin Lai  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Dementia places increased burden on healthcare and welfare services worldwide, due to aging populations. Current diagnosis is based on medical history, physical examinations, laboratory and psychological tests, and neuroimaging. These assessment procedures preclude user friendly and easily accessible early detection, which is essential to maximising the benefits of interventions for cognitive reserves and resilience against underlying neurodegenerative processes. The hippocampus plays an essential role in constructing internal spatial representations of the environment. Integrity of the hippocampus is critical for the formation and retrieval of memory, especially declarative memory of past events and facts, the type of memory most affected by Alzheimer’s disease, and rapid, flexible working memory central to executive function in all subtypes of neurocognitive disorder (NCD).

We aim to validate an online-based, interactive, innovative, immersive spatial memory test. This VR-based working memory test (VRWMT) is a novel person-centred, self-pacing VR game. It is based on the delayed matching-to-place paradigm developed for rodents in the water-maze. The water-maze task requires animals to swim to escape from water by climbing on an escape platform hidden just underneath the water surface. Efficient escape depends on memory of the platform location as defined by stable landmarks outside the otherwise uniform maze. Changes of the platform location demand flexible working memory – a common deficit in all NCD subtypes. This can be evaluated when the position of the escape platform is switched from one location to another (e.g., every four trials). Evidence supports that the task is a highly sensitive tool to probe hippocampal function, including in humans. Our pilot study indicated its ability to detect pathological models of dementia, age-related deterioration, and hippocampal dysfunction.

As part of the instrument validation process, the research aims to: (a) determine the VRWMT’s ability to discriminate between older adults with known mild NCD and healthy age-matched older adults, (b) predict the deterioration in cognitive function among these two groups over 12 months, and (c) evaluate concurrent validity between the emergence of deterioration in the VRWMT and clinical tools of functional performance in older adults, through 3 specific objectives:

Objective 1. To discriminate between older adults with known mild NCD and age-matched healthy control in working memory performance by VRWMT, as reflected in primary cognitive outcome by the Montreal Cognitive Assessment.

Objective 2. To discriminate between older adults with known mild NCD and age-matched healthy control in functional performance, as reflected by secondary functional performance by the Multiple Errands Test (MET) and the Disability Assessment for Dementia (DAD).

Objective 3. To predict the deterioration of working memory performance in the VRWMT with primary cognitive outcome, secondary functional performance measures and biological biomarkers outcomes over 12 months would be larger in the mild-NCD group relative to the age-matched healthy controls.

Better approaches to detecting early signs of dementia in community-dwelling older adults are necessary; the availability of such tests could be revolutionary for patients, carers, and service providers. Valid tools for the early detection and prediction of dementia will further enable the development of preventative programmes.

Eligibility and How to Apply:

Please note eligibility requirement:

  • Academic excellence of the proposed student i.e., 2:1 (or equivalent GPA from non-UK universities [preference for 1st class honours]); or a Masters (preference for Merit or above); or APEL evidence of substantial practitioner achievement.
  • Appropriate IELTS score, if required.
  • Applicants cannot apply for this funding if currently engaged in Doctoral study at Northumbria or elsewhere or if they have previously been awarded a PhD.

For further details of how to apply, entry requirements and the application form, see 

Please note: Applications that do not include a research proposal of approximately 1,000 words (not a copy of the advert), or that do not include the advert reference (e.g., RDF22/…) will not be considered.

Deadline for applications: 18 February 2022

Start Date: 1 October 2022

Northumbria University takes pride in, and values, the quality and diversity of our staff and students. We welcome applications from all members of the community.

Informal enquiries to Dr Frank Ho-yin Lai ([Email Address Removed]).

Funding Notes

Each studentship supports a full stipend, paid for three years at RCUK rates (for 2021/22 full-time study this is £15,609 per year) and full tuition fees. UK and international (including EU) candidates may apply.
Studentships are available for applicants who wish to study on a part-time basis over 5 years (0.6 FTE, stipend £9,365 per year and full tuition fees) in combination with work or personal responsibilities.
Please also read the full funding notes which include advice for international and part-time applicants.


Lam, L.C.W.*, Lee, A.T.C., Cheng, S.T., Yip, B.H.K., Chan, W.C., Fung, A.W.T., Ma, S.L., Cheng, C.P.W., Kong, R., Chiu H.T.S., Lai, F.H.Y., & Wong, S.Y.S. (2021). Mindfulness Awareness Is Associated with a Lower Risk of Anxiety and Depressive Symptoms in Older Adults with Neurocognitive Disorders. Frontiers in Psychiatry, vol/pp
Man, D.W.K., Lai, F.H.Y.*, Yu, E.C.S. & Lee, G. Y.Y (2021) Effects of traditional Cantonese Opera Songs on Cantonese-speaking, Community-dwelling Older Adults’ Cognitive and Psychological Function, Well-being, and Health, Aging & Mental Health, vol/pp
Hung, S. W., Ho, A.N., Lai, I.W., Lee, C.W., Pong, A.K., Lai. F.H.Y. * (2020). Meta-Analysis on the Effectiveness of Virtual Reality Cognitive Training (VRCT) and Computer-Based Cognitive Training (CBCT) for Individuals with Mild Cognitive Impairment (MCI). Electronics 9, 2185.
Lai F.H.Y. *, Yan E.W., Tsui, W.S., Yu K.K., Chan D.T. Yee, B.K. (2020). The Protective Impact of Telemedicine on Persons with Dementia and Their Caregivers During the COVID-19 Pandemic. American Journal of Geriatric Psychiatry, 28(11):1175-1184.
Lai F.H.Y. *, Yan E.W., Tsui, W.S., Yu K.K. (2020). A randomized control trial of activity scheduling for caring for older adults with dementia and its impact on their spouse caregivers. Archives of Gerontology and Geriatrics, 90, 104167.
Cordier, R., Munro, N., Wilkes-Gillan, S., Speyer, R., Parsons, L., & Joosten, A. (2019). Applying item response theory (IRT) modelling to an observational measure of childhood pragmatics: the Pragmatic Observation Meaure-2. Frontiers in Psychology, 10(408), 1-17. doi: 10.3389/fpsyg.2019.00408
Bonsaksen, T., Lindstad, M. Ø., Håkansson, C., Wagman, P., & Cordier, R. (2021). Rasch analysis of the Norwegian version of the Occupational Balance Questionnaire in a sample of occupational therapy students. Occupational Therapy International. Article ID 8863453, 1-11. doi: 10.1155/2021/8863453
Cordier, R., Brown, T., Clemson, L., & Byles, J. (2018). Evaluating the longitudinal item and category stability of the SF-36 full and summary scales using Rasch analysis. BioMed Research International, Article ID 1013453, 1-30. doi: 10.1155/2018/1013453
Cordier, R., Speyer, R., Schindler, A., Hamdy, S., Michou, E., Heijnen, B.J., Baijens, L.W.J., Karaduman, A., Swan, K., Clave, P., & Joosten, A. (2018). Using Rasch analysis to evaluate the reliability and validity of the Swallowing Quality of Life questionnaire: an item response theory approach. Dysphagia, 33(4), 441-456. doi: 10.1007/s00455-017-9873-4
Swan, K., Cordier, R., Brown, T., & Speyer, R. (2019). Psychometric Properties of Visuoperceptual Measures of Videofluoroscopic and Fibre-Endoscopic Evaluations of Swallowing: A Systematic Review. Dysphagia, 34(1) 2-33. doi: 10.1007/s00455-018-9918-3
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