Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar;35(1):77-101.
doi: 10.1007/s11065-024-09633-7. Epub 2024 Feb 26.

Virtual Reality and Serious Videogame-Based Instruments for Assessing Spatial Navigation in Alzheimer's Disease: A Systematic Review of Psychometric Properties

Juan Pablo Sánchez-Escudero  1 , Ana María Galvis-Herrera  2 , David Sánchez-Trujillo  2 , Laura Cristina Torres-López  2 , Cole J Kennedy  3 , Daniel Camilo Aguirre-Acevedo  4 , Mauricio A Garcia-Barrera  3 , Natalia Trujillo  5   6   7
Affiliations

Virtual Reality and Serious Videogame-Based Instruments for Assessing Spatial Navigation in Alzheimer's Disease: A Systematic Review of Psychometric Properties

Juan Pablo Sánchez-Escudero et al. Neuropsychol Rev. 2025 Mar.

Abstract

Over the past decade, research using virtual reality and serious game-based instruments for assessing spatial navigation and spatial memory in at-risk and AD populations has risen. We systematically reviewed the literature since 2012 to identify and evaluate the methodological quality and risk of bias in the analyses of the psychometric properties of VRSG-based instruments. The search was conducted primarily in July-December 2022 and updated in November 2023 in eight major databases. The quality of instrument development and study design were analyzed in all studies. Measurement properties were defined and analyzed according to COSMIN guidelines. A total of 1078 unique records were screened, and following selection criteria, thirty-seven studies were analyzed. From these studies, 30 instruments were identified. Construct and criterion validity were the most reported measurement properties, while structural validity and internal consistency evidence were the least reported. Nineteen studies were deemed very good in construct validity, whereas 11 studies reporting diagnostic accuracy were deemed very good in quality. Limitations regarding theoretical framework and research design requirements were found in most of the studies. VRSG-based instruments are valuable additions to the current diagnostic toolkit for AD. Further research is required to establish the psychometric performance and clinical utility of VRSG-based instruments, particularly the instrument development, content validity, and diagnostic accuracy for preclinical AD screening scenarios. This review provides a straightforward synthesis of the state of the art of VRSG-based instruments and suggests future directions for research.

Keywords: Alzheimer disease; COSMIN; Digital neuropsychology; Psychometric properties; Serious games; Systematic review; Virtual reality.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics Approval: Not applicable. Consent to Participate: Not applicable. Consent for Publication: Not applicable. Conflict of Interest: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. Summary of search
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Abma, I. L., Rovers, M., & Van Der Wees, P. J. (2016). Appraising convergent validity of patient-reported outcome measures in systematic reviews: Constructing hypotheses and interpreting outcomes. BMC Research Notes,9(226), 1–5. 10.1186/s13104-016-2034-2 - PMC - PubMed
    1. Allison, S. L., Fagan, A. M., Morris, J. C., & Head, D. (2016). Spatial navigation in preclinical Alzheimer’s disease Samantha. Journal of Alzheimer’s Disease,52(1), 77–90. 10.3233/JAD-150855 - PMC - PubMed
    1. Allison, S. L., Rodebaugh, T. L., Johnston, C., Fagan, A. M., Morris, J. C., & Head, D. (2019). Developing a spatial navigation screening tool sensitive to the preclinical Alzheimer disease continuum. Archives of Clinical Neuropsychology,34(7), 1138–1155. 10.1093/arclin/acz019 - PMC - PubMed
    1. Alsbury-Nealy, K., Wang, H., Howarth, C., Gordienko, A., Schlichting, M. L., & Duncan, K. D. (2021). OpenMaze: An open-source toolbox for creating virtual navigation experiments. Behavior Research Methods,54(3), 1374–1387. 10.3758/s13428-021-01664-9 - PubMed
    1. Alzheimer’s Association. (2023). 2023 Alzheimer’s disease facts and figures,19(4), 1598–1695. 10.1002/alz.13016 - PubMed

Publication types

LinkOut - more resources