A Comparison of Virtual Reality and Traditional Measures of Memory in the Diagnostic Discriminability of Neurocognitive Disorders: A Virtual Kitchen Protocol Study

Abstract

This study explored the diagnostic accuracy of a virtual reality-based cooking task compared to traditional memory tests for neurocognitive disorders (NCDs). Older adults (N = 127) were administered the Virtual Kitchen Protocol for Learning and Memory (VKP-LM) Immediate and Delayed Recall (VKP-IR and DR), the California Verbal Learning Test Short and Long Delay (CVLT-SD and LD), and the Wechsler Memory Scale-Visual Reproduction subtests (WMS-VR1 and VR2). A hierarchical logistic regression showed the VKP-DR as an independent predictor of NCDs (Exp[B] = 0.10, p < .001) among all study variables. Further analyses revealed that the VKP-DR had the highest area under the curve (AUC), reflecting the strongest classification performance. The CVLT-LD also showed good AUCs, while the WMS-VR2 demonstrated fair performance. The VKP-DR likely emerged with the highest diagnostic accuracy due to (a) delayed memory measures are consistently shown to be more accurate when classifying those with NCDs and (b) because NCD diagnostic criteria emphasize not only deficits in neurocognitive domains but also demonstrable impairment in everyday functioning. By embedding memory demands within a realistic, functionally relevant task (e.g., meal preparation), the VKP-DR may better approximate instrumental activities of daily living and thus capture the functional component required for diagnosis. This alignment with the Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR) criteria likely enhanced its predictive accuracy.

Keywords: Virtual Kitchen Protocol; memory assessment; predicting neurocognitive disorders; virtual reality environment.