Preliminary validation of Cogniclear: a virtual reality cognitive screening tool for older adults against the Montreal Cognitive Assessment

Virtual reality (VR) offers new opportunities for cognitive assessment by enabling immersive, ecologically valid task execution and continuous behavioral monitoring. However, it remains unclear whether performance in VR-based assessments reflects underlying cognitive functioning rather than interaction-related factors. This study aimed to evaluate the validity of a VR-based cognitive assessment environment by examining its relationship with the Montreal Cognitive Assessment (MoCA).

Forty older adults were recruited, of whom 38 completed both assessments and were included in the analyses. Cognitive status was independently assessed using the MoCA. Performance metrics derived from system interaction logs were analyzed together with measures of usability (VRSUQ), workload (NASA–TLX), age, education, and prior VR experience.

Significant associations were observed between MoCA scores and VR-derived performance measures, including Global Score, Success Rate, and task duration. Domain-level analyses revealed moderate-to-strong correlations between corresponding cognitive domains measured by MoCA and the VR system. Regression analyses demonstrated that cognitive status and age remained independently associated with Global Score after accounting for participant characteristics, whereas prior VR experience, workload, and usability were not independently associated with Global Score.

The findings support the validity of the proposed VR-based assessment approach and suggest that immersive environments can capture meaningful aspects of cognitive functioning. VR-based assessments may complement traditional cognitive screening by providing ecologically valid tasks and rich behavioral information derived from user interactions. The authors would like to thank all participants for their time and contribution to this study.

This work has been co-funded by the Interregional Innovation Investments (I3) instrument under the European Regional Development Fund (Project No. 101161333). The views and opinions expressed are those of the authors only and do not necessarily reflect those of the European Union. Neither the European Union nor the granting authority can be held responsible for them.

Grzegorz Zwoliński and Dorota Kamińska contributed equally to this work. Institute of Mechatronics and Information Systems, Lodz University of Technology, Żeromskiego 116, 90-924, Lodz, Poland Virtuleap, R. Rodrigues de Faria 103, 1300-501, Lisbon, Portugal A.B. is affiliated with the company that developed and commercializes the Cogniclear application used in this study.