Executive functions in young and older adults while performing a shopping task within a real and similar virtual environment

As conventional tools for assessing and improving the ability of older adults to perform functional tasks that entail executive functions (EF) are limited, there is a need to identify alternate approaches including the use of simulated environments. The objectives of this study were (1) to investigate differences in EF in older and young adults as determined by their performance on the Adapted Four-Item Shopping Task in both real and simulated shopping malls, as well as clinical EF assessments; and (2) to examine the ecological validity of the shopping task in the simulated environment and the concurrent validity between both simulated and real environments and clinical assessments of EF. Twenty healthy older adults and 34 healthy young adults were tested during a single two-hour experimental session that included clinical assessments (Montreal Cognitive Assessment, Executive Function Route-finding Task (EFRT), questionnaires of system usability (System Usability Scale, Short Feedback Questionnaire) Trail Making Tests A and B (TMT-A&B), and performance of the Adapted Four-Item Shopping Task in both the real and in simulated shopping malls (created by the EnvironSim authoring tool). Between-group differences were found primarily in the simulated environment where the older adults took more time to complete the shopping task, made more mistakes, required a longer training time and used overt cognitive strategies. Significant between-group differences were found in the TMT-A&B. A positive correlation was found between both environments in the purchase time of the first item, and several correlations were found between the simulated environment and the TMT-A&B and the EFRT. Both groups gave positive reports regarding their experience with the simulated environment, but the older adults reported a lower level of usability with the simulation. This study demonstrated the potential use of EnvironSim to create customized simulated shopping tasks for the assessment of age-related EF decline.