Grocery shopping has become complicated: managing dual-tasks in a supermarket for patients with Alzheimer’s disease

The executive functions neuropsychological assessment with paper and pencil tests is particularly sensitive to the lack of ecological validity. If the purpose of the clinician is not to get a merely theoretical measure, but to assess the deficit impact on patient’s life, the classical tests for executive functions are not very informative. A more ecological measure could be provided by the direct observation of the patient in his daily life, but this practice is largely cost-demanding and difficult to implement. Moreover by assuming an enactive cognition approach, the role of interaction between the embodied behaviors and the affordances provided in the coupling with the environment in which the agent’s activity is placed remains unrevealed from classical neuropsychological tests. Recently, the introduction of virtual reality simulations in clinical neuropsychology seems to provide peculiar opportunities for the evaluation of the ecological impact of disease in neurological patients, while introducing new inputs for the research on embodied cognition and enactive knowledge acquisition. This contribution aims in analyzing how a virtual reality dual-task test, set in the scene of a supermarket, can be used to assess executive functions in adult/elderly population and in patients with Alzheimer disease. The results show that the test has convergent validity, compared to the Mini Mental State Evaluation and Tower of London tests and discriminant validity in identifying the degenerative disease, compared to healthy subjects matched for age, sex and education.