本研究希望能建立一套針對失智老人所設計的空間認知與記憶能力測試軟體，本研究之重點為：(1) 建立空間認知能力評估理論基礎：將藉由動物行為科學上之莫里斯水迷宮理論模型為基礎，建立一套適用於人類的空間認知能力評估工具。(2) 建立軌跡策略分析與失智傾向評估演算法：藉由遊戲所記錄下來的時間參數，將針對不同受測對象繪製其學習曲線，分析不同族群之學習效果，並討論其搜尋策略使用內容之變化。(3) 設計工作記憶評估遊戲：本研究希望能藉由電腦軟體來輔助評估受測對象之注意力與工作記憶，而設計之輔助評估遊戲將以圖像記憶為主，包括翻牌遊戲與動物管理員(視覺版)。(4) 系統信度與關聯性分析：本研究收案過程中，將同時以傳統失智量表進行評估，進而比較兩套同為失智傾向評估系統之關聯性。
本研究經過實際收案所收集到的數據，將分為：正常年輕人、正常中年人、正常老年人以及輕微失智症患者等四個族群共52位，並以統計分析方法進行分析。其分析結果如下說明：(1) 虛擬莫里斯水迷宮：水迷宮實驗中完成任務的時間，將隨著年齡的增加而需要更長的時間來完成，而受測者在戒指周圍之關鍵區域(Critical Zone)中的時間百分比則隨之降低；(2) 翻牌遊戲：由翻牌遊戲的兩個變數可知，隨著年齡的增加，其記憶能力衰退，造成錯誤率上升，若有失智症傾向，其錯誤率更是大幅的增加；(3)動物管理員(視覺版)：動物管理員遊戲所收集到的正確率與反應時間數據中，其隨著年齡的增加，正確率隨之降低且反應時間亦隨之變慢；(4)各項變數與MMSE量表之關聯性，由相關分析結果可知，其中翻牌遊戲中12張牌的錯誤率更達到高度的負相關(-0.753)，而其他量測指標包括：(i)隱藏平台探索實驗的兩個實驗區塊平均完成時間與Critical Zone平均時間百分比；(ii)無平台探索實驗中的Critical Zone平均時間百分比；以及(iii)動物管理員小遊戲的反應時間與正確率，皆與MMSE都有中度以上的相關程度；(5)各項變數在各個族群之間的顯著程度由Post Hoc檢定的結果指出，翻牌遊戲的8張牌與12張牌的錯誤率在正常老年人與失智症患者之間達到顯著水準。而水迷宮任務之各項變數，包括：(i)隱藏平台探索實驗的兩個實驗區塊平均完成時間與Critical Zone平均時間百分比；(ii)無平台探索實驗中的Critical Zone平均時間百分比；以及動物管理員的正確率與反應時間等七項量測指標在正常年輕人與其他三個族群之間也達到顯著水準(P<0.05)；(6)水迷宮任務的再測信度分析中，可以看到在隱藏平台實驗的第二個實驗區塊與無平台探索實驗的數據都達到極高的相關水準(0.926及0.934)，其顯著性也達到顯著水準(P<0.01)。可見虛擬莫里斯水迷宮任務之信度是相當穩定的；(7)在戒指區域直徑為16 pixels的實驗環境中，正常老年人找到戒指的機率成長率約成長13%，而失智症患者則看不到學習效果；(8) 觀察不同族群之受測者在搜尋策略的使用變化，其中正常年輕人與正常中年人逐步的增加使用空間策略的機率，可看出明顯的學習效果。而正常老年人與失智症患者在空間策略的使用機率上並無太大的變化，學習效果不顯著。

The purpose of this study is to establish a spatial cognition and memory ability assessable system for the elderly with dementia. The research purpose of this study is: (1) Developing elder-orient entertainment games to assessment elder spatial cognitive ability. (2) Establishing searching strategy assessable algorithm to analyze the learning effect. (3) Collecting clinical data and the key indicators that are different between normal elder and dementia patient.
We collected four groups’ data that includes normal young people, normal middle-aged person, normal elderly and dementia patient amount to 52. The results are showed as following: (1) The result of virtual Morris water maze showed that the latency time and the time percentage in the critical zone will grow as the age increases. (2) The result of card matching game showed that the identification error rate rises with the increase of age. (3) The correct rate of animal manager game (visual edition) reduced and the response time extended with increase of age. (4) The error rate of 12 card matching game obtained significantly high negative correlation with MMSE (-.753), and the other variables including: the latency time, the ratio of time in the critical zone, the reaction time and correct rate of animal manager game had medium correlation with MMSE. (5) The 8 card and 12 card error rate of card matching game were significantly difference in normal elderly and dementia patient. (6) The test-retest reliability analysis of water maze task showed had significantly correlation. (7)In the experiment environment of platform diameter is 16 pixels, the growth rate of hit rate of normal elderly is 13%, but there is no learning effect in dementia patient. (8) The results of spatial strategy analysis showed that the young people and the normal middle-aged person had learning effect visibly. But the normal elderly and the dementia patient will have no change in their search strategy. The learning effect is not apparent.

指導教授推薦書
口試委員審定書
長庚大學博碩士論文著作授權書 iii
誌 謝 iv
中文摘要 v
英文摘要 viii
目錄 x
表目錄 xii
圖目錄 xiii
第一章 緒論 - 1 -
1.1 研究背景 - 1 -
1.2 研究動機 - 5 -
1.3 研究目的 - 7 -
1.4 論文架構 - 9 -
第二章 文獻調查 - 10 -
2.1 傳統失智症評估相關研究 - 10 -
2.2 莫里斯水迷宮相關研究及其應用 - 13 -
2.3 3D虛擬實境開發環境介紹-Virtools - 26 -
第三章 理論模式 - 28 -
3.1 失智症之評估面向 - 28 -
3.2 虛擬水迷宮建置 - 31 -
3.3 記憶評估遊戲流程說明 - 47 -
3.4 統計分析方法 - 59 -
第四章 系統架構與實驗設計 - 65 -
4.1 系統架構 - 65 -
4.2 實驗設計 - 68 -
第五章 成果與討論 - 76 -
5.1 系統建置成果 - 76 -
5.2 資料分析成果 - 105 -
第六章 結論與未來展望 - 131 -
參考文獻 - 137 -
附錄 - 145 -

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