Research psychologist Konstantine Zakzanis had known for years that the convetional tests for cognitive impairment in patients with disorders ranging from depression to Alzheimer’s disesase to post-concussive syndrome were unreliable. He even wrote a book about it. 

Frustrated by his inability to test patients in the real world, where cognitive deficiencies would be obvious, he did the next best thing. He created a video game.

“Virtual reality allows me to engage these patients in ‘real world’ activities,” Zakzanis says, “yet still maintain experimental control to measure impairment reliability and validly.”

The University of Toronto professor built the Multitasking in the City Task with VR software called WorldUp, then augmented it with a version of the Unreal engine. Using a joystick and keyboard, patients do daily tasks, like go to the bank or monitor an assembly line for defective goods. Patients who have trouble with these tasks, it follows, will encounter real difficulties in day to day life. 

The development of reliable testing for cognitive impairment is of crucial importance, Zakzanis says. Convetional tests that ask patients to solve logic or math problems or match cards are not always successful at predicting which patients will truly have difficulty functioning in real life. The Multitasking game, Zakzanis says, can differetiate between patients with cognitive impairments who are truly disabled and those who aren’t.

“The implications can be profound in the context of awarding disability entitlement to someone who may have sustained a traumatic brain injury and can no longer work, yet is not entitled to aid because the tests that a clinician employs won’t illustrate this.”

Even though Zakzanis is now something of a game programmer, he’s not a gamer.

“When I was kid, I wasn’t impressed with the idea of a bouncing a ball back and forth with my gaming partner at the time. So I took up playing the guitar.”