Prospective Memory for Virtual Cooking Tasks in Relation to Adaptive Functioning

Prospective memory (PM), the ability to remember to carry out future intentions, may be critical for everyday independence. The extent to which performance on virtual reality (VR) measures of prospective memory correlates with effective everyday functioning (i.e., adaptive functioning) remains debated. This study examined the association between a function-led measure of prospective memory in a VR environment that more closely resembles everyday tasks (the Virtual Kitchen Protocol for Prospective Memory; VKP-PM) and commonly used clinical-based measures of adaptive functioning among clinic-referred adults. A clinical-based sample of adults (N = 115; Mage = 70.1) was administered the VKP-PM, three self-reported measures (Instrumental Activities of Daily Living Scale IADLS, Functional Activities Questionnaire FAQ, Measurement of Everyday Cognition ECOG), and a performance-based measure of adaptive functioning (Texas Functional Living Scale TFLS). A subset (n = 50-56) had an informant who completed an identical version of each reported measure (see Methods limitations). Multivariate general linear models were conducted to demonstrate the association between the VKP-PM and the four dependent variables (representing adaptive functioning), while adjusting for demographic characteristics (age and gender), depression (Geriatric Depression Scale-15; GDS), and VR-related comfort. Primary analyses revealed that higher VKP-PM scores were associated with better performance-based adaptive functioning, beyond covariates. Associations between VKP-PM and self-reported adaptive functioning were weaker and less consistent, with only the IADLS showing a significant association. Post hoc moderation analyses indicated that GDS exerted broad negative effects on self-report measures. The informant model showed stronger convergence with VKP-PM. Across analytic frameworks, the VKP-PM, representing a function-led, ecologically oriented VR measure of prospective memory, was reliably associated with adaptive functioning, most strongly with performance-based measures, weaker/mixed with self-reported measures, and moderately with informant-reported measures. These findings support the ecological veridicality of the VKP-PM assessment and underscore the influence of affective and methodological factors on self-perceived functioning, emphasizing the need for a multimodal approach to the adaptive functioning assessment in a clinical sample referred for a neuropsychological evaluation.