Ecological and Embodied Assessment of Inhibitory Control Using a VR Stroop Task in Cognitively Healthy Older Adults:...

Background/Objectives: This study examined the concurrent validity and test-retest reliability of the novel virtual reality-based Stroop test (VRST), developed based on the principles of embodied cognition. The VRST simulates a clothing-sorting task to assess inhibitory control using cognitive and behavioral (kinematic) measures. Methods: A total of 224 cognitively healthy older adults (mean age = 71.51 years) completed the VRST and a traditional Stroop test in randomized order. The VRST implemented a fixed-difficulty design consisting of 30 incongruent trials, where participants were required to sort virtual objects by their semantic category while ignoring conflicting color cues. The task duration ranged from approximately 1 to 3 min. The VRST assessed task completion time, error count, 3D movement distance, and hesitation latency. Test-retest reliability was examined after two weeks. Concurrent validity was analyzed via Pearson correlation coefficients with traditional Stroop metrics. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs). Results: VRST performance metrics showed significant correlations with traditional Stroop completion time: task completion time (r = 0.821; p < 0.001), movement distance (r = 0.801; p < 0.001), and hesitation latency (r = 0.784; p < 0.001), indicating good concurrent validity. No significant correlations were observed for error counts. Test-retest analysis showed high reliability for completion time (ICC > 0.9; p < 0.001), movement distance (ICC > 0.9; p < 0.001), and hesitation latency (ICC > 0.9; p < 0.001), but not for error count. These findings suggest that the VRST provides reliable and ecologically grounded behavioral indicators of inhibitory control. Conclusions: This preliminary study supports the VRST as a valid and reliable measure of inhibitory control in healthy older adults. By combining kinematic data with realistic task contexts, the VRST extends executive function assessment beyond traditional methods. Although limited to non-clinical populations, the findings suggest its utility for detecting subtle variations in executive functioning during healthy aging, warranting further investigation across broader cognitive profiles.