**A.1 Example XR-setup for decision-making decline monitoring of dementia patients**

#### *A.1.1 XR-scene development technology*

Any state-of-the-art software can be used for dementia-related testing, such as Unity3D ®, Unreal ®, which are designed for maximum accessibility and ease-ofdevelopment for diverse developers. They lack psychiatric calibration and features suited to patient cognitive behavioral environmental-interactive capture and heartrate AI, as well as geographic solar-shadow and weather calibration for both illumination intensity draws and audio. Last but certainly not least, the player analytics do not accommodate sampling frequencies and these will need to be handbuilt, which leads to significant reduction in frame rates at the time of this chapter's writing. For this reason data needs to be stored on the device for post-session upload and integration into an appropriate repository. In general, leading palliative care institutions should try to achieve approximately 600 longitudinal sessions per patient for at least 1200 patients56 to generate a suitable diagnostic game AI algorithm [57]. These totals represent average numbers of records submitted to the previously-mentioned Human Connectome Project, for example.

Ethical consideration: Large commercial database hosting sellers are eager to acquire patient data for free. And yet, healthcare costs of the producer, the dementia patient, and the time and technology costs are abandoned or ignored. A fee per interaction should be required from the sellers per frame, and reimbursed towards the patient's full needs, particularly those patients and teams who seek rehabilitation strategies and research for immediate potential curative-care opportunities with XR-related prosthetics.

The simplest platform or device that is VR-enabled and lightweight for hosting a real-time XR-scene for a stationary player is suitable. This can include a basic phone such as a Samsung(R) 10 or 10+ in a Gear VR headset, or an Oculus Rift product, and similar. The ideal software will include AI-calibrated illumination intensity and unbiased wavelength delivery, from a light-emitting diode (such as an AMOLED strip) plus brightness settings that can be adjusted manually by the team. It will also collect geographic coordinates of the player, plus time-of-day and ambient light, pollution and player Fowler's position, heartrate plus saccadic blinking and eyetracking. The data collected may need to be temporarily stored on the device and so it should also have sufficient hardware capacity both to allow non-occluding GPU rendering and device storage for a 3-minute game processing and behavioral sampling every 30 seconds, minimum at a framerate no less than 32 to 45 frames per second. In a headset, ensure that audio settings conform to any hearing aid or other *The Need for XR-Measurement of Decision-Making Decline and Conscious-State Transition… DOI: http://dx.doi.org/10.5772/intechopen.97384*

prescription settings. The same is true for visual aid adjustments in the VR-headset. Handheld peripherals should not be used or required for dementia autonomic cognitive decision-making and conscious-state transition settings. The patient should not be required to navigate at any time and a member of the diagnostic patient caregiving team is responsible for the condition, use and removal of the XR-assembly from the patient in all sessions.
