Joe Strong realized medical school wasn’t right for him in the summer before his senior year of college, leaving him little time to think of an alternate path. Through his volunteer work in the hospital and job shadowing in neurology clinics and other healthcare facilities, he knew he enjoyed working with older adults and wanted more opportunities to do so, but he was disenchanted with the roadblocks the insurance industry seemed to introduce into the care of these patients.
“Time and time again, I felt the frustration from the doctors when there’s an experimental treatment . . . but the insurance won’t pay for it, or they’d decline pre-approval for physical therapy or rehab,” said Strong, now a graduate student in social work. “In the clinic, it was common for patients to not be able to afford medication prescribed due to co-pays. This happened weekly, and it was fundamental to my change in career pathways.”
After discussing the matter with a friend in the field, Strong decided to pursue a master’s in social work. He never considered going after a doctoral degree until Terri Combs-Orme, a professor in the College of Social Work, convinced him otherwise.
“Joe came up to me after class and told me he was getting a master’s in social work because he was tired of science and wanted to do something with people,” said Combs-Orme. “I told him that biology is about people! Over the course of the semester he connected all the biology stuff to human behavior and began to see the value of marrying the two. A PhD just seemed perfect for him.”
“I never thought in a million years I would be in a PhD program. But Terri showed me how there is significant room for advancement in interdisciplinary collaboration and education,” Strong said. “When Terri showed me the interplay between the biological and social sciences, everything fell into place and a clear career pathway unfolded before me.”
Several factors influenced Strong’s research interests. In high school, he dated a girl whose grandmother had a form of dementia that caused her to hold conversations with people who weren’t there and with inanimate objects.
His interest in neurology began even earlier.
“When I was a little kid my dad was watching a rerun of the old show Dragnet, and some guy on the show was hallucinating and seeing things that weren’t there. As a kid, that terrified me but also made me really curious about why it occurs,” said Strong. “It prompted a life-long interest in the neurological mechanisms of memory and perception.”
Dementia is a general term for a group of symptoms caused by disorders that affect mental ability. It can affect memory, emotions, problem solving, and self-management, and there are nearly 10 million new cases every year. Dementia is not a normal part of aging; development of new brain cells actually continues, and the brain maintains its ability to change in response to new input.
The idea that became Strong’s research project started as a passing thought after watching a YouTube video on cognitive ease, the measure of how much the brain has to work to process information. Cognitive ease can alter how we feel about something. If something is easy to understand and process, like a scenic view of a quiet lake, our brains have an automatic positive reaction. Cognitive ease in familiar, everyday situations feels good and makes you happy, which in turn can make you more intuitive and more creative. If something requires more cognitive effort, such as attempting to read small moving text on a dim screen with loud music playing in the background, your brain experiences a negative reaction. People with dementia, by definition, have to work harder cognitively to perform basic tasks, which greatly affects their mood and their ability to function independently.
Joe Strong with his VR headset.
Strong hopes to demonstrate the beneficial use of virtual reality, or VR, for older adults with early to moderate dementia though his research. First he takes a baseline assessment of participants’ mood using a visual analogue scale. A series of paired antonyms are presented to the participants, who mark if they’re currently closer to one emotion than another, whether it’s happy or sad, interested or bored.
Strong also times participants in completing simple mazes.
During the four-week trial phase, participants view four different videos of natural scenery using a VR headset, including a seaside and mountain locales. Participants spend time in these virtual realities for four to six minutes at a time, seeing four different scenes twice overall during the trial phase. Then Strong repeats the initial assessment tests using the same visual analogue scale and another maze. His aim is to test the effects of VR on mood and navigation ability.
Strong is excited for the potential of the project, and he’s grateful for that 11th-hour decision not to pursue medical school as well as the many conversations he’s had along the way.
“It wasn’t until the last couple years that I thought what I’m doing now would be possible,” he said. “You need to be open to influence from wherever it may come, even a passing YouTube video or a random comment.”
Strong hopes that if he can show that VR boosts cognitive ability and reduces depression in those with dementia, the technology can make its way into more care facilities.
“People in assisted living facilities aren’t as able to get out and see the world due to safety concerns. It’s very important to me to give a voice to the vulnerable, the ignored, or the forgotten,” said Strong. “I hope this is the start of decades of research to come in a variety of care settings with other conditions beyond dementia.”
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CONTACT:
Raphael Rosalin (865-974-2152, rrosalin@utk.edu)