While mild cognitive impairment (MCI) is common among elderly individuals, most continue to function moderately well in carrying out their usual activities. However, over the following three years after diagnoses of MCI, about 30 per cent of patients develop Alzheimer disease — a neurodegenerative disorder that seriously impairs thinking and memory. Some studies suggest that analyzing cerebrospinal fluid or brain imaging may predict the risk of Alzheimer dementia in patients with MCI, but these techniques are costly and, in some cases, not routinely available. The earliest degeneration of brain tissue with Alzheimer disease occurs in the hippocampus, a region of the brain important for learning, memory and topographical orientation, that is our ability to orient within the environment Dr. Giuseppe Iaria is investigating whether a computerized virtual reality test assessing topographical orientation skills is able to predict the progression of Alzheimer’s disease in patients diagnosed with MCI. If effective, this inexpensive test could be administered in any clinic to identify MCI patients at high risk for developing Alzheimer dementia. With early detection, it may be possible for medication to prevent or slow the progression of nerve cell degeneration because once the damage has occurred, it is generally irreversible.