Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study

Abstract

Background: Older adults living in long term care, rehabilitation hospitals, and seniors' residences often experience reduced mobility, sometimes resulting in confinement indoors and isolation, which can introduce or aggravate symptoms of depression, anxiety, loneliness, and apathy. As Virtual Reality (VR) technologies become increasingly accessible and affordable, there is a unique opportunity to enable older adults to escape their restricted physical realities and be transported to both stimulating and calming places which may improve their general well-being. To date no robust evaluations of the use of immersive VR therapy [experienced through a head-mounted-display (HMD)] for older adults within these settings have been reported. VR-therapy may prove to be a safe, inexpensive, non-pharmacological means of managing depressive symptoms and providing engagement and enjoyment to this rapidly growing demographic. Objectives: Establish whether it is feasible to use immersive VR technology as therapy for older adults who have reduced sensory, mobility and/or impaired cognition. This includes evaluation of tolerability, comfort, and ease of use of the HMD, and of the potential for immersive VR to provide enjoyment/relaxation and reduce anxiety and depressive symptoms. Methods: Sixty-six older adults (mean age 80.5, SD = 10.5) with varying cognitive abilities (normal = 28, mild impairment = 17, moderate impairment = 12, severe impairment = 3, unknown cognitive score = 6), and/or physical impairments, entered a multi-site non-randomized interventional study in Toronto, Canada. Participants experienced 3 to 20 min of 360 •-video footage of nature scenes displayed on Samsung GearVR HMD. Data was collected through pre/post-intervention surveys, standardized observations during intervention, and post-intervention semi-structured interviews addressing the VR experience. Results: All participants completed the study with no negative side-effects reported (e.g., No dizziness, disorientation, interference with hearing aids); the average time spent in VR was 8 min and 76% of participants viewed the entire experience at least Appel et al. VR-therapy for Frail Older Adults once. Participants tolerated the HMD very well; most had positive feedback, feeling more relaxed and adventurous; 76% wanted to try VR again. Better image quality and increased narrative video content were suggested to improve the experience. Conclusion: It is feasible and safe to expose older adults with various levels of cognitive and physical impairments to immersive VR within these settings. Further research should evaluate the potential benefits of VR in different settings (e.g., home/community based) and explore better customization/optimization of the VR content and equipment for the targeted populations.

Breaking Social Isolation Amidst COVID‐19: A Viewpoint on Improving Access to Technology in Long‐Term Care Facilities

“…6,7 These VR applications have shown positive impact, even in individuals with physical and cognitive impairment. 8 Yet, none of these technologies was available in the centers I visited and making them available at present time would be impossible given the risk of disease exposure. I believe there are two reasons we have deprived the older population of technological advances: our inherent bias of assuming the aging population is passive and lacks the ability to learn, combined with the fact that this is a population who does not advocate for itself.…”

Virtual Reality Experience In Long Term Care Resident Older Adults With Dementia: A Case Series

“…Another recent feasibility study in older adults (80.5±10.5) attending hospitals/day care centers (4 centers) used one session (maximum duration was 20 minutes) of 360 0 VR video footage with headset [39]. Similar to us, the participants (n=66) were diagnosed with dementia [39].…”

“…Similar to us, the participants (n=66) were diagnosed with dementia [39]. They declared VR intervention is safe (no AE) and feasible (adherence rate was 100%, attrition rate was 0%) [39]. They measured participants' anxiety status with a modi ed version of the State-Trait Anxiety Inventory (STAI) [83] pre-and post-intervention [39].…”

“…They declared VR intervention is safe (no AE) and feasible (adherence rate was 100%, attrition rate was 0%) [39]. They measured participants' anxiety status with a modi ed version of the State-Trait Anxiety Inventory (STAI) [83] pre-and post-intervention [39]. Overall, the STAI questionnaire revealed lesser anxiety in 12 out of 16 domains (calm, relaxed, content, adventurous, energetic, happy, sad, tense, upset/angry, worried, stressed, and anxious) [39] con rming our ndings.…”

“…Individuals with dementia enjoy virtual experiences [35,39] but its effect can be negligible on emotion (ES=0.1, 95% CI -0.07 to 0.36) and execution of daily activities (ES=0.1, 95% CI -0.3 to 0.49 ) when provided with a headset without music [40]. To date there is no published research about the use of VR experience with BroomX© as a non-pharmacologic intervention in LTC residents with moderate to severe dementia and BPSD.…”