Journal of the American Medical Directors Association | 2021
Feasibility of Group-Based Multiple Virtual Reality Sessions to Reduce Behavioral and Psychological Symptoms in Persons Living in Residential Aged Care.
Abstract
OBJECTIVES\nTo assess the feasibility of using group-based fully immersive virtual reality (VR) across multiple sessions to reduce behavioral and psychological symptoms (BPSs), including depression, anxiety, and agitated behaviors, in cognitively diverse aged care residents.\n\n\nDESIGN\nA 6-session feasibility trial was conducted within a residential aged care facility using convenience sampling to recruit N\xa0= 25 residents of varying cognitive capacity. Groups of 5 residents viewed 360-degree videos on a wireless head-mounted display to provide fully immersive VR experiences.\n\n\nSETTING AND PARTICIPANTS\nHalf of the participants recruited from the 160-bed facility had a diagnosis of dementia (48%), whereas assessment with the Psychogeriatric Assessment Scale for cognitive impairment revealed that 64% experienced cognitive impairment (mild 20%, moderate 16%, and severe 28%). Additionally, 32% of participants had an existing anxiety or depression diagnosis.\n\n\nMEASURES\nThe Cornell Scale for Depression in Dementia, Generalized Anxiety Disorder 7-item, and Cohen Mansfield Agitation Inventory-Short were used to assess changes in persisting BPS pre- to postintervention period. The Person-Environment Apathy Rating apathy subscale, Observed Emotions Rating Scale, and a visual analog scale (Smileometer) were used to assess immediate mood responses from residents at every VR session. VR tolerability and resident feedback was also recorded.\n\n\nRESULTS\nPleasure (z\xa0=\xa0-5.892, P < .001) and general alertness (z\xa0=\xa0-2.455, P\xa0= .014) of participants improved at VR sessions, whereas apathy diminished (z\xa0=\xa0-5.275, P < .001). Compared to baseline, post-intervention depression was significantly lowered (z\xa0=\xa0-2.60, P\xa0= .009), whereas agitation increased (z\xa0=\xa0-2.98, P\xa0= .003). No significant changes in anxiety were observed. The quality of 360-degree videos and the device used did not induce any major VR-related negative side effects.\n\n\nCONCLUSIONS AND IMPLICATIONS\nOverall group-based VR reduced depressive symptoms and apathy, and induced a positive emotional response in most residents, with few observed side effects. Results indicate feasibility of group-based VR technological innovation within RAC.