How VR Can Help People With Dementia
Virtual reality is a promising therapeutic option for increasing the quality of life for people with dementia.
Virtual reality (VR) is most well-known for its applications in gaming. But, there is currently a large amount of research into the therapeutic benefits of this technology.
Increasing the quality of life of people with dementia (PWD) is a significant struggle for our healthcare services. However, some research has found that VR therapy may be a promising new treatment.
What Is Dementia?
Dementia is an umbrella term for progressive disorders of the brain. These disorders are characterized by a loss of brain functions such as judgment and memory. There are over 100 diseases that may cause dementia. The most common are Alzheimer’s disease, vascular dementia, dementia with Lewy bodies¹, and Huntington’s disease².
Approximately 46 million people worldwide are diagnosed with some form of dementia³. There is no cure for dementia currently. However, there is a lot of research into finding effective treatments. Leqembi is a new Alzheimer’s treatment approved by the FDA on January 6th, 2023⁴.
Studies⁵ have suggested that half of all people with dementia (PWD) have depression. This alone is an upsetting fact, indicating that some intervention is needed to improve the quality of life for PWD. Unfortunately, depression may also worsen the cognitive decline associated with dementia, further reducing the quality of life⁶.
Since there is no cure, it is important to find means of improving the quality of life for PWD.
What is Virtual Reality?
Virtual reality is a computer-generated, interactive, three-dimensional world delivered via a head-mounted display (HMD). VR is designed to make the user feel as though they are actually in the world being displayed to them.
Although many people have heard of VR as a gaming device, it has many more applications, including:
- Education
- Healthcare — including patient care and medical training
- Journalism
- Sports
- Workplace training
How Can VR Help People With Dementia?
As dementia is progressive, many people tend to require full-time care as the disease gets worse. Often, this means residing in specialized retirement homes or psychiatric hospitals. However, when in these facilities, it can be hard for the PWD to maintain their lifestyle, leisure activities, and sense of identity.
Mobility can also be difficult for PWD. For some, this is a direct result of dementia⁷. For others, mobility issues can be due to comorbidities. Because of this, many PWD may be restricted from partaking in activities and experiences they previously would have enjoyed.
The loss of autonomy, sense of identity, privacy, and inability to maintain their lifestyle and partake in leisure activities can negatively affect a person’s quality of life⁸.
Researchers from the University of Kent set out to determine how VR technology could be used to improve the quality of life for PWD⁶.
What The Study Did
Participants in this study had a diagnosis of dementia and resided in a locked psychiatric facility. The mean age of participants was 69.6 years.
The study took place within the ward the patients resided in to minimize any stress caused by changes to their environment.
Initially, participants were monitored for 15 minutes within their usual setting as a ‘pre-exposure’ measure. The participant and a caregiver were then taken to a room within the ward for the VR experience.
The participant was able to experience five different environments through the VR headset. They were able to change between these locations on their own. The environments were:
- A cathedral
- A forest
- A rocky beach
- A sandy beach
- The countryside
Participants were assured that they could stop the VR experience whenever they wanted to, and it lasted a maximum of 15 minutes.
After the VR exposure, the participants underwent a semi-structured interview. They were then monitored for 15 minutes ‘post-exposure.’ The caregivers present were also interviewed.
The participants were offered to try the VR experience again two weeks later.
Key Findings
This study found that VR treatment has the potential to improve the quality of life for PWD⁶.
Participants in the VR treatment had an uplifted mood during the experience and for a short time afterward.
One of the participants said to a researcher, “It was the best day,” while shaking their hand and thanking them. The participant went on to tell his peers about the experience and was heard saying, “Best day I ever had.”
Some of the ways VR treatment was shown to benefit participants are discussed below.
Recollection of old memories. One of the most stand-out results of this research was that the VR experience helped patients to recall old memories. This is because the VR exposed the participant to new stimuli, which prompted memories they could no longer reach on their own.
As more research is done in this area and VR technology continues to improve, there is potential for this VR treatment to become more personal. For example, VR could be used to explore a participant’s home or a place they enjoyed in the past, aiding in unlocking old memories.
Ability to do activities they otherwise could not do. As mentioned before, many PWD cannot maintain activities they previously enjoyed due to mobility or safety restrictions. This restriction affects a person’s quality of life. VR provides a solution to that problem by ‘transporting’ the participant to a new environment where such activities could take place without the physical requirements.
In this study, patients could explore a forest or visit a beach, but in the future, this could be expanded to a variety of other locations. Additionally, since VR has interactive gaming abilities, there is potential for this to be adapted to interactive activities that participants enjoyed before their mobility was restricted — such as sports like bowls or golf, shopping, or cooking.
Improving caregiver-PWD relationship. Many participants opened up about themselves and their feelings while using VR technology. This helped the caregiver learn more about them and see them not just as a patient but as a person.
Additionally, by hearing about the participant’s feelings and past experiences, the caregiver got to know the participant better. This can aid in future care by allowing caregivers to adjust activities and experiences to be more personalized for the PWD.
It is known that having positive therapeutic relationships with long-term caregivers results in better outcomes⁹, so improving this relationship in any manner is a win.
Reduced aggression. Participants displayed considerably less aggressive behaviors during the observed ‘post-exposure’ portion of the experiment than they did ‘pre-exposure.’
The VR treatment allowed participants their own ‘personal space’ for the short time they were using it. This is something that many PWD in care facilities do not generally receive.
Often, aggressive behaviors that are associated with dementia are caused by a triggering stimulus. By allowing participants this personal space in a low-stimuli environment — away from things that may trigger them — participants appeared more relaxed and less aggressive.
This suggests that VR could be used in the future to help de-escalate or prevent aggressive behaviors that are difficult for both caregivers and PWD.
Conclusion
There is a lot of new research into the use of VR therapy for many different conditions — including dementia. This research is promising and paves the way for more studies to hopefully increase the quality of life for those who live with dementia.
References
- Types of dementia. Dementia Australia. Accessed January 11, 2023. https://www.dementia.org.au/information/about-dementia/types-of-dementia
- Huntington’s Disease. Alzheimer’s Association. Accessed January 11, 2023. https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/huntington-s-disease
- Prince M, Wimo A, Guerchet M, Ali G, Wu Y, Prina M. World Alzheimer Report 2015. The Global Impact of Dementia. An Analysis of Prevalence, Incidence, Cost, and Trends. Alzheimer’s Disease International; 2015.
- U.S. Food & Drug Administration. FDA Grants Accelerated Approval for Alzheimer’s Disease Treatment. Published January 06, 2023. Accessed January 11, 2023. https://www.fda.gov/news-events/press-announcements/fda-grants-accelerated-approval-alzheimers-disease-treatment
- Schreiner AS, Yamamoto E, Shiotani H. Positive affect among nursing home residents with Alzheimer’s dementia: the effect of recreational activity. Aging Ment Health. 2005;9(2):129–134. doi:10.1080/13607860412331336841
- Tabba L, Ang C S, Rose V, Siriaraya P, Stewart I, Jenkins K G, Matsangidou M. Bring the Outside In Providing Accessible Experiences Through VR for People with Dementia in Locked Psychiatric Hospitals. In Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems (CHI ‘19). 2019;236:1–15. doi.org/10.1145/3290605.3300466
- Mental, physical, and speech abilities in later stages of dementia. Alzheimer’s Society. Updated June 29, 2022. Accessed January 11, 2023. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/mental-and-physical-activities#:~:text=the%20later%20stages-,Mobility,be%20more%20likely%20to%20fall
- Long C, Mclean A, Boothby A, Hollin C. Factors associated with quality of life in a cohort of forensic psychiatric in-patients. The British J. Forensic Pract. 2008;10(1):4–11. doi.org/10.1108/14636646200800002
- Kane RA. Long-term care and a good quality of life: bringing them closer together. Gerontologist. 2001;41(3):293–304. doi:10.1093/geront/41.3.293
