Virtual Reality Experience Intervention May Reduce Responsive Behaviors in Nursing Home Residents with Dementia: A Case Series

J Alzheimers Dis. 2021;84(2):883-893. doi: 10.3233/JAD-210010.

Abstract

Background: People with advanced dementia often exhibit responsive behaviors such as apathy, depression, agitation, aggression, and psychosis. Non-pharmacological approaches (e.g., listening to music, watching television, doing arts and crafts) are now considered as a first-line strategy to manage responsive behaviors in clinical practice due to the potential risks associated with the antipsychotic medications. To date, no evaluations of immersive non-head mounted virtual reality (VR) experience as a non-pharmacologic approach for people with advanced dementia living in nursing homes have been reported.

Objective: To evaluate the feasibility (acceptance and safety) of VR experience.

Methods: A single site case series (nonrandomized and unblinded) with a convenience sample (N = 24; age = 85.8±8.6 years; Cognitive Performance Scale score = 3.4±0.6) measuring depression and agitation before and after the intervention. The intervention was a 30-min long research coordinator- facilitated VR experience for two weeks (10 sessions).

Results: The intervention was feasible (attrition rate = 0% ; adverse events = 0). A reduction in depression and in agitation was observed after the intervention. However, we suggest extreme caution in interpreting this result considering the study design and small sample size.

Conclusion: This study provides the basis for conducting a randomized controlled trial to evaluate the effect of VR experience on responsive behaviors in nursing homes. Since our intervention uses a smart remote-controlled projector without a headset, infectious exposure can be avoided following the COVID-19 pandemic-induced physical distancing policy in care homes.

Keywords: Dementia; nursing home; responsive behaviors; virtual reality experience intervention.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aggression / psychology
  • COVID-19 / virology*
  • Dementia / psychology
  • Female
  • Humans
  • Male
  • Nursing Homes*
  • Quality of Life / psychology
  • SARS-CoV-2 / pathogenicity*
  • Virtual Reality*