Authors: (including presenting author): :
Lau WYS (1)(2), Tong TK (1)(2), Tsang SW (1)(2)
Affiliation: :
(1) Occupational Therapy Department, Castle Peak Hospital
(2) Department of Old Age Psychiatry, Castle Peak Hospital
Keyword 1: :
Immersive Virtual Reality
Keyword 3: :
Behavioral and Psychological Symptoms of Dementia
Keyword 4: :
Non-pharmacological intervention
Introduction: :
Behavioral and psychological symptoms (BPSD) in dementia are prevalent and particularly challenging in inpatient acute wards. Immersive virtual reality (IVR) rehabilitation is an emerging non-pharmacological intervention; however, evidence for its effectiveness in managing BPSD in acute hospital settings remains limited.
Objectives: :
This study evaluated the feasibility and effectiveness of IVR rehabilitation in reducing BPSD among inpatients with dementia in an acute psychogeriatric ward. It was hypothesized that IVR would be well accepted and associated with reductions in agitation and depressive symptoms.
Methodology: :
Inpatients with dementia participated in two to three 45-minute IVR sessions delivered via a cave automatic virtual environment system. Intervention content was based on participants’ life history, cultural background, and daily living experiences. BPSD were assessed before and after the intervention using the Neuropsychiatric Inventory Questionnaire (NPI-Q), Cohen-Mansfield Agitation Inventory (CMAI), and Cornell Scale for Depression in Dementia (CSDD). Usability was evaluated using the Virtual Reality System Usability Questionnaire (VRSUQ).
Result & Outcome: :
Six subjects were female with a mean age of 79 years and mild to moderate dementia. They completed training within two months, with zero dropout rate. Wilcoxon signed-rank tests showed significant reductions in NPI-Q Severity scores (z = −2.207, p = 0.027) and NPI-Q Distress scores (z = −2.201, p = 0.028) post-training. CMAI and CSDD scores were also significantly lower after training (z = −2.207, p = 0.027; z = −2.201, p = 0.028). Positive feedback was received with a mean VRSUQ score of 59.83 (SD = 22.65). The IVR incorporates person-centered design principles and multisensory prompts to enhance engagement among patients with dementia. Evidence indicates that culturally tailored content promotes greater participation and facilitates social interaction, thereby reducing frustration that may precipitate aggressive behaviors and providing alternative outlets for emotional expression. Furthermore, the IVR excels in supporting reminiscence processes, eliciting positive emotions, autobiographical recall, and a sustained personhood—elements that often persist longer than recent episodic memory in dementia. In addition, the IVR generates a robust sense of presence, effectively transporting participants into calming environments. This heightened engagement captures and sustains attention more effectively than traditional activities. Nevertheless, findings are constrained by the single-arm design and small sample size, warranting confirmation through larger randomized controlled trials.
