VR&R: Providing Caregiver Respite by Managing BPSDs and Improving QoL in People with Dementia Using Immersive VR-Therapy

NCT ID: NCT05867641

Last Updated: 2025-03-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-12

Study Completion Date

2027-02-01

Brief Summary

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The goal of this interventional trial is to learn about how immersive Virtual Reality (VR) therapy can be used at home by individuals with dementia, with assistance from their informal (e.g., friend/family) caregivers.

The main question it aims to answer are:

1. Can caregivers receive quality respite time by using VR-therapy at home with their loved ones with dementia? Does this intervention reduce feelings of burden and improve well-being and resilience for caregivers?
2. Does VR-therapy help to manage behavioural and psychological symptoms (e.g., mood, apathy, agitation) and improve quality of life for individuals with dementia?
3. What types of VR "medium" (passive or cooperative) are most effective for achieving the above objectives?

Participant pairs will be asked to:

* Take part in an initial at-home VR technology training session and complete a series of brief questionnaires (e.g., health history/technology use, well-being/quality of life, symptoms of dementia)
* Use "VR\&R" (VR Rest \& Relaxation Therapy) for a period of 4 weeks (30 minute sessions, desired frequency), and answer a brief set of questions after each VR\&R session
* Provide feedback on the VR\&R intervention in semi-structured interview with the researcher and answer additional questionnaires at a 2-week follow-up

During VR\&R sessions, participants with dementia will have the opportunity to choose to watch (1) immersive 360-degree videos (e.g., of a live performance, or beach) on their own and (2) experience the same VR videos together with a researcher.

Caregivers will be asked to assist their loved one with dementia to use VR\&R by helping to put on the VR headset, selecting a VR experience through a user-friendly application, and remaining nearby to supervise and provide assistance as needed. During VR\&R sessions, caregivers may use this time to take a personal break or complete short tasks (e.g., make a cup of coffee, have an uninterrupted phone call).

Detailed Description

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Caregivers of individuals with dementia experience twice as much distress as those providing care for other seniors. This burden is particularly common when the person with dementia displays aggression. A number of recent studies have indicated that Virtual Reality (VR)-therapy is a safe, acceptable, and enjoyable non-pharmacological intervention for individuals with dementia, with potential to manage symptoms and promote quality of life. However, further research is needed to determine how to best design VR-therapy for this purpose. Moreover, it is not yet known whether VR is helpful for providing respite for caregivers. In this study, the investigators aim to determine whether "VR\&R", an immersive VR-therapy, is helpful for providing caregiver respite and managing symptoms of dementia (mood, apathy, agitation). Additionally, this study will explore what type of VR "medium" is most effective for achieving these outcomes. The VR\&R intervention includes a user-friendly web-application that caregivers can use to select among three different multi-sensory mediums for their loved one with dementia to experience (1) "Solo VR": 360-degree videos that simulate real-life environments (the ocean, watching a ballet) and (2) "Social VR": where a researcher interacts with the participants while using VR. Participants will use VR\&R at home for up to 30 minutes at a time, for four weeks. Outcomes will be evaluated using mixed methods (questionnaires, semi-structured interviews, observations, objective metrics of VR usage). The investigators predict that the intervention will provide caregivers with uninterrupted time to complete brief tasks that they may not have been able to otherwise, improving well-being and reducing feelings of burden. This study's findings will have implications for designing and implementing home-based VR interventions, including which types of VR experiences keep individuals with dementia engaged the longest, are easiest to use, and are seen as most beneficial by end-users.

Conditions

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Dementia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Pragmatic crossover interventional trial including a four-week home-based intervention (two weeks per condition) and two-week follow-up.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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VR&R Therapy - Solo First

Recruited dyads will include one person diagnosed with dementia and their caregiver (e.g., family/friend). The caregiver will assist their loved ones with dementia to use VR-therapy at home. Caregivers may use the time while their loved ones are engaged for respite, remaining nearby to supervise and assist.

For the first two weeks, only the caregiver will be present to use VR with the person with dementia. For the following two weeks, a research assistant will be present to use VR with the person with dementia.

Group Type EXPERIMENTAL

Immersive VR Therapy in Head-Mounted Display (HMD) (Solo)

Intervention Type BEHAVIORAL

Caregivers will be trained to administer VR\&R therapy to their loved ones with dementia, in their private home/residence. Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, approximately every other day (or as desired), for two weeks. The caregiver will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

Immersive VR Therapy in a Head-Mounted Display (HMD) (Social)

Intervention Type BEHAVIORAL

Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, 2 to 3 times per week, for 2 weeks. A research assistant who is trained in dementia care will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

VR&R Therapy - Social First

Recruited dyads will include one person diagnosed with dementia and their caregiver (e.g., family/friend). The caregiver will assist their loved ones with dementia to use VR-therapy at home. Caregivers may use the time while their loved ones are engaged for respite, remaining nearby to supervise and assist.

For the first two weeks, a research assistant will be present to use VR with the person with dementia. For the following two weeks, only the caregiver will be present.

Group Type EXPERIMENTAL

Immersive VR Therapy in Head-Mounted Display (HMD) (Solo)

Intervention Type BEHAVIORAL

Caregivers will be trained to administer VR\&R therapy to their loved ones with dementia, in their private home/residence. Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, approximately every other day (or as desired), for two weeks. The caregiver will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

Immersive VR Therapy in a Head-Mounted Display (HMD) (Social)

Intervention Type BEHAVIORAL

Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, 2 to 3 times per week, for 2 weeks. A research assistant who is trained in dementia care will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

Interventions

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Immersive VR Therapy in Head-Mounted Display (HMD) (Solo)

Caregivers will be trained to administer VR\&R therapy to their loved ones with dementia, in their private home/residence. Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, approximately every other day (or as desired), for two weeks. The caregiver will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

Intervention Type BEHAVIORAL

Immersive VR Therapy in a Head-Mounted Display (HMD) (Social)

Participants with dementia will view immersive VR experiences using a commercially-available VR head-mounted device for up to 30 minutes a time, 2 to 3 times per week, for 2 weeks. A research assistant who is trained in dementia care will use the custom application on a tablet to select and monitor what their loved one sees in VR.

Staying nearby to monitor for safety and assistance, the caregiver may choose to use the time when their loved one is engaged to take some respite time for themselves (e.g., make a cup of coffee, have an uninterrupted phone call).

Intervention Type BEHAVIORAL

Other Intervention Names

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Solo VR Therapy Social VR Therapy

Eligibility Criteria

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Inclusion Criteria

* Individuals who are 65 years of age or older
* Individuals living at home with a family caregiver
* Individuals diagnosed with dementia


* Individuals who identify as a primary caregiver for the PwD
* Individuals who have access to the internet through a device (computer, tablet, or mobile phone) that can be used during the study

Exclusion Criteria

* Individuals with open wounds on face (sutured lacerations exempted)
* Individuals with a history of seizures or epilepsy
* Individuals with a pacemaker
* Individuals with head trauma or stroke leading to their current admission
* Individuals with cervical conditions or injuries that would make it unsafe for them to use the VR headset
* Individuals who identify as being legally blind
* Individuals with alcohol related dementia/ Korsakoff syndrome.
* Individuals who have a Public Guardian and Trustee (PGT) as Substitute Decision Maker (SDM)
* Individuals who cannot speak and understand English


* Individuals who cannot speak and understand English
* Individuals who are cognitively unable to provide informed consent for themselves
* Identify as legally blind
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre for Aging and Brain Health Innovation

OTHER

Sponsor Role collaborator

Ontario AHSC AFP Innovation Fund

UNKNOWN

Sponsor Role collaborator

Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Lora Appel

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Acclaim Health

Oakville, Ontario, Canada

Site Status RECRUITING

Chester Village

Toronto, Ontario, Canada

Site Status RECRUITING

Circle of Care

Toronto, Ontario, Canada

Site Status RECRUITING

Toronto Grace Hospital - Main Site

Toronto, Ontario, Canada

Site Status ACTIVE_NOT_RECRUITING

Toronto Grace Hospital - Remote Care Monitoring

Toronto, Ontario, Canada

Site Status RECRUITING

Toronto Grace Hospital - Specialized Care Centre

Toronto, Ontario, Canada

Site Status RECRUITING

McGill Dementia Education Centre

Montreal, Quebec, Canada

Site Status NOT_YET_RECRUITING

Countries

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Canada

Central Contacts

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Lora Appel, PhD

Role: CONTACT

6475046537

Lora Appel, PhD

Role: CONTACT

Facility Contacts

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Patricia Blakely

Role: primary

Cynthia Marianelli

Role: primary

416-466-2173

Lisa Rae

Role: primary

416-635-2860 ext. 284

Danielle Lechman

Role: primary

437-233-2661

Chrincia Bernard

Role: primary

647-670-2611 ext. 201

Diane Weidner

Role: primary

References

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Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA. Exergaming and older adult cognition: a cluster randomized clinical trial. Am J Prev Med. 2012 Feb;42(2):109-19. doi: 10.1016/j.amepre.2011.10.016.

Reference Type BACKGROUND
PMID: 22261206 (View on PubMed)

Appel L, Appel E, Bogler O, Wiseman M, Cohen L, Ein N, Abrams HB, Campos JL. Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study. Front Med (Lausanne). 2020 Jan 15;6:329. doi: 10.3389/fmed.2019.00329. eCollection 2019.

Reference Type BACKGROUND
PMID: 32010701 (View on PubMed)

Appel L, Kisonas E, Appel E, Klein J, Bartlett D, Rosenberg J, Smith C. Introducing virtual reality therapy for inpatients with dementia admitted to an acute care hospital: learnings from a pilot to pave the way to a randomized controlled trial. Pilot Feasibility Stud. 2020 Oct 31;6(1):166. doi: 10.1186/s40814-020-00708-9.

Reference Type BACKGROUND
PMID: 33292729 (View on PubMed)

Appel L, Kisonas E, Appel E, Klein J, Bartlett D, Rosenberg J, Smith CN. Administering Virtual Reality Therapy to Manage Behavioral and Psychological Symptoms in Patients With Dementia Admitted to an Acute Care Hospital: Results of a Pilot Study. JMIR Form Res. 2021 Feb 3;5(2):e22406. doi: 10.2196/22406.

Reference Type BACKGROUND
PMID: 33533720 (View on PubMed)

Appel L, Ali S, Narag T, Mozeson K, Pasat Z, Orchanian-Cheff A, Campos JL. Virtual reality to promote wellbeing in persons with dementia: A scoping review. J Rehabil Assist Technol Eng. 2021 Dec 21;8:20556683211053952. doi: 10.1177/20556683211053952. eCollection 2021 Jan-Dec.

Reference Type BACKGROUND
PMID: 35024166 (View on PubMed)

Baker JR, Webster L, Lynn N, Rogers J, Belcher J. Intergenerational Programs May Be Especially Engaging for Aged Care Residents With Cognitive Impairment: Findings From the Avondale Intergenerational Design Challenge. Am J Alzheimers Dis Other Demen. 2017 Jun;32(4):213-221. doi: 10.1177/1533317517703477.

Reference Type BACKGROUND
PMID: 28506126 (View on PubMed)

D'Cunha NM, Nguyen D, Naumovski N, McKune AJ, Kellett J, Georgousopoulou EN, Frost J, Isbel S. A Mini-Review of Virtual Reality-Based Interventions to Promote Well-Being for People Living with Dementia and Mild Cognitive Impairment. Gerontology. 2019;65(4):430-440. doi: 10.1159/000500040. Epub 2019 May 20.

Reference Type BACKGROUND
PMID: 31108489 (View on PubMed)

Dermody G, Whitehead L, Wilson G, Glass C. The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review. J Med Internet Res. 2020 Jun 1;22(6):e17331. doi: 10.2196/17331.

Reference Type BACKGROUND
PMID: 32478662 (View on PubMed)

Huygelier H, Schraepen B, van Ee R, Vanden Abeele V, Gillebert CR. Acceptance of immersive head-mounted virtual reality in older adults. Sci Rep. 2019 Mar 14;9(1):4519. doi: 10.1038/s41598-019-41200-6.

Reference Type BACKGROUND
PMID: 30872760 (View on PubMed)

Munoz J, Mehrabi S, Li Y, Basharat A, Middleton LE, Cao S, Barnett-Cowan M, Boger J. Immersive Virtual Reality Exergames for Persons Living With Dementia: User-Centered Design Study as a Multistakeholder Team During the COVID-19 Pandemic. JMIR Serious Games. 2022 Jan 19;10(1):e29987. doi: 10.2196/29987.

Reference Type BACKGROUND
PMID: 35044320 (View on PubMed)

Related Links

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Other Identifiers

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VR&R

Identifier Type: -

Identifier Source: org_study_id

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