Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer’s Disease: A Pilot Randomized Controlled Trial

Abstract

The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

A systematic literature review and meta‐analysis on digital health interventions for people living with dementia and Mild Cognitive Impairment

“…In relation to cognitive outcomes, while both Bahar‐Fuchs et al 31 . ( d = 0.80) and Oliveira et al 37 . ( η 2 = 0.24; d > 0.80) reported large effect sizes on global cognitive ability, the largest effect size for this outcome was found in Swinnen et al 43 .…”

“…While Schwenk et al 42 also found large improvements in balance (η 2 = 0.26; d = 0.80), the largest effect size on balance was reported in Hsieh et al 32 (d = 1.01). Kwan et al 34 reported a large reduction in frailty (d = −1.41), Swinnen et al 43 In relation to cognitive outcomes, while both Bahar-Fuchs et al 31 (d = 0.80) and Oliveira et al 37 (η 2 = 0.24; d > 0.80) reported large effect sizes on global cognitive ability, the largest effect size for this outcome was found in Swinnen et al 43 (η 2 = 0.38; d > 0.80). Regarding behavioural and psychological outcomes, Swinnen et al 43 found large reduction in depression score (η 2 = 0.43; d > 0.80).…”

Leveraging mHealth and Virtual Reality to Improve Cognition for Alzheimer’s Patients: A Systematic Review

“…The standard PICOS table summarizes study characteristics in a manner commensurate with the literature (See Table 1 ). Of the 22 studies analyzed over the 10-year period, 0 were from 2012, 1 was from 2013 [ 23 ], 3 were from 2014 [ 24 , 25 , 26 ], 2 were from 2015 [ 27 , 28 ], 4 were from 2016 [ 29 , 30 , 31 , 32 ], 2 were from 2017 [ 33 , 34 ], 2 were from 2018 [ 35 , 36 ], 3 were from 2019 [ 37 , 38 , 39 ], 3 were from 2020 [ 40 , 41 , 42 ], 2 were from 2021 [ 43 , 44 ], and 0 were from 2022. All studies involved older adults mostly above 50 years except one study where participants with MCI were above 42 years.…”

“…Six themes and seven individual observations were identified by the reviewers for a total of 41 occurrences in the literature. Nine interventions improved cognition, as measured by the MMSE, ADAS-Cog, or WAIS tests [ 24 , 25 , 26 , 29 , 32 , 34 , 35 , 38 , 43 ]. Seven interventions improved memory [ 23 , 28 , 30 , 31 , 34 , 36 , 40 ].…”

Impact of COVID-19 lockdown on physical exercise among participants receiving the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) intervention: a repeated measure study

“…However, there is accumulating evidence on the benefits of health services via electronic information and telecommunication technologies in people living with dementia. Provided adequate infrastructure and support, digital interventions including exergaming, [26][27][28][29][30][31] computerised cognitive training, [32][33][34] assistive technology, [35] teleassistance, [36] and dyadic (i.e., person living with dementia and caregiver) care support, [37] have been linked to improvements in executive functioning, maintenance of physical abilities, reduction of frailty, delayed admission to care and service optimisation (reduction of staff travel time).…”