Feasibility of Group-Based Multiple Virtual Reality Sessions to Reduce Behavioral and Psychological Symptoms in Persons Living in Residential Aged Care

  • Rachel E. Brimelow
    UQ Centre for Clinical Research, Royal Brisbane & Women’s Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia
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  • Karthick Thangavelu
    UQ Centre for Clinical Research, Royal Brisbane & Women’s Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia
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  • Romana Beattie
    Wesley Mission Queensland, Chermside, Brisbane, Queensland, Australia
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  • Nadeeka N. Dissanayaka
    Address correspondence to Nadeeka N. Dissanayaka, PhD, UQ Centre for Clinical Research, University of Queensland, Royal Brisbane & Women’s Hospital, Herston, Building 71/918, Brisbane, Queensland 4029, Australia.
    UQ Centre for Clinical Research, Royal Brisbane & Women’s Hospital, Faculty of Medicine, University of Queensland, Herston, Brisbane, Queensland, Australia

    Department of Neurology, Royal Brisbane & Women’s Hospital, Herston, Brisbane, Queensland, Australia

    School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia
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Published:August 26, 2021DOI:



      To assess the feasibility of using group-based fully immersive virtual reality (VR) across multiple sessions to reduce behavioral and psychological symptoms (BPSs), including depression, anxiety, and agitated behaviors, in cognitively diverse aged care residents.


      A 6-session feasibility trial was conducted within a residential aged care facility using convenience sampling to recruit N = 25 residents of varying cognitive capacity. Groups of 5 residents viewed 360-degree videos on a wireless head-mounted display to provide fully immersive VR experiences.

      Setting and participants

      Half of the participants recruited from the 160-bed facility had a diagnosis of dementia (48%), whereas assessment with the Psychogeriatric Assessment Scale for cognitive impairment revealed that 64% experienced cognitive impairment (mild 20%, moderate 16%, and severe 28%). Additionally, 32% of participants had an existing anxiety or depression diagnosis.


      The Cornell Scale for Depression in Dementia, Generalized Anxiety Disorder 7-item, and Cohen Mansfield Agitation Inventory–Short were used to assess changes in persisting BPS pre- to postintervention period. The Person-Environment Apathy Rating apathy subscale, Observed Emotions Rating Scale, and a visual analog scale (Smileometer) were used to assess immediate mood responses from residents at every VR session. VR tolerability and resident feedback was also recorded.


      Pleasure (z = −5.892, P < .001) and general alertness (z = −2.455, P = .014) of participants improved at VR sessions, whereas apathy diminished (z = −5.275, P < .001). Compared to baseline, post-intervention depression was significantly lowered (z = −2.60, P = .009), whereas agitation increased (z = −2.98, P = .003). No significant changes in anxiety were observed. The quality of 360-degree videos and the device used did not induce any major VR-related negative side effects.

      Conclusions and implications

      Overall group-based VR reduced depressive symptoms and apathy, and induced a positive emotional response in most residents, with few observed side effects. Results indicate feasibility of group-based VR technological innovation within RAC.


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