Virtual Reality (VR) and Dementia (Alzheimer's) Guide | VU Dream

Disease is an awful thing to experience or have a loved one experience.

Yet, we all know it's inevitable.

Taking steps in your life like eating healthy and exercising are positive measures. We can't account for everything but you never know what can happen next in your life.

Diseases of the brain like Alzheimer's are one of the most impactful and destructive.

Worldwide, around 47 million people have dementia with almost 10 million new cases every year. Alzheimer's disease is the most common cause of dementia and may contribute to 60–70% of cases.

Alzheimer's disease is ultimately fatal.

An estimated 5.5 million Americans of all ages have Alzheimer's disease. Of the estimated 5.5 million Americans living with Alzheimer's dementia in 2017, an estimated 5.3 million are age 65 and older and approximately 200,000 individuals are under age 65 and have younger-onset Alzheimer's.

The study found that dementia prevalence (total number of cases) increased with age: 13.5 percent at 80 to 84 years; 30.8 percent at 85 to 89 years; 39.5 percent at 90 to 94 years; and 52.8 percent among those older than 94. Prevalence was 25.8 percent among women and 17.1 percent among men.

Alzheimer's disease is the most common irreversible cause of dementia, accounting for 50% to 70% of all dementia cases. AD is caused by abnormal deposits of protein in the brain that destroys cells in the areas of the brain that control memory and mental functions.

Plenty of preventative uses also exist for Alzheimers and Dementia and I'd recommend being proactive in disease prevention (Healthy Diet & Exercise). However, there are factors that are beyond our control..(for the time being).

Take a look at some of the VR use cases that are currently being used in the industry today.

VR Case #1 – Sea Hero Quest

One of the first symptoms of dementia is a loss of navigational skills, Sea Hero Quest mobile provided enough data to help create the world's first benchmark for human spatial navigation.

And now the intuitive nature of Sea Hero Quest VR allows us to track even more subtle and detailed reactions such as eye movements, as well as replicate highly credible lab-based experiments not possible in a mobile setting.

Persons with dementia are known to have difficulty with participation and focus during physical activity. Virtual reality offers a unique medium for motor learning but has only been used previously for cognitive assessment for PWD.

The study had two objectives:

(1) investigate the feasibility and safety of an exercise-based VR training program in PWD

(2) investigate its effects on balance and mobility.

The intervention consisted of daily (5 d/wk, 1 h each) VR training sessions for 2 wk for a single research participant. Clinical balance and mobility measures were assessed 1 wk prior to, during, 1 wk following, and 1 mo after the intervention. Post-intervention interviews provided qualitative feedback from the participant and his caregivers.

Results indicate that VR training is feasible, safe, and enjoyable for PWD. However, balance and mobility measures were unaffected. VR training is well tolerated in a single research participant with dementia and is an engaging medium for participation in exercise.

The following information is provided by Linda Garcia, Adi Kartolo and Eric Méthot-Curtis, Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, EntourAGE Lab, Ottawa, Canada

Why VR works so well with Dementia

According to the Disability Creation Process model of functioning, a problem in life participation can be created when functional limitations (e.g. communication problems) interact with environmental factors (e.g. negative attitudes) that are non-facilitating.

Three interacting domains are used to describe the lived experience of individuals with functional limitations in creating successful engagement in life activities.

1. Personal Factors

includes organic systems and capabilities, which, together, entail all components of the human body that interrelate with the individuals' potential to perform A Discussion of the Use of Virtual Reality in Dementia 125 mental or physical tasks; it also includes other variables such as age, sex and socio-cultural identity. Includes the pathophysiological changes to the brain as well as their consequences on processes such as perception, memory and language.

encompasses the resources – which could be either facilitators or obstacles – within the individuals' living dimensions. In dementia, for instance, this might include the physical design of long term care facilities, the attitude of the general public, or the access to health coverage. These factors influence the lived experiences as they can make life easier or harder as one transitions through the journey of dementia.

refers to the result of the interaction of the first two domains as they impact the lived experiences valued by the individuals and their respective socio-cultural context. This domain encompasses important life areas such as work, interpersonal relationships, community involvement and so on. Overall, this model of functioning gives a framework from which to identify the role of environmental factors in creating positive or negative lived experiences. For example, a simple goal-oriented task such as get-a-book-sit-and-read may be challenging for persons with dementia due to impaired executive functions. That is, they may simply not think of initiating the task of reading the book or may have difficulty planning the steps for executing the activity.

An environmental cue such as a chair located near a bookcase might help persons with dementia improve their planning, organizing, and prioritization (i.e. executive functions) – to get a book, sit, and read. The impairment (i.e. dementia) in this example does not change, but the environment facilitates the realization of the activity. Fundamentally, the Disability Creation Process model offers a framework from which to understand the relationships amongst all the domains and help identify areas which might improve the lived experience through the modification of either or all of the domains.

Situations, where there is a strong environmental press on an individual with lower levels of competence, will result in negative affect and maladaptive behavior.. Likewise, environments that are weak and demand little of the individual who has higher levels of competence will also result in negative and maladaptive behaviors.

In the case of the get-a-book-sit-and-read task, placing a chair right beside the bookcase in addition to hiring an attendant who will get the book may prevent persons with dementia from using any residual planning processes, thereby fostering a sense of helplessness and loss of personhood.

Immersive virtual environments allow researchers to create very realistic environments while maintaining a high level of experimental control. Immersive virtual environments technology has been used in therapy for phobias, stress, anxiety, exercising, and memory problems, yet it has hardly been used in the area of dementia. Several reasons might explain the dearth of publications on this topic. On the one hand, scientists might assume that persons with dementia cannot use the necessary paraphernalia to engage with virtual environments. On the other hand, there may be a concern that the cognitive difficulties associated with dementia prevent participants from attaining the level of presence necessary to engage with these environments.

VR as an Assessment Tool in Dementia

Immersive virtual environment technology gives researchers the opportunity to study how persons with dementia interact with their environment and which elements are most A Discussion of the Use of Virtual Reality in Dementia 131 facilitating or creating the least distress while capitalizing on residual cognitive resources.
Virtual reality technologies offer the potential to capture the impact of physical environments, as well as social interactions by deconstructing these environments. Further research into this area will help develop a better understanding of how persons with dementia can act to influence their environments and how changes in the environment can affect them. The objective may not be to learn a new skill but rather to understand how to better design physical spaces or modify social environments for better quality of life. One of the advantages of virtual reality is the potential to control and modify these environments when it cannot be easily, or completely, changed outside of the virtual world.

For example, human interaction and social presence would be particularly useful to examine in persons with dementia using virtual reality. More detailed knowledge about how others influence interactions with persons with dementia would help offer advice for caregivers on how to interact with this population. For instance, one might manipulate the verbal and non-verbal aspects of communication of virtual humans as they interact with the user. As Garcia et al. pointed out, if we want to study the impact of tone of voice on persons with dementia during social interaction, we could create experimental conditions where a virtual human modifies tone of voice while maintaining neutral facial expressions.

This type of experimentation is impossible outside of the virtual environment since human conversational partners cannot voluntarily isolate these parameters. Knowing more about the impact of these changes in the environment may lead to remarkable changes in clinical approaches and improve quality of life. Immersive virtual environment technologies offers a promising avenue for testing these hypotheses as well as helping us to better understand the processes involved in presence.

VR as a Training Tool in Dementia

It is unlikely for persons with dementia to acquire new skills as they tend to experience rapid deteriorations in their brain mappings throughout the journey of dementia. Such progression, however, might be slowed down by medications and brain-stimulating activities based on the theory of neuroplasticity – the ability of brains and nervous systems to reconstruct new cellular synapses as a result of the interaction with enriched environments.

Nonetheless, the perception of such environments may be different for individuals, and it would be financially impossible to construct a customized enriched environment for every individual. Virtual Reality has the potential to fulfil this requirement at a lower cost. In addition, virtual reality would allow researchers to systematically study the various desired brain-stimulating activities as a function of the rate of neuroplasticity experienced in persons with different types of dementia.

It is known that dementia of different types may experience deterioration in different regions of the brains; thus, it is very important to 132 Virtual Reality in Psychological, Medical, and Pedagogical Applications explore the possibility of conducting such 'targeted' brain-stimulating activities in light of deteriorating regions of the damaged brain.

Check back on this page frequently for updates and additions.

We've seen a tremendous amount of disruptive change coming from the Virtual Reality Industry. It is surely certain that this kind of content will accelerate based on trends in the future.

You most likely have some other VR ideas that can change the world! Share them with us on social media!

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