JMIR Publications

ABSTRACT

Background:

Virtual reality (VR) interventions are emerging as promising non-pharmacological strategies for people with dementia, aiming to prevent cognitive decline, reduce behavioral and psychological symptoms of dementia (BPSD), and alleviate caregiver burden. Although some studies have reported beneficial effects, findings remain inconsistent, and little is known about the duration and sustainability of these effects, particularly in real-world care settings.

Objective:

This study aimed to examine both the immediate and long-term effects of an immersive VR reminiscence intervention on BPSD and caregiver burden in people with dementia attending day care centers.

Methods:

This longitudinal observational study was conducted in 10 dementia day care centers in Kaohsiung, Taiwan. A total of 82 participants with dementia were enrolled. The VR intervention consisted of twice-weekly sessions over one month, featuring culturally familiar live-action 360° scenes filmed in well-known Taiwanese locations. Each session lasted approximately 10-12 minutes and included interactive elements. Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q), and caregiver burden was assessed using the Zarit Caregiver Burden Interview (ZBI). Measurements were taken at three time points: pre-intervention, immediately post-intervention, and two months after the intervention ended. The Wilcoxon signed-rank test was used for statistical comparisons, and rank-biserial correlation was calculated as the effect size.

Results:

Significant improvements were observed after one month of VR intervention in both caregiver burden (Z = -3.095, P = .002, r = 0.34) and neuropsychiatric symptoms (Z = -2.929, P = .003, r = 0.32). At the two-month follow-up, neuropsychiatric symptoms remained significantly improved (Z = -4.327, P < .001, r = 0.48), although caregiver burden returned to pre-intervention levels. Regarding specific neuropsychiatric symptoms, significant improvements were observed immediately after the intervention in dysphoria/depression, anxiety, and sleep/nighttime behaviors. These effects were sustained over time, with additional long-term improvements noted in euphoria/elation, apathy/indifference, irritability/lability, aberrant motor behavior, and appetite/eating behaviors.

Conclusions:

A one-month immersive VR reminiscence intervention appears to improve neuropsychiatric symptoms and temporarily reduce caregiver burden in people with dementia, with some symptom improvements lasting up to two months. These findings suggest that VR may offer a meaningful therapeutic option in day care settings. Future studies with control groups, including non-immersive 2D conditions, and comparisons to traditional reminiscence therapy are needed to validate and expand upon these findings.