Project 1: Virtual Reality to Support Cognitive Health and Engagement and Socialization Among Aging Adults

Project Summary
Maintaining cognitive health has become a topic of increased importance with population aging, given the
criticality of cognition to quality of life and independence. Unfortunately, changes in life circumstances, health
declines, and other factors such as mobility limitations, limit opportunities for cognitive, social and activity
engagement for older adults, all of which are important to cognitive health. Virtual reality (VR) systems have
evolved, are more powerful and accessible to consumers, and present unique opportunities to foster cognitive
and social engagement among older adults in their own homes. VR systems provide an immersive and engaging
experience that give users the realistic impression of being present in a context or situation outside their home,
alone or with others. Despite the significant potential of VR, few studies have examined usability and acceptance
of VR applications or their efficacy with older adults. Further, most studies of VR involving older adults have
targeted physical functioning or cognitive rehabilitation; few have examined social or cognitive engagement
applications. Both researchers and system developers underscore the need for more rigorous research in this
area with adequate control conditions, across a wider range of VR applications, and with larger, diverse samples
of older adult populations in home settings. This highly innovative cross-site Stage 1 Intervention Development
Project (NIH Stage Model) [18] will apply the CREATE systematic approach to the design and evaluation of an
immersive VR program, Cognitive Activity Social Technology (CAST), for older adults. The program will provide a
suite of virtual cognitive, social and activity engagement applications; and allow for virtual interactions. Phase I,
akin to NIH Stage 1a [18], will involve focus groups and usability testing across the three CREATE sites with
older adults, and heuristic analysis to gather information on user preferences, usability problems, implementation,
and training protocols. Phase II, akin to NIH Stage 1b, will involve a cross-site pilot randomized trial with a large
and diverse sample of aging adults (N =216). Participants will be randomized, following a baseline assessment,
to the VR CAST condition or a table control condition, where participants will be exposed to similar context in 2d
(e.g., online museum tours). Following training on the VR program/tablet, they will use the VR program/tablet in
their home for two months. The battery of measures will be re-administered at 1 and 2-months post
randomization. The battery will include demographic and technology experience, attitudes, and proficiency
measures; measures of usability, safety/comfort, perceived usefulness, enjoyment, and measures of cognitive
abilities, social connectivity, loneliness, well-being, and quality of life. VR participants will also complete
measures of “presence” and cybersickness. We will collect real time data on use of the VR program/tablet. The
planned project represents one of the largest and most rigorously controlled study on the topic to date. It will yield
significant and timely information on the feasibility of using VR support for older adults, delineate potential
mediator and moderators of the benefits of VR, and design guidelines for VR interventions for older adults.

Grant Number: 5P01AG073090-04
NIH Institute/Center: NIH
Principal Investigator: Neil Charness