Development and Initial Testing of an Artificial Intelligence-Based Virtual Reality Companion for People Living with Dementia in Long-Term Care

<b>Background/Objectives:</b> Feelings of loneliness are common in people living with dementia (PLWD) in long-term care (LTC). The goals of this study were to describe the development of a novel virtual companion for PLWD living in LTC and assess its feasibility and acceptability. <b>Methods</b>: The computer-generated virtual companion, presented using a head-mounted virtual reality display, was developed in two stages. In Stage 1, the virtual companion asked questions designed to encourage conversation and reminiscence. In Stage 2, more powerful artificial intelligence tools allowed the virtual companion to engage users in nuanced discussions on any topic. PLWD in LTC tested the application at each stage to assess feasibility and acceptability. <b>Results</b>: Ten PLWD living in LTC participated in Stage 1 (4 men and 6 women; average 82 years old) and Stage 2 (2 men and 8 women; average 87 years old). Session lengths ranged from 0:00 to 5:30 min in Stage 1 and 0:00 to 53:50 min in Stage 2. Speech recognition issues and a limited repertoire of questions limited acceptance in Stage 1. Enhanced conversational ability in Stage 2 led to intimate and meaningful conversations with many participants. Many users found the head-mounted display heavy. There were no complaints of simulator sickness. The virtual companion was best suited to PLWD who could engage in reciprocal conversation. After Stage 2, response latency was identified as an opportunity for improvement in future versions. <b>Conclusions</b>: Virtual reality and artificial intelligence can be used to create a virtual companion that is acceptable and enjoyable to some PLWD living in LTC. Ongoing innovations in hardware and software will allow future iterations to provide more natural conversational interaction and an enhanced social experience.