Counterclockwise Virtual Reality–Based Embodiment of a Younger Self and Revisit of a Past Iconic Event in Older Adults: Between-Groups Study of Cognitive and Physical Performance

Background: The original counterclockwise study carried out in the late 1970s provided an extreme example of "reminiscence therapy," reporting improvements in older adults' cognitive and physical functioning after they had lived for 5 days in a house set up as if decades earlier (the 1950s). We tested a virtual reality (VR) analog of this approach, enhanced by embodying participants in a virtual body that looked like themselves at the corresponding younger age. Objective: This study aimed to examine whether brief VR exposures combining (1) embodiment in a virtual body as one's younger self and (2) immersion in an iconic past event improve age-related subjective and performance outcomes compared with a current-self VR control condition. Methods: We carried out a between-groups study with 23 healthy older adults (aged 65-85 years; mean age 71.2, SD 4.03 years). Participants were randomly allocated to either a Young Self condition (n=11; mean 72.3, SD 4.17), where they were embodied in a virtual body that looked like themselves from the 1960s, or in a Current Self control condition (n=12; mean 70.1, SD 3.75), where participants were embodied in their current body. There were 5 sessions. In Session 1, participants completed a baseline assessment. There were then 2 VR exposures, approximately 1 week apart (Sessions 2-3), and follow-ups at 1 week (Session 4) and approximately 2 weeks (Session 5) after the final VR exposure. Outcomes included subjective age, awareness of age-related change, World Health Organization-Five Well-Being Index, Trail Making Test performance, and physical functioning (eg, grip strength). Results: A hierarchical Bayesian analysis revealed that 1 week after the final VR exposure, those in the Young Self condition demonstrated lower subjective age than those in the Current Self condition (prob=.95). They had higher awareness of positive age-related change (prob=.89) and a higher score on the World Health Organization-Five Well-Being Index (prob=.84). Moreover, with respect to performance variables, they took less time to trace a trail (prob≥.99), made fewer mistakes in doing so (prob=.89), had greater right-hand (prob=.85) and left-hand (prob≥.99) grip strength. However, 2 weeks after their final VR exposure, these differences diminished apart from positive awareness of age-related change (prob=.82), trail-making mistakes (prob=.83), and left-hand grip strength (prob≥.99). Here, "prob" refers to posterior probability. Conclusions: The results demonstrate that even 2 short VR exposures, where people were embodied in their younger body and immersed in an iconic event from more than 50 years earlier, resulted in improvement in some age-related responses. This is encouraging for further research with more extensive VR experiences over a longer time period.