Effectiveness of a Virtual Reality Immersion Process as a Nonpharmacological Intervention for Behavioral and Psychological Symptoms of Dementia and Immediate Well-Being in People Living in Nursing Homes: Randomized Controlled Trial

Abstract Background Behavioral and psychological symptoms of dementia (BPSD) are common among nursing home residents, notably those with Alzheimer disease and related diseases, impacting both themselves and health care professionals. Nonpharmacological interventions, including virtual reality (VR), have shown promise, but evidence from multicenter ecological studies remains limited. Objective This study aimed to evaluate the effectiveness, in terms of BPSD evolution, immediate well-being, and social interactions, of a VR-based immersion intervention (Lumeen) as a nonpharmacological approach to managing BPSD among nursing home residents. It also aimed to confirm the feasibility of implementing and evaluating group-based immersive VR interventions in nursing homes. Methods Fifty-six nursing home residents with BPSD took part in this multicenter randomized controlled trial (ClinicalTrials.gov NCT04769024), receiving either VR-based sessions or an active control condition consisting of nondigital cognitive stimulation. Both interventions consisted of two 45-minute group sessions per week for 6 weeks, resulting in a total of 12 sessions in each intervention group. BPSD severity was assessed preintervention and postintervention using the Neuropsychiatric Inventory (NPI) and the Apathy Interview. Immediate well-being and social interaction were assessed at each session using the Immediate Well-Being Evaluation and the Social Observation Behaviors Residents Index, respectively. Results No significant between-group differences were found in BPSD reduction or in overall well-being outcomes. However, immediate well-being increased from presession to postsession in both groups when averaged across the 12 sessions, and social interactions were more frequent in the active control group. Only 2 mild adverse events were reported. Conclusions VR interventions in nursing home residents with neurocognitive disorders did not demonstrate superiority over an active cognitive stimulation control in reducing BPSD. Both interventions were associated with improvements in immediate well-being, suggesting that nonpharmacological group-based activities may be beneficial in nursing home settings. Additionally, VR interventions were safe and feasible in this population. Immersive VR warrants further investigation in adequately powered pragmatic trials to clarify its specific added value and optimal implementation conditions for BPSD.