Anxiety in Older Adults, Caregiver Stress, Cognitive Decline in Older Adults, Depression in Older Adults, Social Isolation in Older Adults
Conditions
Keywords
Virtual Reality, Respite Care, Caregivers, Older Adults, Randomized Controlled Trial, Mental Health, Cognitive Function, uality of Life
Brief summary
The goal of this study is to examine the effectiveness of VR-based respite in improving cognitive function, mental health, and quality of life in caregivers and homebound older adults compared to a control group using videos and a usual care group. Participants are randomly assigned to one of three groups: VR intervention, video control, or usual care. The VR group receives immersive VR sessions using the SilVR Adventures platform. The video group receives non-immersive video sessions with similar content. The usual care group receives no additional intervention. Assessments are conducted at baseline, immediate post-intervention, and 3 months post-intervention to measure changes in depression, anxiety, loneliness, quality of life, and other outcomes. The intervention dosage will be 4 weeks (1 sessions/week; 30 min/session). Secondarily, the study explores differences in effectiveness between caregivers and homebound older adults, and potential moderators or mediators such as baseline health status, technological literacy, and social support.
Detailed description
All participants will provide informed consent at the time of enrolment. Both caregivers (CGs) and care recipients (CRs) will complete assessments at baseline. CRs are assessed for cognitive function (using Mini-Mental State Examination - MMSE) and other health indicators. CGs are assessed for mental health, quality of life, and caregiving burden. Participants are randomized into three groups: VR intervention (n=30 dyads), video control (n=30 dyads), or usual care (n=30 dyads). Randomization is stratified by CG age (\<60 vs. ≥60) and CR cognitive status (MMSE \<24 vs. ≥24). As the intervention, the VR group receives 4 weekly 30-minute sessions of immersive VR experiences (e.g., virtual travel and social activities) facilitated by trained research staff. The video group receives 4 weekly 30-minute sessions of non-immersive videos with similar themes, also facilitated. The usual care group receives no additional intervention beyond community services. At the end of the intervention, participants complete assessments again to measure changes in physical and mental health. All participants will be contacted for follow-up assessment 3 months after the completion of intervention.
Interventions
DEVICEVR-based Respite
Caregivers and homebound older adults will receive 4 weeks of VR-based respite sessions. 4 weeks (1 session/week; 30 min/session) of immersive VR sessions using SilVR Adventures platform. Sessions include virtual travel destinations (e.g., cities, natural wonders) and social activities (e.g., group tours). Facilitated by trained research staff, with 5-10 minutes viewing and 20 minutes reflection/discussion.
DEVICEVideo-based Respite
Caregivers and homebound older adults will receive 4 weeks of video-based respite sessions. 4 weeks (1 session/week; 30 min/session) of non-immersive video sessions with content similar to VR themes (e.g., landscapes, cultural events). Facilitated by trained research staff, with post-video discussion. EEG data collected during viewing to assess emotional states.
Sponsors
Hong Kong University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Caregivers (CGs) Inclusion Criteria: * Aged 18 or above * Provide care to at least one homebound older adult (aged 60 or above) * Provide no less than 6 hours of caregiving per week * Able to communicate in either Cantonese, Mandarin or English * Willing to participate for the entire duration * Able to tolerate VR headset for at least 5 minutes (no severe motion sickness/epilepsy)
Exclusion criteria
* History of severe psychiatric disorders (e.g., schizophrenia, bipolar) * Severe cognitive impairment (MMSE \<10) * Major neurological diseases (e.g., recent stroke, severe Parkinson's) * Uncorrectable visual/hearing impairments affecting VR/video * Unable to tolerate VR due to motion sickness or discomfort * Care recipient receiving long-term care service that conflicts with study Care Recipients (CRs) Inclusion Criteria: * Aged 60 or above * Homebound (unable to leave home without assistance) * Stable medical condition * Willing to participate for the entire duration * Able to tolerate VR headset for at least 5 minutes (no VR contraindications) * Able to understand and provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in depression and anxiety on PHQ-4 after intervention | Baseline, Immediate after intervention, and 3 months after intervention | The Patient Health Questionnaire-4 (PHQ-4) is a validated 4-item scale measuring depression and anxiety over the past two weeks. Rated on a 4-point scale from "not at all" to "nearly every day." Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in quality of life on EQ-5D-5L after intervention | Baseline, Immediate after intervention, and 3 months after intervention | EQ-5D-5L is a validated 6-item scale measuring quality of life across 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) plus a visual analogue scale (EQ-VAS, 0-100). Higher scores indicate better quality of life. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in loneliness on UCLA Loneliness Scale after intervention | Baseline, Immediate after intervention, and 3 months after intervention | The 3-item UCLA Loneliness Scale is a validated tool measuring feelings of loneliness and social isolation. The total score can range from 3 to 9. Higher scores indicate greater degrees of loneliness. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in subjective happiness on Subjective Happiness Scale after intervention | Baseline, Immediate after intervention, and 3 months after intervention | The Subjective Happiness Scale is a validated 4-item scale measuring global subjective happiness on a 7-point Likert scale. Reverse the score for Item 4. Calculate the mean of all four item scores (the three regular scores plus the reversed score from Item 4). The total score ranges from 1 to 7. Higher scores indicate greater subjective happiness. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in cognitive function on MMSE after intervention (For CRs only) | : Baseline, Immediate after intervention, and 3 months after intervention | The Mini-Mental State Examination (MMSE) is a validated 30-point questionnaire assessing cognitive function (orientation, memory, attention, etc.). Scores range from 0-30; higher scores indicate better function. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in role captivity on Pearlin's model after intervention(For CGs only) | Baseline, Immediate after intervention, and 3 months after intervention | Pearlin's Role Captivity Scale is a 3-item tool measuring internal strain of caregiving role on a 4-point Likert scale. The total scores range from 3 to 12. Higher scores indicate greater role captivity. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in technology acceptance on STAM after intervention | Baseline and Immediate after intervention | The Senior Technology Acceptance Model (STAM) is a validated 14-item scale consisted of a 4-factor structure (Attitudinal beliefs, Control beliefs, Gerontechnology anxiety, and Health). Each construct is measured by several items on a 10-point scale. For each of the four factors, calculate a composite score. This is done by taking the mean of all the items that load onto that factor. Additionally, a higher global score indicates a more positive overall attitude towards technology acceptance. Change = Immediate after intervention - baseline |
| 4. Change from baseline in quality of life on OPQOL-brief after intervention (For CRs only) | Baseline, Immediate after intervention, and 3 months after intervention | The Older People's Quality of Life - brief questionnaire (OPQOL-brief) is a validated 13-item scale measuring QoL domains (health, social relationships, independence) on a 5-point Likert scale. Add together the scores from all 13 items after the reverse-scoring has been completed. The total score ranges from 13 to 65. A higher total score indicates a better self-reported quality of life. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
| Change from baseline in caregiving burden on CZBI-short after intervention (For CGs only) | Baseline, Immediate after intervention, and 3 months after intervention | The Cantonese short version of the Zarit Burden Interview (CZBI-short) is a validated 12-item scale measuring caregiver burden on a 5-point Likert scale (0=never to 4=very frequently). Scores range from 0-48; higher scores indicate greater burden. Change = (Immediate after intervention - baseline) and (3 months after intervention - baseline) |
Countries
Hong Kong
Contacts
CONTACTDongling Linda Wang, PhD
Outcome results
None listed