Virtual reality intervention to improve apathy in residential aged care: protocol for a multi-site trial

Background: Apathy is a prevalent neuropsychiatric symptom for older adults residing in aged care. Left untreated, apathy has been associated with accelerated cognitive decline and increased risk of mortality. Pharmacological interventions have not been established and can have side effects, placing a priority on the evaluation of non-pharmacological interventions. Reminiscence therapy, a psychosocial, person-centred intervention is commonly used in aged care and has demonstrated to reduce apathy. Traditional methods of reminiscence utilise physical objects and more recently technology including tablets and laptop computers have demonstrated potential. Virtual reality (VR) has successfully been used to treat psychological disorders, however there is little evidence on using VR for behavioural symptoms such as apathy in older adults. Using VR to deliver reminiscence therapy provides an immersive experience, and readily available applications provide access to a large range of content allowing easier delivery of therapy over traditional forms of therapy. This study aims to examine the effect of tailored reminiscence therapy using VR on apathy.Methods: In this multi-site trial, participants will be allocated to one of three groups; a reminiscence therapy intervention using VR; an active control using a laptop computer or physical items; and a passive control usual care group. A total of 45 participants will be recruited from residential aged care (15 in each group). The three groups will be compared at baseline and follow-up. The primary outcome is apathy, secondary outcomes include cognition and depression. Side effects from using head-mounted displays will also be examined in the VR group.Discussion: This study intends to establish if using VR reminiscence therapy improves levels of apathy compared to traditional reminiscence therapy or usual care. Results from this study will inform the therapeutic use of VR for older adults residing in aged care and provide knowledge for implementing VR into existing lifestyle activities in this context.Trial registration: This trial was registered in the Australian and New Zealand Clinical Trials Registry (ACTRN12619001510134). Registered 31 October 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378564&isReview=true