Reducing behavioural and psychological symptoms of dementia in older adult long term care home residents with virtual reality therapy
Bibliographic record
Abstract
Individuals with dementia often exhibit Behavioural and Psychological Symptoms of Dementia (BPSD). BPSD worsens as dementia progresses and intensifies caregiver distress. The Registered Nurses’ Association of Ontario recommends non-pharmacologic methods such as group activities, music therapy, cognitive behavioral therapy, and cognitive stimulation therapy (CST) to manage BPSD. I wanted to explore the potential of virtual reality (VR) as a possible CST for Ontario long-term care home (LTC) residents with moderate to severe dementia. I analyzed data of a single site case series (n=24), piloted to explore the feasibility of VR therapy, residents’ tolerance for the therapy, facilitators and barriers to implementing the therapy, sensitivity to change, and longitudinal construct validity of the selected BPSD measuring tools. The VR therapy was provided with Broomx© (http://www.broomx.com/broomxvr.php) for 30 minutes, five days a week for two weeks. The analysis revealed that older adults with moderate to severe dementia could tolerate VR therapy. Strategies such as use of Broomx© projector instead of headset, tailored VR library items, and a soundproof room with no visual distractions facilitated, whereas residents’ conflicting schedule challenged, VR implementation. The selected measuring tools were sensitive to change and were valid. The logistics of collecting these measures were of concern since they were additional to mandated outcomes and had to be completed by Personal Support Workers. I also performed an interpretive description using semi-structured interviews (n=15) with individuals positioned to observe the residents during the pilot. In my interpretation, residents’ mood, demeanor, and daily activities improved noticeably during VR therapy. Several issues (e.g. VR library items, therapy schedule, staff commitment) were important in implementing the therapy. Based on the findings from both studies, I designed a matched-pair cluster randomized control trial (CRT) using mandated outcome measures in 659 participants or 28 LTC homes or 14 matched-pairs to evaluate if usual care and VR therapy can reduce BPSD in older adults with moderate to severe dementia living in Ontario LTC compared to usual care alone, useful in clinical decision making. The CRT also will compare the cost between the intervention and control.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".