Group virtual reality was no better than cognitive stimulation for dementia symptoms in nursing homes

Design

Multicentre randomised controlled trial with an active control

Population

56 nursing home residents with behavioural and psychological symptoms of dementia

Primary outcome

Neuropsychiatric Inventory and Apathy Interview change over 6 weeks

Effect

No significant between-group difference in symptoms or overall well-being; 2 mild adverse events

In this multicentre randomised trial, 56 nursing home residents with behavioural and psychological symptoms of dementia had either group virtual reality sessions or an active control of nondigital cognitive stimulation, each for two 45-minute group sessions weekly over six weeks (12 sessions). Symptoms were measured with the Neuropsychiatric Inventory and Apathy Interview, and well-being and social interaction at each session.

There was no significant between-group difference in symptom reduction or overall well-being. Immediate well-being rose from before to after sessions in both groups, and social interaction was more frequent in the control group. Only two mild adverse events were reported.

The trial was small and not powered for superiority, so it cannot exclude a modest benefit. The practical point is that structured group activity of either kind appears to help in-session mood, and expensive technology has not been shown to add anything for symptoms.

• No significant difference in behavioural symptom reduction between virtual reality and cognitive stimulation.
• Both groups had higher well-being after sessions.
• Social interaction was more frequent in the cognitive stimulation group.
• Only two mild adverse events were reported.
• Prioritise structured group activities that residents enjoy, whatever the format.

Why it matters

Care homes are being sold costly technology, and this trial did not show an advantage over simple group activity.

Don't overread it

A small feasibility-scale trial cannot show that virtual reality is ineffective, only that no advantage was shown.

The statistics, in plain English

With 56 participants the trial could miss a real but modest difference, so 'no difference' means no superiority was shown. Session-level well-being rose in both arms, which suggests the activity or attention, not the technology, may be what helps.

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