Depression in the elderly

Before examining some applications of VR in geriatrics, it is important to put them in context. Clinically diagnosed depression affects between 1 and 5 percent of older adults in the United States, and up to 14 percent of those who need home or institutional care.

Additionally, many more people experience milder symptoms of depression. For example, a study conducted in France found that 23% of older adults showed signs of depression. And even milder symptoms can lead to a serious decrease in quality of life.

The same study also found that depression increases the risk of death among older adults, findings that have been repeatedly confirmed by the NIH in its study on quality-adjusted life expectancy.

The fact is that depression makes life more miserable, exacerbates existing health problems, deters older adults from engaging with each other and the outside world, and – ultimately – shortens lives. Any therapy likely to alleviate his symptoms is therefore welcome. And VR fits into this category, as a quick overview of recent innovations shows.

Using VR to treat anxiety in older adults

Anxiety is a major mental health problem in the general U.S. population, but it is particularly serious among older adults. According to the Geriatric Mental Health Foundation, 10 to 20 percent of older Americans suffer from some form of clinical anxiety – most commonly phobias. And this condition can seriously compromise their standard of living.

Is it possible that VR can help? According to some researchers, the answer is yes. VR can help compensate for the lower effectiveness of treatments like cognitive behavioral therapy in older age groups – allowing practitioners to change behavior in situations where this was previously impossible.

Research published in 2015 by Sébastien Grenier of the University of Montreal suggested that VR could help by allowing older adults to virtually “confront” the source of their anxiety. By using VR headsets to create situations in which older adults are exposed to sources of anxiety, therapists can help them deal with these issues without needing to leave their home or place of care.

Can VR alleviate depression caused by reduced mobility?

The same theme fuels a broader debate on the application of virtual reality to geriatrics: can VR treatments help older people cope with depression caused by reduced exposure to the outside world, their bodies becoming less mobile and less physically capable?

Loss of mobility is certainly a cause of depression in older people. And it's also a major symptom of depression, creating dangerous feedback cycles that harm patients' mental health.

Older adults may choose to socialize less, go to fewer outdoor places, and generally interact less with the outside world due to bereavements, stress, and anxiety, making them less confident and more unhappy. This is a tragic situation for individuals, but potentially a very fruitful application of VR technology.

Studies conducted in healthcare settings have shown that head-mounted displays can safely and effectively deliver VR content to elderly patients, and that study participants report a high degree of comfort and enjoyment during VR therapies.

And the experience of those working in this field also shows that these therapies can be extremely effective.

VR headsets have become a staple at Minneapolis' Ebenezer Care Center, where residents use them to virtually visit places they've already seen or always wanted to visit. Feedback from residents using the headsets suggests that they become more relaxed and more open to social interactions after the VR sessions – exactly what you would want to see in a treatment for depression in older adults.

Using VR to help with pain management

In addition to alleviating anxiety and treating depression caused by reduced mobility, VR is finding unexpected uses in pain management – another important contributor to poor mental health in older populations.

In 2014, a major study showed that VR could be used to create cognitive distractions that can help people with chronic and acute pain. In many cases, this reorientation of attention can help reduce the perception of pain, with beneficial effects lasting beyond VR immersion sessions.

Additionally, immersive VR software has been used as a training aid to teach older adults effective pain management and physiotherapy techniques, which can often be the most important measure to alleviate pain in the long term. And it can be paired with wearable devices to provide valuable feedback to medical practitioners who may be far from patients.

All of this contributes to more effective pain management, which directly influences mood and overall happiness. As any older person who has suffered from chronic arthritis will inform you, pain and mental health are closely linked, and anything that helps relieve one tends to help when treating the other.

These virtual reality applications form the tip of the iceberg. The use of augmented reality in therapies such as the CBT is still in its infancy, but there is strong reason to believe that the use of specially designed head-mounted displays and therapy software can help alleviate the symptoms of depression.

In the future, it is likely that techniques such as virtual reality exposure therapy (VRET) will become more widespread, as therapists carefully expose patients to experiences that can alleviate their anxieties.

On a less sophisticated level, VR experiences that simulate tourism and other social situations will be a common option for older adults in their leisure lives. So expect to see a mix of therapeutic, medically robust tools and commercially produced applications – resulting in a rich mix of techniques to make life more enjoyable and less stressful.

Many of the mental health problems that affect older adults stem from the loss of rich social experiences and their isolation from the outside world. With VR, we now have a set of tools that can counteract these problems like never before. And that’s why geriatric specialists, engineers, caregivers and older users are increasingly excited about what the technology has to offer.

VR is more than just a new thing. It is a far-reaching medical therapy that can ensure that old age is not a time of misery, fear and pain. Enriched social lives and positivity are available instead, provided the technology reaches its potential.

Sources: [in the order they are linked in the text above]

https://www.sciencedirect.com/science/article/abs/pii/S1064748119300971

https://www.sciencedaily.com/releases/2019/02/190206091423.htm

https://pmc.ncbi.nlm.nih.gov/articles/PMC4590980/

https://www.aagponline.org/index.php?src=gendocs&ref=anxiety

https://www.sciencedaily.com/releases/2015/02/150217114123.htm

https://pmc.ncbi.nlm.nih.gov/articles/PMC6974513/

https://www.startribune.com/vr-helps-seniors-cope-with-depression-anxiety-minneapolis-center-finds/467195193/

https://pmc.ncbi.nlm.nih.gov/articles/PMC4043364/