Depression in the elderly

Recent years have seen a huge uptick in the use of VR in geriatrics. As Mathias et al reported in a 2019 review of the literature, VR has become an effective tool in screening for and treating cognitive impairment, while it has also found uses in the treatment of Alzheimer’s Disease. The use of VR in treating mood disorders and other forms of depression in the elderly has lagged behind, but there are reasons to believe that it will be the next frontier in treating mental health disorders among American seniors. VR has been used with great success in treating ADHD, anxiety, and depression among teens and younger people, leading many geriatrics specialists to see exciting potential for older age groups. So let’s look in more detail about how the technology could be applied, and the kind of benefits seniors can anticipate.

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1. DEPRESSION : A MAJOR CHALLENGE FOR GERIATRICS IN THE USA

Before we look at a few applications for VR in geriatrics, it’s important to put them into context. Clinically diagnosable depression affects between 1-5% of US seniors, and as many as 14% of those requiring home or institutional healthcare. Additionally, many more people suffer from milder symptoms of depression. For instance, one study in France found that 23% of elderly people showed some signs of depression. And even milder symptoms can lead to seriously diminished quality of life. The same study also found that depression increases the risk of death among seniors, findings that have been repeatedly backed up by the NIH in its studies of quality-adjusted life expectancy.
The fact is that depression makes life more miserable, exacerbates existing health conditions, deters seniors from engaging with each other and the outside world and – ultimately – shortens lives. So any therapies that can ease its symptoms are to be welcomed. And VR fits into that category, as a quick tour of recent innovations demonstrates.

Using VR to treat anxiety among the ederly

Anxiety is a major mental health issue among the US population in general, but it is particularly serious among older age groups. According to the Geriatric Mental Health Foundation, 10-20 percent of American seniors suffer from some form of clinical anxiety – most often phobias. And this condition can seriously compromise their standard of living. How could VR help? According to some researchers, the answer is yes.
VR can help to compensate for the lower efficacy 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 seniors to virtually “confront” the source of their anxiety.
By using VR headsets to create situations in which seniors are exposed to sources of anxiety, therapists can help them deal with those issues without needing to leave their home or care setting.

Can VR allevate depression caused by poor mobility

The same theme feeds into a broader discussion about the application of Virtual Reality to geriatrics: can VR treatments help elderly people to deal with the depression caused by decreased exposure to the outside world as their bodies become less mobile and physically capable? Lost mobility is certainly a cause of depression in senior populations. And it is also a major symptom of depression, creating dangerous feedback cycles which damage the mental health of patients. Seniors may choose to socialize less, visit fewer external locations, and generally interact less with the outside world due to bereavements, stress, and anxiety – causing them to become less trustful and more unhappy.
This is a tragic situation for individuals, but potentially a very fruitful application of VR technology. Studies in care settings have found that Head Mounted Displays (HMDs) can deliver VR content safely and effectively to elderly patients, and that participants in studies report a high degree of comfort and enjoyment during VR therapies. And the experience of those in the field also shows that these therapies can be extremely successful.
VR headsets have become a regular sight at the Ebenezer Care Center in Minneapolis, where residents use them to virtually visit locations they have seen before or have always wished to visit.
Feedback from residents using the headsets suggests that they become more relaxed and open to social interactions following VR sessions – exactly what you would want to see from a treatment for depression among the elderly.  

Using VR to assist with pain management

Alongside anxiety alleviation and the treatment of depression caused by decreased mobility, VR is also finding unexpected uses in pain management – another major contributor to poor mental health among elderly populations. Back in 2014, a major study showed that VR could be used to create cognitive distractions which can help sufferers of chronic and acute pain. In many instances, this redirection of attention can help to reduce the perception of pain, with beneficial effects lasting beyond VR immersion sessions.
Moreover, immersive VR software has been used as a training aide to teach seniors effective pain management and physiotherapy techniques, which can often be the most important measure in mitigating pain over the long term.
And it can be linked with wearable devices to provide valuable feedback for medical practitioners who may be distanced from the patients. All of this contributes to more efficient pain management, which directly influences mood and general happiness. As any senior who has suffered from chronic arthritis will inform you, pain and mental health are tightly interlinked, and anything which can alleviate one tends to help when treating the other.

2. VIRTUAL REALITY THERAPY COULD REVOLUTIONIZE GERIATRIC MENTAL HEALTH

These applications of virtual reality form the tip of an iceberg. The use of augmented reality in therapies like CBT is in its infancy, but there are strong signs that the use of HMDs and specially devised therapeutic software can help to alleviate depressive symptoms. In the future, we are likely to see techniques like Virtual Reality Exposure Therapy (VRET) becoming mainstream, as therapists carefully expose patients to experiences which can lessen their anxieties. On a less sophisticated level, VR experiences which simulate tourism and other social situations will be a common option for seniors in their recreational lives.
So expect to see a mix of medically robust therapeutic tools and commercially produced apps – resulting in a rich mix of techniques to make life more enjoyable and less stressful.
Many of the mental health problems affecting seniors stem from the loss of rich social experiences and their isolation from the external world.
With VR, we now have a set of tools which can counteract those problems like never before. And that’s why geriatric specialists, engineers, care givers, and elderly users are becoming more and more excited by what the technology has to offer.
VR is more than just a novelty. It’s a far-reaching medical therapy which can ensure that old age isn’t a time of misery, fear, and pain. Enriched social lives and positivity are available instead, providing the technology reaches its potential.   Sources: in order they are linked to in the text above]

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

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

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

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

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

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

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

Do you need further information or have any specific questions ?

FAQ

Virtual reality (VR) is an innovative technology that enables patients to be exposed to immersive and controlled environments, facilitating the management of numerous psychological and psychiatric disorders. Its use in mental health offers several advantages:
  • Gradual and Controlled Exposure: VR allows patients to confront anxiety-inducing situations in a secure environment, gradually adjusting the intensity of stimuli to promote habituation and emotional regulation.
  • Realistic and Reproducible Environments: Unlike traditional techniques, VR provides immersive scenarios that can be consistently reproduced, ensuring a coherent and effective approach.
  • Increased Patient Engagement: The interactive and immersive nature of VR enhances treatment adherence and motivates patients to continue their therapy.
  • Personalized Treatment: Virtual environments can be adapted to meet the specific needs of each patient.
  • Versatile Applications: VR is used to treat anxiety disorders (phobias, post-traumatic stress disorder, obsessive-compulsive disorders), addictions, mood disorders, and even cognitive remediation.
The use of virtual reality in healthcare is not new! It has been studied and utilized for over 30 years in the medical and psychological fields. As early as the 1990s, researchers began exploring its potential for treating anxiety disorders, particularly phobias and post-traumatic stress disorder. Since then, numerous scientific studies have confirmed its effectiveness in addressing various psychiatric, neurological, and cognitive disorders.
Today, VR is widely integrated into therapeutic and medical practices, with clinically validated protocols. It is used in hospitals, clinics, and psychologists' offices worldwide to provide patients with innovative, effective, and safe treatments.
To use virtual reality, one must immerse themselves in a virtual environment. There are several ways to achieve this.
In the past, the CAVE system (Cave Automatic Virtual Environment), a 3D setup consisting of multiple screen walls, was the primary method used. This system allowed users to be fully immersed in the virtual world, with their movements detected in real-time. However, this technology was expensive and not widely accessible.
Since around 2016, with the introduction of virtual reality headsets like the Oculus Rift and HTC Vive, VR has become much more accessible. These headsets immerse users in virtual reality through an enclosed screen that projects digital images. The user's head movements are tracked, enabling them to look around and interact with the environment as they would in the real world.
Today, VR headsets are wireless and standalone, providing maximum comfort and ease of use without requiring external sensors or cables.
A virtual environment is an immersive digital simulation created through virtual reality. It allows users to navigate in a 3D space that accurately replicates everyday situations or specific contexts.
In mental health, these environments are designed to help individuals gradually face certain situations, manage their emotions, or enhance cognitive skills. By interacting with these virtual spaces, patients can engage in meaningful experiences tailored to their needs.
You need to equip yourself with a virtual reality headset. Our software is compatible with Meta Quest 2, 3, and 3S. 
You will then only need an internet connection. 
Numerous studies confirm that virtual reality is safe to use. However, some restrictions are in place to protect users from potential adverse effects.
For instance, individuals with epilepsy and pregnant women should avoid this type of therapy.
As with any immersive technology, prolonged use may cause visual fatigue or mild discomfort, particularly for those sensitive to motion sickness. Therefore, it is recommended to take regular breaks and adjust session durations according to individual needs.
Virtual environments are designed to be gradual and controlled, minimizing the risk of excessive anxiety. Most users quickly adapt to immersion and experience the benefits of this innovative approach from the first sessions.
Anxiety disorders and phobias can be effectively treated using virtual reality. Patients are gradually and progressively exposed to anxiety-inducing situations in various environments while remaining in a safe space. This process helps develop a sense of habituation, ultimately reducing or even eliminating anxiety over time.
Behavioral and substance addictions can also be addressed through virtual reality. By incorporating synthetic stimuli into the environments that trigger craving responses, patients struggling with addiction can work on their cravings to diminish the urge to consume.
Additionally, multiple environments—such as bars, casinos, and social settings—enable cognitive work on dysfunctional beliefs associated with specific temptation scenarios.
Regarding eating disorders, virtual reality software helps target key etiological factors, such as body dysmorphia, allocentric lock (a tendency to focus on others rather than oneself), and food cravings.
Currently, our TERV (Virtual Reality Exposure Therapy) solutions include multiple software programs designed to address critical psychiatric, psychological, and neuropsychological determinants such as relaxation, cognitive stimulation, behavioral activation, and social skills training.
Reminiscence therapy is also a major therapeutic tool in treating depression. By allowing patients to relive sensations linked to past pleasurable activities (such as sports, driving, or traveling), virtual reality stimulates hypoactive brain areas, enhancing therapeutic success. VR serves as an excellent mediator for reigniting engagement in enjoyable activities.
Moreover, cognitive stimulation for elderly individuals is another area where virtual reality proves beneficial. By leveraging technology to make stimulation activities more engaging and accessible, patients and nursing home residents can improve executive functions and memory through specially designed applications.
Today, virtual reality in mental health care is advancing rapidly. Researchers, clinicians, and developers continue to explore new therapeutic targets to offer innovative and effective treatment solutions in the near future.
VR can be used by all healthcare professionals assisting patients with anxiety, phobias, post-traumatic stress disorders, addictions, or other psychological challenges.
It is particularly beneficial for psychologists, psychiatrists, neuropsychologists, specialized nurses, as well as psychomotor therapists, physiotherapists, dietitians, sophrologists, and hypnotherapists. With a wide range of immersive environments, VR enhances therapeutic approaches and provides innovative tools to improve patient care.
Healthcare providers incorporating virtual reality exposure therapy (VRET) expand their range of treatment options. VRET is a well-established therapeutic technique with scientific validation from cognitive-behavioral therapy research.
  • Professional Differentiation: Integrating VR into practice allows therapists to stand out from traditional treatment options.
  • Scientific Validation: VRET is backed by extensive research, reinforcing its credibility as an effective treatment method.
  • Improved Patient Engagement: The interactive nature of VR fosters greater patient involvement in therapy.
  • Time-Saving: VR provides direct access to various exposure environments without needing external logistics.

One of the considerable advantages of virtual reality is that it is effective on a wide spectrum of populations. Existing data from the literature on the subject shows us that it is entirely possible to expose a wide age group to virtual reality, with real therapeutic benefits.

The studies attest, in fact, to excellent feasibility and significant results; particularly in adults, in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders and mood disorders.

The results are identical for adolescents with a significant added value concerning therapeutic engagement where virtual reality promotes adolescents' interest in their therapy.

Among elderly subjects, study results encourage the use of virtual reality with the aim of working on cognitive stimulation, on behavioral disorders but also on anxiety.

One of the major advantages of virtual reality is its effectiveness across a broad spectrum of the population. Existing literature on the subject shows that virtual reality can be used with individuals of various age groups, providing significant therapeutic benefits.
Studies confirm excellent feasibility and significant results, particularly among adults in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders, and mood disorders.
The results are equally promising for adolescents, with a notable advantage in terms of therapeutic engagement, as virtual reality enhances their interest and participation in treatment.
For older adults, research supports the use of virtual reality to improve cognitive stimulation, behavioral disorders, and anxiety management.
However, people with epilepsy and pregnant individuals are not advised to undergo this type of therapy.
Yes, all our environments are grouped within a single application.
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