Abstract

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There is increasing evidence of the effectiveness of game-based dementia treatments, with a growing investment in Virtual Reality (VR). VR games offer a superior sense of immersion, interactivity, and imagination, providing players with exciting and life-like multisensory experiences. A scoping review was conducted to (1) identify immersive VR games designed to be used by people living with dementia (PLwD) in a head-mounted display (HMD), (2) describe their availability, therapeutic targets, and user-centered design features, (3) summarize the evidence to support their use, and (4) raise awareness of important gaps. Following PRISMA-ScR methodology, 211 applications designed to be used in a VR HMD by PLwD were extracted from popular game engines (e.g., Oculus, Steam), peer-reviewed, and grey literature, resulting in 23 applications that underwent in-depth charting. The two applications that were available for download were tested in a HMD.

The primary purpose of the applications varied with 11 designed for therapeutic recreation, six for improving cognition, five for exercise, and one for dementia screening/diagnosis. Most (18) were only described in the literature or had unclear availability. Nearly all (21) presented at least some dementia-specific features to support physical/cognitive limitations, social-emotional needs, or safety and 15 had undergone early stage trials to evaluate feasibility and initial clinical efficacy. Five were only in the initial stage of development and validation (i.e., human-centered design with end-users), three had no apparent validation efforts, and none had undergone randomized controlled trials.

Our findings suggest that of the very few immersive VR applications that exist for dementia care, there is limited evidence for usability, acceptability, safety, and efficacy. Further research to establish dementia-specific VR design guidelines and rigorous studies demonstrating efficacy and safety are required before VR applications can be widely recommended for PLwD as medical devices or through social prescribing.