GETTING SERIOUS
about serious
VR
GamesForDementia
BACKGROUND
Environmental Scan
of VR apps designed to date
There is increasing evidence of the effectiveness of game-based dementia treatments, with a growing investment in Virtual Reality (VR). VR-games are immersive, interactive, and imaginative, providing exciting and life-like multisensory (visual, auditory, and tactile) experiences.
Despite its promise, it is currently unknown how many VR apps have been created for people with dementia or how to best design for this unique population.
If we are serious about designing effective serious VR games for people with dementia, these are things that we need to know.
To help fill this knowledge gap and lay the groundwork for developing a set of design guidelines, we conducted a systematic environmental scan to identify and describe currently available VR applications and their design features.
Our
Methods
Prisma
Framework
Search conducted: December 6-8, 2022
We included only apps designed to be used in a VR HMD, by people with dementia.
255 apps were initially extracted from popular VR game-engines (Oculus, Steam, iOS, Google Store), peer-reviewed and grey literature (Google and Google Scholar). After screening by three reviewers, 12 apps were included in the analysis.
Thematic
Analysis
In-depth thematic charting (by three reviewers) included documenting available information on:
-
App purpose and design
-
Design features specific to PwD
(e.g., accessibility, safety, user instructions, interaction requirements) -
Evidence of therapeutic benefits
-
Indications for medical use
HMD
Testing
2 apps were tested in an Oculus Go & Meta Quest 2
Two apps - “Seas the Day” and “The Wayback” - were commercially available to download and were tested in a Meta Quest 2 VR HMD.
Of the remaining apps, four were available for businesses and six were only described in the literature.
12 Apps that
Made the Cut
2001
LEGEND
Direct to Consumer
Business to Business
Described in the Literature
Exercise
Social and Psychological Well-Being
Improve Cognition
Diagnosis
2015
2016
2017
2019
2020
2021
2022
Visuals
8 Used Computer Graphics
6 Used 360-degree video
2 Used static 360-degree images
(e.g. Google Maps)
Seas the Day. (2023, April 1). In SideQuest VR. Retrieved April 27, 2023, from https://sidequestvr.com/app/4441/seas-the-day
Wayback Productions Ltd.. “1953 Preview”. Screen capture from app displayed on smartphone.
Virtue Health Inc., (n.d.). Image of smartphone with The Lookback companion app. Retrieved April 28, 2023 from: https://www.virtue.io/lookback/
Movement
Interaction
8%
None (stationary only)
42%
First-person
motion
25%
Leap-motion
25%
Not described
8%
None (head movement only)
8%
Hand movement
8%
Not described
25%
Caregiver control through
a secondary device
(e.g. tablet, smartphone)
50%
Hand-held
controllers
Social &
Co-Operative
Experiences
3 apps allowed users to meet with another individual in VR.
For example, the RendeverLiveTM program offers daily live programs and live interaction with a virtual program host.
Dementia-Specific Considerations
8 apps described dementia-specific design features.
7 apps described having dementia-specific user instructions.
COGNITIVE
-
Clear, specific tasks
-
Incorporating task-focused activities that do not rely on memory (e.g., Montessori approach)
-
Verbal and visual cues
-
No-fail conditions
-
Simple, recognizable visuals to prevent overwhelm
-
Intuitive and realistic game mechanics (e.g., rowing a boat)
PHYSICAL
-
Based on prescribed movements for people with dementia
-
Incorporation of natural movements (e.g., reach over head to lift box of apples)
-
Simple interaction with virtual objects (larger boundary around an object so that it can be easily grabbed)
-
Designed to be used seated
-
5-minute exercise time limit to minimize fatigue
-
Lightweight VR headset
SOCIAL
-
Familiar content and music to foster positive emotion and trigger memories
-
Group use: TV casting and networking to synchronize multiple headsets
-
Design to meet psychological needs of people with dementia (e.g., quiet environment, positive words, remaining occupied)
-
Person-centered approach: choice of exercise duration, feedback on behaviour and self-monitoring (e.g., distance cycled)
-
Experience personalization: music choice, photograph
Evidence
Theory/
Expert Opinion
Lived Experience/
User Testing
Peer Reviewed
Article
Peer Reviewed
Article Evaluating
Effectiveness
100%
75%
75%
0%
While all apps were described as based on theory and/or expert opinion and many had peer-reviewed publications describing the design or user testing, evidence to support effectiveness was scarce.
Where in the world are the apps developed?
