Background: Dementia is one the major problems of aging societies, and, novel and effective non-drug therapies are required as interventions in the oldest-old to prevent cognitive decline. Objective: This study aims to examine the efficacy and safety of reminiscence using immersive virtual reality (iVR reminiscence) focusing on anxiety that often appears with cognitive decline. The secondary objective is to reveal the preference for VR image types for reminiscence: live-action (LA) or computer graphics (CG). Methods: This was a pilot, open-label, and randomized crossover study which was conducted on January 2020 at a single nursing home. The subjects were randomly divided into two groups (A or B) in equal numbers, and they alternately viewed two types of VR images (LA and CG) themed on the mid- to late Showa era (A.D. 1955–1980) in Japan. In group A, the CG images were viewed first, and then the LA images were viewed (CG→ LA). In group B, the images were viewed in the opposite order (LA→ CG). Before VR viewing, subjects responded to Mini-Mental State Examination (MMSE) Japanese version and State-Trait Anxiety Inventory (STAI) Japanese version. After viewing the first and second VR, subjects responded to STAI and the numerical rating scale (NRS) for satisfaction and side effects (nausea, dizziness, headache, and tiredness). Results: Ten subjects participated in this study. The values of analyses are presented in the mean (SD). The age was 87.1 years (4.2), and the MMSE was 28.5 (1.8). The total STAI score before VR viewing was 36.1 (7.2), but it significantly decreased to 26.8 (4.9) after the first VR viewing (P = 0.0010), and further decreased to 23.4 (2.8) after the second VR viewing (P < 0.001). The NRS score for satisfaction tended to be higher after viewing LA in group A (CG→ LA) (CG vs. LA; 7.0 (2.3) vs. 8.6 (1.5), P = 0.0993), while in group B (LA→ CG), the score after CG was slightly lower than that after LA. There were no serious side effects. Conclusions: This study suggests that iVR reminiscence can reduce anxiety in the oldest-old without causing serious side effects. Furthermore, the impacts might be better with LA images.

中文翻译：

---

身临其境的虚拟现实回忆在不引起严重副作用的情况下减少最年长老人的焦虑：单中心、试点和随机交叉研究

背景：痴呆症是老龄化社会的主要问题之一，需要新型有效的非药物疗法作为干预老年人的干预措施，以防止认知能力下降。目的：本研究旨在检查使用沉浸式虚拟现实（iVR reminiscence）进行回忆的有效性和安全性，重点关注认知能力下降时经常出现的焦虑。次要目标是揭示 VR 图像类型对回忆的偏好：真人 (LA) 或计算机图形 (CG)。方法：这是一项试点、开放标签和随机交叉研究，于 2020 年 1 月在一家疗养院进行。受试者被随机分成相等数量的两组（A 或 B），他们交替观看以日本昭和中后期（公元 1955-1980 年）为主题的两种类型的 VR 图像（LA 和 CG）。A组先看CG图，再看LA图（CG→LA）。在 B 组中，图像以相反的顺序查看（LA → CG）。在观看 VR 之前，受试者对简易精神状态检查 (MMSE) 日文版和状态-特质焦虑量表 (STAI) 日文版做出反应。在观看了第一个和第二个 VR 后，受试者对 STAI 和数字评定量表 (NRS) 的满意度和副作用（恶心、头晕、头痛和疲倦）做出反应。结果： 10 名受试者参与了这项研究。分析值以平均值 (SD) 表示。年龄为 87.1 岁 (4.2)，MMSE 为 28.5 (1.8)。VR观看前的STAI总分为36.1（7.2），但在第一次VR观看后显着下降至26.8（4.9）（P = 0.0010），并进一步下降至23.4（2. 8) 第二次 VR 观看后 (P < 0.001)。在 A 组（CG→ LA）（CG vs. LA；7.0 (2.3) vs. 8.6 (1.5)，P = 0.0993）中，观看 LA 后的 NRS 满意度得分往往更高，而在 B 组（LA→ CG )，CG后的得分略低于LA后的得分。没有严重的副作用。结论：这项研究表明，iVR 回忆可以减少老年人的焦虑，而不会引起严重的副作用。此外，洛杉矶图像的影响可能会更好。这项研究表明，iVR 回忆可以减少老年人的焦虑，而不会引起严重的副作用。此外，洛杉矶图像的影响可能会更好。这项研究表明，iVR 回忆可以减少老年人的焦虑，而不会引起严重的副作用。此外，洛杉矶图像的影响可能会更好。