TY  - JOUR
AU  - Imai, Ayu
AU  - Matsuoka, Teruyuki
AU  - Nakayama, Chikara
AU  - Hashimoto, Nana
AU  - Sano, Mutsuo
AU  - Narumoto, Jin
PY  - 2024
DA  - 2024/8/1
TI  - Effectiveness of a Virtual Reality Open-Air Bath Program in Reducing Loneliness and Improving Brain Function for Dementia Prevention in Older Adults: Protocol for a Prospective Randomized Crossover Study
JO  - JMIR Res Protoc
SP  - e57101
VL  - 13
KW  - loneliness
KW  - virtual reality
KW  - VR
KW  - Alzheimer disease
KW  - predementia
KW  - intervention
KW  - subjective cognitive decline
KW  - mild cognitive impairment
KW  - dementia
KW  - older adult
KW  - geriatric
KW  - depression
KW  - cognitive impairments
AB  - Background: Older adults often face loneliness due to chronic illness or loss of close ones, a situation worsened by the COVID-19 pandemic. Increased loneliness heightens the risk of diseases, especially dementia, necessitating urgent action. Objective: This study aims to assess the impact of a virtual reality (VR)–based open-air bath program on depression and loneliness in older individuals with subjective cognitive decline/mild cognitive impairment attending the Dementia Medical Center in Kyoto, Japan. We further aim to evaluate the feasibility of the program (participant recruitment and adherence) and to measure program enjoyment and satisfaction. Methods: The study design is a crossover trial with a 1:1 ratio, wherein 12 participants will be randomly assigned to groups 1 and 2, with group 2 serving as a waitlist control and group 1 receiving the VR program from the onset for 6 months; the VR program will be conducted 6 times (monthly). Program completion for group 1 will be followed by an observation period from months 7 to 12. Group 2 will participate in the VR program from months 7 to 12, with an observation period from months 1 to 6. Cognitive tests, psychiatric assessments, and the University of California, Los Angeles Loneliness Scale will be conducted before the study, at 6 months, and at 12 months. Results will be analyzed using repeated-measures ANOVA. Head magnetic resonance imaging and single-photon emission computed tomography scans will be performed before and after the VR program to evaluate changes and effects on brain regions. Results: Recruitment began in September 2023 and data collection is expected to be completed by March 2025. Complete study results will be published by September 2025. Conclusions: This study examines the preliminary effects of VR on loneliness in older adults with predementia through open-air bath simulations. VR experiences could benefit this population, particularly those with limited outdoor activities. Quantifying VR’s impact will aid in determining the size for a larger clinical trial. Qualitative results will inform participation mechanisms and guide the implementation and design of future trials. Trial Registration: University hospital Medical Information Network UMIN000052667; https://tinyurl.com/3yaccay5 International Registered Report Identifier (IRRID): DERR1-10.2196/57101 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2024/1/e57101
UR  - https://doi.org/10.2196/57101
UR  - http://www.ncbi.nlm.nih.gov/pubmed/39088243
DO  - 10.2196/57101
ID  - info:doi/10.2196/57101
ER  -