Virtual and Augmented Reality Games in Dementia Care: Systematic and Bibliographic Review

Abstract

Background: This review investigates the use of virtual and augmented reality games in dementia care. It provides an insight into the last 13 years of research, including the earliest publications on this topic, and takes a systematic and bibliographic approach. Methods: We sourced research publications from three different scientific databases (PubMed, Scopus, and APA PsycInfo) for this publication. We chose the PRISMA approach and categorized the studies according to the publisher. A set of 12 variables was defined across three categories (bibliographic, medical, and technical). Results: Of the 389 identified articles, 36 met the inclusion and exclusion criteria. After a phase of pilot studies mainly being conducted, the number of publications increased by four times but decreased again in 2023. Dominating were pilot and feasibility studies; 8 out of the 36 trials were RCTs. The median trial population was 24, and the protocols were performed for an average of 10 weeks, with two 40-min sessions a week. Simulator sickness was reported but not by the majority of participants. A total of 59% of the studies used fully immersive 3D-VR systems. We identified only three publications that provided high immersion quality. These findings indicate the positive effects of using virtual and augmented reality systems on participants' cognitive function and mood. Conclusions: This publication focuses on the technical aspects of the applied technologies and immersion levels of the patients. Using augmented and virtual reality methods to improve the quality of life and physical interaction of dementia patients shows the potential to enhance cognitive functioning in this population, but further investigation and multicenter RCTs are needed. There are strong indications that this research branch has high potential to benefit both caretakers and patients.

Keywords: Alzheimer’s; augmented reality; bibliographic review; dementia; medicine; systematic review; virtual reality.

Figure 1

PRISMA workflow. A visual representation of the stages involved, illustrating the individual steps and the number of excluded publications at each stage.

Figure 2

Timeline of publications. The bars illustrate the number of publications in each specific year, ranging from 2012 to 2024.

Figure 3

(a) Number of subjects in the study: The median is 16 subjects in 34 trials. The dots represent the individual trials and subject numbers. (b) Overall duration of the study: The average trial length was 3 weeks. The grey dots denote individual trials, while the dark blue violin plot shows the distribution of the number of publications over varying durations (n = 31). (c) Number of sessions per week: The average number of sessions per week was two sessions. The grey dots represent individual trials and the corresponding session counts. (d) Single-session duration: The median single-session duration is 35 min.

Figure 4

Immersion level: The Reproduction Fidelity (RF) is shown on the x-axis as an indicator of the graphical and auditive modeling quality. The Extent of Presence on the y-axis represents the users’ engagement with and immersion in the VR and AR worlds (n = 36).