The effects of virtual reality and video conferencing on personal and relational well-being among older adults with cognitive impairments and their adult children: The Thrive randomized controlled trial.

UNLABELLED: Older adults in senior living communities (SLCs) often face barriers to maintaining emotional well-being and family ties. This stratified, unblinded, parallel-group randomized controlled trial tested a four-week virtual reality (VR) intervention (Thrive) designed to improve well-being for older adults with cognitive impairment and their adult children living at a distance, compared to an active video conferencing (VC) control. A total of 186 dyads - each comprising a parent with mild cognitive impairment (MCI) or mild-to-moderate Alzheimer's disease and related dementias (ADRD) and an adult child - were recruited from 23 SLCs and randomized 1:1 to VR (n=90) or VC (n=96). Primary outcomes - including personal, social, and relational well-being for parents and adult children, and perceived stress and caregiver guilt for adult children - were assessed at baseline, one week post-intervention (primary endpoint), and one and three months post-intervention using intention-to-treat linear mixed models; secondary outcomes captured session engagement via self-report and behavioral coding. Retention was high (89% at post-intervention). Parents with ADRD showed significantly greater improvement in VR than VC for psychological well-being, social connection, and relationship quality, while parents with MCI showed a comparable pattern favoring VC for relationship quality and social connection. Adult children in both conditions reported improved personal, social, and relational well-being, with VR showing more sustained reductions in caregiver guilt through three months. Overall, VR sessions elicited more engagement than VC. These findings indicate that both VR and VC improved well-being and family connection, with VR conferring additional benefits for parents living with dementia and a sustained caregiver-guilt benefit for adult children, suggesting that tailoring technology to cognitive abilities may enhance outcomes in senior care settings.

FUNDING: National Institute on Aging (NIA), National Institutes of Health (NIH), USA.