An Emotion-Adaptive VR Experience for Recreational Use with People Living with Dementia

Abstract

Dementia is an umbrella term for progressive loss of cognitive abilities, which mainly affects elderly- affecting relationships, feelings and behaviour. A person living with dementia (PLWD) might forget the names of their grandchildren, the face of their loved ones, important places and life events. Due to the rising population growth with more than 55 million people living with dementia (8.1 % of women and 5.4% of men over 65 years) and increasing life expectancies, dementia is already recognized by the WHO (World Health Organization) as a public health priority, and it is now the 7th leading cause of death (WHO, 2021).

The population pressure that care homes are currently under cannot be easily remedied without significant monetary investment into the manpower of the industry. Therefore it would be more fruitful to enable PLWD to function more independently from the help of their carers.

VR technology has seen immense growth in the last 10 years especially within the field of child and elderly care. Although dementia has been understood since 700BCE, the decrease in stigma has allowed the current era of dementia care to flourish using music, art and drama therapy- amongst other person-centred care techniques. Combining these reminiscence therapy techniques with the booming technology of VR is therefore the next logical step in improving immersion. To this end, VR offers control and consistency in testing virtual environments that guarantee safety. However, a key obstacle in the uptake of VR for PLWD is the risk of behavioural and psychological symptoms of dementia- negative behaviours. To reduce these behaviours, a balance must be struck between stimulation and overload- namely stress.

Emotion classification models were established using the valence-arousal circumplex model before identifying the physiological embodiments of such emotion. Of the stress sensing technology surveyed, electromyography was the only technology reviewed that showed evidence of accurate, low-latency, sensation of arousal and valence by way of measuring contractions in the trapezius and zygomaticus muscles respectively.

To design a conducive VR environment, overarching goals for reminiscence in VR were identified as presence, occupation, comfort, inclusion and novelty. The method of reminiscence therapy was broken down into three forms- place, object and interaction based. The parameters of brightness, volume and non-player character movement were established to be adapted in VR for stress reduction over the course of a 10 minute exploration test.

Results of the study showed a 26% decrease in average stress experienced during the three modulation stages over the control stage. Volume modulation was identified as the most effective parameter showing a 32% stress reduction.

Participants reported that the presentation of familiar environments in VR did in fact promote feelings of nostalgia and reported moments of reminiscence. Future work opportunities call for more studies with PLWD, multi-modal & multi-channel stress sensing and concurrent parameter modulation.

Technology improvements such as integrating all peripherals into a standalone system as well as utilising more convenient and ergonomic sensors that could be applied semi-permanently to form a more holistic data overview for PLWD outside experimental conditions.