Depression in the elderly

Recent years have seen a huge uptick in the use of VR in geriatrics. As Mathias et al reported in a 2019 review of the literature, VR has become an effective tool in screening for and treating cognitive impairment, while it has also found uses in the treatment of Alzheimer’s Disease. The use of VR in treating mood disorders and other forms of depression in the elderly has lagged behind, but there are reasons to believe that it will be the next frontier in treating mental health disorders among American seniors. VR has been used with great success in treating ADHD, anxiety, and depression among teens and younger people, leading many geriatrics specialists to see exciting potential for older age groups. So let’s look in more detail about how the technology could be applied, and the kind of benefits seniors can anticipate.

SUMMARY

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1. DEPRESSION : A MAJOR CHALLENGE FOR GERIATRICS IN THE USA

Before we look at a few applications for VR in geriatrics, it’s important to put them into context. Clinically diagnosable depression affects between 1-5% of US seniors, and as many as 14% of those requiring home or institutional healthcare. Additionally, many more people suffer from milder symptoms of depression. For instance, one study in France found that 23% of elderly people showed some signs of depression. And even milder symptoms can lead to seriously diminished quality of life. The same study also found that depression increases the risk of death among seniors, findings that have been repeatedly backed up by the NIH in its studies of quality-adjusted life expectancy.
The fact is that depression makes life more miserable, exacerbates existing health conditions, deters seniors from engaging with each other and the outside world and – ultimately – shortens lives. So any therapies that can ease its symptoms are to be welcomed. And VR fits into that category, as a quick tour of recent innovations demonstrates.

Using VR to treat anxiety among the ederly

Anxiety is a major mental health issue among the US population in general, but it is particularly serious among older age groups. According to the Geriatric Mental Health Foundation, 10-20 percent of American seniors suffer from some form of clinical anxiety – most often phobias. And this condition can seriously compromise their standard of living. How could VR help? According to some researchers, the answer is yes.
VR can help to compensate for the lower efficacy of treatments like cognitive behavioral therapy in older age groups – allowing practitioners to change behavior in situations where this was previously impossible. Research published in 2015 by Sébastien Grenier of the University of Montreal suggested that VR could help by allowing seniors to virtually “confront” the source of their anxiety.
By using VR headsets to create situations in which seniors are exposed to sources of anxiety, therapists can help them deal with those issues without needing to leave their home or care setting.

Can VR allevate depression caused by poor mobility

The same theme feeds into a broader discussion about the application of Virtual Reality to geriatrics: can VR treatments help elderly people to deal with the depression caused by decreased exposure to the outside world as their bodies become less mobile and physically capable? Lost mobility is certainly a cause of depression in senior populations. And it is also a major symptom of depression, creating dangerous feedback cycles which damage the mental health of patients. Seniors may choose to socialize less, visit fewer external locations, and generally interact less with the outside world due to bereavements, stress, and anxiety – causing them to become less trustful and more unhappy.
This is a tragic situation for individuals, but potentially a very fruitful application of VR technology. Studies in care settings have found that Head Mounted Displays (HMDs) can deliver VR content safely and effectively to elderly patients, and that participants in studies report a high degree of comfort and enjoyment during VR therapies. And the experience of those in the field also shows that these therapies can be extremely successful.
VR headsets have become a regular sight at the Ebenezer Care Center in Minneapolis, where residents use them to virtually visit locations they have seen before or have always wished to visit.
Feedback from residents using the headsets suggests that they become more relaxed and open to social interactions following VR sessions – exactly what you would want to see from a treatment for depression among the elderly.  

Using VR to assist with pain management

Alongside anxiety alleviation and the treatment of depression caused by decreased mobility, VR is also finding unexpected uses in pain management – another major contributor to poor mental health among elderly populations. Back in 2014, a major study showed that VR could be used to create cognitive distractions which can help sufferers of chronic and acute pain. In many instances, this redirection of attention can help to reduce the perception of pain, with beneficial effects lasting beyond VR immersion sessions.
Moreover, immersive VR software has been used as a training aide to teach seniors effective pain management and physiotherapy techniques, which can often be the most important measure in mitigating pain over the long term.
And it can be linked with wearable devices to provide valuable feedback for medical practitioners who may be distanced from the patients. All of this contributes to more efficient pain management, which directly influences mood and general happiness. As any senior who has suffered from chronic arthritis will inform you, pain and mental health are tightly interlinked, and anything which can alleviate one tends to help when treating the other.

2. VIRTUAL REALITY THERAPY COULD REVOLUTIONIZE GERIATRIC MENTAL HEALTH

These applications of virtual reality form the tip of an iceberg. The use of augmented reality in therapies like CBT is in its infancy, but there are strong signs that the use of HMDs and specially devised therapeutic software can help to alleviate depressive symptoms. In the future, we are likely to see techniques like Virtual Reality Exposure Therapy (VRET) becoming mainstream, as therapists carefully expose patients to experiences which can lessen their anxieties. On a less sophisticated level, VR experiences which simulate tourism and other social situations will be a common option for seniors in their recreational lives.
So expect to see a mix of medically robust therapeutic tools and commercially produced apps – resulting in a rich mix of techniques to make life more enjoyable and less stressful.
Many of the mental health problems affecting seniors stem from the loss of rich social experiences and their isolation from the external world.
With VR, we now have a set of tools which can counteract those problems like never before. And that’s why geriatric specialists, engineers, care givers, and elderly users are becoming more and more excited by what the technology has to offer.
VR is more than just a novelty. It’s a far-reaching medical therapy which can ensure that old age isn’t a time of misery, fear, and pain. Enriched social lives and positivity are available instead, providing the technology reaches its potential.   Sources: in order they are linked to in the text above]

 https://www.sciencedirect.com/science/article/abs/pii/S1064748119300971 

https://www.sciencedaily.com/releases/2019/02/190206091423.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590980/ 

https://www.sciencedaily.com/releases/2015/02/150217114123.htm 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974513/


https://www.startribune.com/vr-helps-seniors-cope-with-depression-anxiety-minneapolis-center-finds/467195193/


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043364/

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