— NextAvenue.org, March 2017
British-born Alma, shown here, lived in Northern California and thought that she'd never again travel to her native land. So I outfitted Alma and her daughter with these lightweight goggles that have smart-phones snapped into the case. The gear lets you view special "360º" or "spherical" imagery — also called virtual reality. I launched Google Earth in street map view, then entered the address that Alma remembered, and whoosh! suddenly she and her daughter were "visiting" Fort Royal Hill, a park in Alma’s hometown of Worcester, England. A reserved 91-year-old suffering from lung cancer, Alma happily reminisced as she looked around, especially when she spotted the playground roundabout she enjoyed as a child.
Catching on to how Google Earth works, Alma asked to visit the New Jersey home where she’d lived as a young mother married to a U.S. Air Force officer. This triggered memories of raising children “here.” Alma concluded her virtual reality adventures by flying through a whimsical 3D version of Van Gogh's Starry Night.
After Alma removed the headset, her daughter asked, "Isn't it amazing?" Alma said, "It's MORE than amazing! Wow!” She looked around her living room and said, "I can't believe I'm still here!” Two months later, she was gone. After Alma’s death, her daughters expressed gratitude for the pleasure their mother experienced while seeing Worcester one final time.
Alma was ill, but her brain was still sharp. She got lucky in the brain roulette game; 37% of Americans over age 85 have cognitive impairment, known as memory loss or dementia.
In conjunction with living longer, physically healthier lives, we are learning how to do the same for our aging brains.
Neuroscientists have learned this: stimulating the aging brain boosts recall and thinking scores of people who have memory problems.
After frail elders engage in a mentally stimulating activity, they communicate and interact more effectively than before. Caregivers report improved quality of life. Apparently this sort of activity can build “cognitive reserves” to replace damaged brain cells — and cognitive stimulation may help reduce symptoms associated with dementia.
Gentle Reader: cognitive stimulation is job #1 for maintaining brain fitness — because today there is NO medical treatment or prevention of dementia, one of the top ten causes for death worldwide.
Who you gonna call, if there’s no brain ghostbusters? Self-care is the place to start. Excellent diet, exercise, sleep, and stress management have been shown to reduce the risk of developing cognitive problems. And now scientists believe that pushing the brain’s thinking capacity puts another arrow in the cognitive quiver.
“Approaches to Cognitive Stimulation in the Prevention of Dementia” is a report by European gerontologists. They analyzed studies of cognitive intervention strategies for people with mild memory loss or moderate dementia. They concluded that the practice of cognitive intervention (stimulation) has 3 fundamental goals, each using multiple strategies:
1— Educational training teaches people who develop memory problems about their symptoms, such as onset and duration of decline, and ways to cope;
2— Functional memory improvement uses memory aids (calendars, memory books, etc.), reality orientation (repeated presentation of name, date, time, place, weather, other basic info), and methods of loci (mnemonic systems for linking an item with a place);
3— Cognitive functioning techniques exercise your ability to memorize, calculate, perceive, and react, and include reminiscence therapy, a clinical intervention that evokes discussion of positive nostalgic experiences, increases motivation and focus, and fosters self-worth, psychological resilience and improved well-being (Yamagami et al., 2007*)
Most elders love to tell and re-tell old stories. Why? Recalling and sharing life experiences produces the lovely neurotransmitter dopamine, which plays a role in human motion and emotion. Low dopamine levels lead to lack of motivation, fatigue, addictive behavior, mood swings, and memory loss. Hence, increasing dopamine levels likely improves mood and reduces memory loss.
And if an elder is struggling with short-term memory loss (peoples’ names, meals eaten), the ability to recall and share long-term memories is a gift.
Get back to where you once belonged
Reminiscence therapy is a fantastic application for mobile virtual reality (mobile VR); i.e., “immersive,” 360-degree, spherical imagery.
In the journal Neuropsychiatric Disease & Treatment, neuroscientist Michel Benoit and his team described a feasibility study testing the hypothesis that visual cues provided by “image-based rendering virtual environments” to people with dementia can enhance production of autobiographical memories. They concluded that cues involving an environment related to the subject’s life increase the quantity of conscious recollections of memories.
Researchers today also are developing 360º video and real-time VR and augmented reality applications for cognitive assessment and training applications. An excellent overview of VR use in this field appears in a 2015 “Frontiers in Aging Neuroscience,” by Madrid researcher Rebeca Garcia-Betances and her team.
“Virtual reality-based cognitive rehabilitation systems support procedures for mitigating behavioral and psychological symptoms of patients having mild cognitive impairment and early-stage Alzheimer’s disease.”
— American Journal for Alzheimer’s Disease and Other Dementias
In May 2016, I met two MIT grad students, Dennis Lally and Reed Hayes, who founded a company, Rendever, while attending B-school. Both in their 20s, they had seen older relatives languish in assisted-living facilities, and decided to create a business delivering mobile VR to offer engaging activities for frail elders. They teamed with other students to design an app, code a mobile architecture and prototype a method enabling one tablet device to control selection and presentation of curated, streaming 360º content displayed in multiple Samsung GearVR headsets and smartphones.
The MIT team asked me to compile feedback from senior-living providers, end users (residents, care-givers, activity leaders), geriatric health specialists, and 360º content developers.
Demo content included 360º slide shows of scenic and historical landmarks, annotated photo tours of cultural sites, and spherical videos of circus performers, animals, underwater life, mountain-climbers, race-cars, orchestras, abstract art “walkthroughs,” NYTVR clips, and so on. Also, my favorite, Google Earth.
— visiting exotic locales
— viewing natural and wildlife scenes
— flying and other out-of-body adventures
Typically a single viewing of each video or slideshow was sufficient. No one ever requested a repeat experience, with one exception: people couldn’t get enough of visiting familiar settings via Google Earth.
In this setup, everyone in the group sees the same single scene, although they can each look around the scene independently. I observed these results at every care facility, in every city: When one participant recalled an old home address and the resulting street scene appeared, that person became excited, twisting around in their chair, pointing at recognized landmarks, marveling at changed foliage or new structures, gesturing to a garden or garage or window, saying “Look over there, by the red car! My father planted a magnolia tree right there!,” etc.
Fellow participants responded enthusiastically as they learned something new about each other. This provides residents living together due to happenstance, not choice, to build interpersonal connection and enhance understanding, in addition to self-worth and motivation. It elevates conversation between resident and caregiver beyond, “Do you want to wear this jacket today?” or “It’s time for your shower.”
It’s exciting to bring these experiences to our elders, and all people who no longer freely have access to the outside stimuli that normally would enhance motivation and focus. These are the people for whom virtual reality applications can provide excitement and wonder that would otherwise be impossible for them to experience.
Besides, there's nothing quite so rewarding as blowing the mind of a 90-year-old. As Alma said: It's MORE than amazing. Wow!!
*Yamagami T. Oosawa M. Ito S. Yamaguchi H. (2007). Effect of activity reminiscence therapy as brain-activating rehabilitation for elderly people with and without dementia. Psychogeriatrics , 7(2), 69–75