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

For many older adults living in senior communities, the physical world can feel increasingly small. While they may be surrounded by neighbors and staff, the people who matter most—often their adult children—live far away, separated by geography and the daily demands of life. This distance can create a quiet but profound sense of isolation, a feeling that is particularly acute for those navigating memory loss or cognitive decline. When the mind struggles to hold onto the past or follow a complex conversation, the standard tools for staying connected, like a phone call or a video chat, can sometimes feel like a barrier rather than a bridge. The challenge for families and caregivers is finding a way to maintain a deep, meaningful bond that goes beyond simply seeing a face on a screen, especially when the person they love is no longer able to engage in the same way they once did.

To address this, researchers set out to test whether a specific kind of technology could help. They compared two different ways of connecting: a standard video call, where two people talk face-to-face on a screen, and a fully immersive virtual reality experience. In this virtual world, the older adult wears a headset that blocks out the physical room and places them in a shared digital space with their family member. They can "travel" together to a childhood home, ride in a hot air balloon, or sit side-by-side on a virtual couch to look at old family photos. The researchers wanted to know if this immersive approach offered something the video call could not, particularly for those with cognitive impairments, and if it could ease the heavy emotional burden that often weighs on adult children who worry about their parents from afar.

The study, known as the Thrive trial, brought together 186 pairs of parents and their adult children. The parents, who lived in senior communities across the United States, had either mild cognitive impairment or mild-to-moderate dementia. The adult children lived at least 45 minutes away. The pairs were randomly assigned to one of two groups for a four-week period. One group met weekly using the immersive virtual reality platform, while the other group met using a standard video conferencing tool. Both groups were encouraged to talk and share experiences during their twenty-minute weekly sessions. The researchers then measured how the participants felt about their well-being, their relationship with each other, and the level of stress or guilt the adult children felt about being distant caregivers. They checked these feelings immediately after the four weeks ended, and again one month and three months later.

The results revealed a clear difference in how the two technologies affected the parents, depending on the state of their memory. For parents living with dementia, the immersive virtual reality sessions provided a significant boost to their psychological well-being and their sense of connection to the world. They felt more socially engaged and reported a higher quality of life after the VR sessions compared to the video calls. In contrast, parents with milder cognitive issues, known as mild cognitive impairment, did not show the same advantage from the virtual reality; for them, the standard video call was just as effective, and in some measures of relationship quality, it worked slightly better. This suggests that the type of technology that works best depends on the specific needs of the person using it. For those with more advanced memory loss, the rich, sensory experience of virtual reality seemed to bypass the difficulties of conversation, offering a shared space that felt more real and engaging than a flat screen.

For the adult children, the story was a bit different. Both groups of children, whether their parents used virtual reality or video calls, reported feeling better overall. They experienced less stress, felt less guilty about being far away, and felt closer to their parents. However, there was one lasting difference that stood out. The reduction in guilt felt by the adult children in the virtual reality group lasted for the entire three-month follow-up period. Those who used the video call felt better immediately after the study, but that feeling of relief faded over time. The researchers suggest that the immersive nature of the virtual reality sessions created a deeper, more memorable sense of shared time. Because the experience felt so vivid and special, it may have provided a stronger sense of having done something meaningful for their parent, which helped ease their worry long after the sessions ended.

When the researchers looked closely at what happened during the sessions, they saw that the two technologies encouraged different kinds of behavior. In the virtual reality sessions, the parents were more likely to take the lead in the conversation, to laugh more, and to move their bodies with more energy. They also talked more about their past and shared memories. In the video call sessions, the adult children tended to do more of the talking and leading. The virtual reality environment seemed to spark a sense of wonder and vitality in the parents that the video call did not. The parents in the virtual reality group also reported feeling less strain in their relationship with their children and felt they were learning new things together. The video calls, while effective for connection, did not generate the same level of physical movement or emotional excitement.

The study did not find that either technology reduced feelings of loneliness on its own, which the researchers noted might be because the senior community residents already had access to other social activities. However, the findings strongly suggest that technology can be tailored to support different levels of cognitive ability. The immersive virtual reality platform proved to be a powerful tool for those with dementia, offering a way to connect that felt more natural and engaging than a standard video call. It also provided a unique, lasting benefit for the adult children, helping them feel less burdened by the distance between them and their parents. The research indicates that while video calls remain a valuable and accessible option, adding immersive, shared experiences to family care could offer a deeper, more enduring form of support for families navigating the challenges of aging and memory loss.