Single-group pre-post pilot study of immersive VR 'outworld' experiences for 13 in-patients with dementia: feasible, well-tolerated, and qualitatively engaging
How this was rated
Single-group pre-post pilot study (n=13) without a control condition. Peer-reviewed in JMIR Aging (a recognized open-access PubMed-indexed journal). Acceptability and feasibility findings are robust at the pilot level; clinical-outcome inferences are limited by the absence of a control group, the small sample, the single-session-or-short-protocol design, and the heterogeneity of dementia type, severity, and stage in the included sample (precise breakdown of dementia subtypes not detailed in the Nudelman et al. 2026 scoping review tabulation).
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A single-group pre-post pilot study of immersive virtual reality experiences delivered to 13 hospital in-patients with dementia (mean age 73.2, range not reported; 13 women in the Nudelman scoping review listing). Patients used an HTC VIVE Pro Eye HMD to access curated 'outworld' VR environments (places they could no longer visit in person). Mixed-methods evaluation combined pre-post quantitative measures with qualitative interviews. The VR experience was well-tolerated and produced positive engagement, though the small single-group design without a control limits causal inference about therapeutic benefit.
A pilot study showing that immersive VR (HTC VIVE Pro Eye) is feasible, well-tolerated, and qualitatively engaging for hospital in-patients with dementia, when used to deliver 'outworld' experiences (curated VR environments the person can no longer visit physically). The study supports the feasibility of immersive VR in dementia inpatient care; it does NOT establish efficacy on clinical outcomes (cognition, mood, behavior) - a controlled trial with longer follow-up is needed before recommending immersive VR as standard dementia care. For SLPs working with cognitive-communication impairments in dementia, this is useful feasibility evidence.
Key findings
- Single-group pre-post pilot of immersive VR 'outworld' experiences (curated VR environments the patient can no longer visit) in 13 hospital in-patients with dementia
- HTC VIVE Pro Eye head-mounted display - higher-resolution research-grade hardware, providing a strong test of feasibility with the most capable consumer-VR systems
- Mixed-methods evaluation: pre-post quantitative measures plus qualitative interviews capturing in-the-moment and post-session experience
- Immersive VR was feasible and well-tolerated in this dementia in-patient population - a non-trivial finding given that earlier reports raised concerns about cybersickness, disorientation, and HMD-fit issues in older or cognitively impaired users
- Qualitative interviews reported positive engagement and emotional response to outworld scenarios - aligning with the broader VR-in-dementia literature on emotional benefit and 'reminiscence' affordances
- Mean participant age 73.2 years (range not reported in the Nudelman scoping review tabulation of this study)
Background
Dementia is associated with progressive loss of independence and reduced access to environments and activities that anchored the person’s identity and social life. Hospital inpatient stays compound this by isolating people in clinical environments. Immersive virtual reality has been proposed as a way to deliver ‘outworld’ experiences - curated environments the person can no longer visit physically - with potential benefits for engagement, mood, reminiscence, and environmental orientation. However, prior to this study, the feasibility of consumer-grade research VR (HTC VIVE Pro Eye) in actual dementia inpatient populations was not well established.
What the researchers did
13 hospital in-patients with dementia were enrolled in a single-group pre-post mixed-methods pilot study. Each patient used the HTC VIVE Pro Eye head-mounted display to access an immersive VR ‘outworld’ experience. The study combined quantitative pre-post measures with qualitative interviews to capture in-the-moment and post-session experience.
What they found
The immersive VR experience was feasible and well-tolerated in this dementia in-patient population - a non-trivial finding given prior concerns about cybersickness, disorientation, and HMD-fit issues in older or cognitively impaired users. Qualitative interviews reported positive engagement and emotional response.
Why this matters
This is a feasibility pilot, not an efficacy trial. Its contribution is establishing that immersive VR with research-grade hardware (HTC VIVE Pro Eye) is workable in a dementia inpatient setting, opening the door to controlled trials of specific therapeutic applications - cognitive-communication work, reminiscence therapy, environmental orientation, family engagement.
Limitations
- Single-group pre-post design with no control. Engagement and positive response cannot be attributed to the VR specifically rather than to the attention, novelty, or social interaction surrounding the session.
- Small n=13 - precision of acceptability estimates is limited.
- Heterogeneity of dementia type and severity not detailed in available scoping-review tabulations; generalization across the dementia spectrum is unclear.
- Short protocol - sustained engagement over weeks or months, and longer-term cognitive/behavioral outcomes, were not evaluated.
- Research-grade hardware (HTC VIVE Pro Eye) - replication with consumer-grade HMDs (Meta Quest 2/3) would inform real-world deployability.
Implications for practice
For SLPs and allied clinicians working with people with dementia in inpatient settings, this study supports the feasibility of immersive VR with research-grade hardware. The 'outworld experiences' frame - using VR to access places the patient can no longer physically visit - is a clinically useful concept that maps onto reminiscence work, environmental engagement, and family/identity-anchored therapy goals. However, this is a pilot with no control group; do not cite it as efficacy evidence for cognition, mood, or behavioral outcomes. Use it to justify a feasibility pilot in your own service, not to argue that immersive VR is a proven dementia intervention.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{matsangidou2023,
author = {Matsangidou, M. and Solomou, T. and Frangoudes, F. and Papayianni, E. and Pattichis, C. S.},
title = {Offering Outworld Experiences to In-Patients With Dementia Through Virtual Reality: Mixed Methods Study},
journal = {JMIR Aging},
year = {2023},
doi = {10.2196/45799},
url = {https://withvr.app/evidence/studies/matsangidou-2023}
}TY - JOUR
AU - Matsangidou, M.
AU - Solomou, T.
AU - Frangoudes, F.
AU - Papayianni, E.
AU - Pattichis, C. S.
TI - Offering Outworld Experiences to In-Patients With Dementia Through Virtual Reality: Mixed Methods Study
JO - JMIR Aging
PY - 2023
DO - 10.2196/45799
UR - https://withvr.app/evidence/studies/matsangidou-2023
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
Affiliations: University of Cyprus and Cyprus Research and Innovation Center. Funding details not extracted from the published PDF used for this summary (the available PDF was a rasterized ProQuest print without selectable text). Open access via JMIR Aging. No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published peer-reviewed paper and the Nudelman et al. 2026 scoping review tabulation. The VR system used was a custom HTC VIVE Pro Eye-based 'outworld experiences' application, NOT Therapy withVR or Research withVR.