Virtual Reality Cognitive Intervention for Critically Ill Delirium Survivors (Vr-Cog)
Investigating VR Brain Games for People Confused After Intensive Care
Sikandar Khan, MD
Primary Investigator
Brief description of study
Acute respiratory failure (ARF) accounts for 2 million admissions to adult intensive care units (ICUs) in the United States annually, and up to 80% of older adults with ARF suffer delirium, a form of ICU-related acute brain dysfunction. Delirium doubles the risk for new cognitive impairment or dementia within 12 months of ICU discharge. In addition, delirium survivors frequently develop related mental health and quality of life impairments. Unfortunately, there are few effective or scalable interventions to improve cognitive outcomes for ICU survivors. The purpose of this study is to find out if using virtual reality (VR) brain games can help improve memory, attention, and mood for ICU survivors. The VR program will be used at home through a headset and hand controls. We want to learn if this type of training is safe, easy to use, and helpful for patients after the ICU.
Detailed description of study
- DeviceVR-based cognitive training program
- DeviceVR-based attention control
Participants randomized to either arm will receive identical VR headsets and hand controllers with built-in headphones at their homes and will participate in identically timed training sessions in a seated position. The schedule for training sessions will be identical for both arms (week 1: 15 minutes/day x 5 days; week 2: 20 minutes/day x 5 days; week 3: 25 minutes/day x 5 days; and week 4: 30 minutes/day x 5 days). Participants will receive text and/or phone call reminders to start sessions, the sessions will be monitored remotely, and the VR devices will log intervention characteristics. This will enable us to identify dose differences among participants who train less than the protocol or choose to split their training each day into multiple brief sessions. Participants readmitted to the hospital will resume once able to complete 4 weeks of training.
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Acute respiratory failure, Intensive Care Acquired Cognitive Impairment, Post Intensive Care Unit Syndrome
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Age: 50 years - 100 years
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Gender: All
Inclusion Criteria:
- Adults aged 50 years or older
- English speaking
- Admitted to the intensive care unit (ICU) with acute respiratory failure/invasive mechanical ventilation
- Screening positive for delirium (using Richmond Agitation Sedation Scale and Confusion Assessment Method for the ICU)
Exclusion Criteria:
- Acute neurologic injury such as stroke, traumatic brain injury, brain mass, intracranial hemorrhage, seizures, or central nervous system infection
- Chronic cognitive or physical function deficit preventing participation in study interventions or assessments (determined by chart diagnoses and direct participant interview)
- Chronic cognitive impairment (including mild cognitive impairment or dementia) identified by chart diagnosis, prescription of anti-dementia medications, or Informant Questionnaire on Cognitive Decline in the Elderly Score (IQCODE) >3.3 obtained from family caregiver
- Severe, uncorrected vision or hearing impairment preventing participation in intervention or outcomes assessments
- Admitted with acute alcohol or drug intoxication or withdrawal
- Severe, uncontrolled psychiatric disorder (bipolar disorder or schizophrenia)
- History of severe vertigo, motion-induced sickness, headaches, light sensitivity, seizures, or prior intolerance of virtual reality (VR)
- Receiving comfort care measures or not expected to survive the hospitalization
- Prisoners or patients unable to provide consent
- Not expected to be discharged home from the hospital, or living more than 50 miles from the nearest recruitment site, or homeless
This study investigates the use of virtual reality (VR) brain games for people who have survived delirium after being in the intensive care unit (ICU) due to acute respiratory failure. Delirium is a condition where a person becomes very confused and disoriented. It often happens to older adults in the ICU and can lead to memory problems or dementia. The purpose of this study is to see if VR brain games can improve memory, attention, and mood for these individuals.
Participants in the study will use VR headsets and hand controls at home to play brain games. They will have training sessions that increase in length each week over four weeks. The sessions will be monitored remotely to ensure everything is going smoothly. This study will help us understand if this type of training is safe and easy to use for people who have been in the ICU.
- Who can participate: Adults aged 50 years or older who speak English and were in the ICU with breathing problems can join. They must have been confused while in the ICU. Those with certain neurological injuries, severe cognitive impairments, or other specific conditions are not eligible.
- Study details: Participants will use VR headsets and controllers at home for brain games. They will get instructions and reminders for their sessions, which are watched over from afar.
Interested in the study?
This study is accepting only persons who receive care at a certain clinic or doctor or who are part of an invited group. Questions about this study can be directed to the study team listed in the description or contact your doctor to see if you are eligible.
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