Virtual Reality Cognitive Intervention for Critically Ill Delirium Survivors (VR-Cog)

Purpose

The purpose of this study is to measure the feasibility, acceptability of virtual reality (VR) brain games and estimate their effect on memory, attention, and mood for ICU survivors. The VR program will be used at home through a headset and hand controls.

Conditions

  • Intensive Care Unit Delirium
  • Intensive Care Acquired Cognitive Impairment
  • Post Intensive Care Unit Syndrome
  • Virtual Reality Cognitive Training

Eligibility

Eligible Ages
Over 50 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

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

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
VR-based cognitive training program (VR-Cog) vs. VR-based attention control (VR AC)
Primary Purpose
Treatment
Masking
Double (Investigator, Outcomes Assessor)
Masking Description
The study team staff performing outcomes assessments will be blinded.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
VR-based cognitive training program
  • Device: VR-based cognitive training program
    VR-Cog features HomeTown Bound, a suite of 18 modules organized into four training categories: attention, processing speed, memory, and visuospatial.
    Other names:
    • VR-Cog
Placebo Comparator
VR-based attention control
  • Device: VR-based attention control
    VR-AC consists of a library of 9 nature scenes (content provided by Nature Treks VR).
    Other names:
    • VR-AC

Recruiting Locations

IU Health Methodist Hospital
Indianapolis, Indiana 46202
Contact:
Sikandar Khan, DO, MS
317-274-9424
sikhan@iu.edu

More Details

Status
Recruiting
Sponsor
Indiana University

Study Contact

Sikandar Khan, DO, MS
(317) 274-9427
sikhan@iu.edu

Detailed Description

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. Primary Objective Aim 1: Measure the feasibility, acceptability, and adherence of VR-Cog in older adult ICU delirium survivors at risk for ICU-acquired MCI and ADRD. Secondary Objective Aim 2: Estimate the effect of VR-Cog on cognitive performance among older adult ICU delirium survivors. Tertiary/Exploratory/Correlative Objectives Aim 3: Explore the effects of VR-Cog on mental health (depression and anxiety).