Acceptability and effects on mental health of a music-based virtual reality intervention in geriatric outpatients: Results from a pilot randomized controlled trial

Kévin Galéry^1,2*Katia Djerroud^2,3Julia Chabot⁴Harmehr Sekhon^4,5Thomas TANNOU^2,6,7Auriane Gros^1,10,8,9Olivier Beauchet^11,2,6

• ¹Université Côte d'Azur, Nice, Provence-Alpes-Côte d'Azur, France
• ²Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Quebec, Canada
• ³Montreal University, Montreal, Quebec, Canada
• ⁴St. Mary's hospital and research center, Montreal, Canada
• ⁵The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
• ⁶Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
• ⁷Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - LINC UMR 1322 INSERM, Besançon, France
• ⁸EA7276 Cognition Behavior Technology (CoBTeK), Nice, Provence-Alpes-Côte d'Azur, France
• ⁹Centre Hospitalier Universitaire de Nice, Nice, Provence-Alpes-Côte d'Azur, France
• ¹⁰UFR Médecine de Nice, Département d'orthophonie, Nice, France
• ¹¹Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Canada

Background. Although the benefits of music on mental health are well established, few studies have investigated the impact of delivering it through virtual reality (VR) technologies. VR offers immersive experiences that can enhance mental health benefits in geriatric patients. However, accessibility to VR music-based interventions for geriatric outpatients remains uncertain. This study aimed to evaluate the acceptability and effects of a music-based VR intervention on emotion, well-being and mood in geriatric outpatients living in Montreal (Quebec, Canada). Methods. A single-center randomized controlled trial (RCT) with two parallel arms (i.e., control versus intervention) was conducted at the Montreal Geriatric University Institute (Quebec, Canada). A total of 41 outpatients from the geriatric and memory clinics were recruited and randomly assigned in the control group (n=20; music listening via headphones) and in the intervention group (n=21; VR-based music experience). The primary outcome was the acceptability of the intervention assessed using three complementary criteria: adoption defined as a retention rate ≥80%, satisfaction defined as willingness to reuse the intervention and perceived mental health benefits, and tolerance using the Simulator Sickness Questionnaire [SSQ] score (high tolerance defined by a score ≤9). Secondary outcomes were the effect on emotional state assessed with the Positive and Negative Affect Schedule (PANAS), on well-being assessed with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS) and on mood states assessed with the Visual Analog Mood Scale (VAMS). Results. High retention (95.2%), satisfaction (85.0%) and tolerance (95%) rates were observed in the intervention group. The PANAS positive score significantly improved in the VR group (β = 15.9, 95% CI [6.8, 25.1], p = 0.001). No significant intergroup differences were observed for well-being and mood. Interpretation. This study demonstrates that a music-based VR intervention was highly acceptable and led to a significant improvement in positive emotional state among older adults in geriatric outpatients. Trial registration: NCT06296199; Title: Music, virtual reality and mental health of inpatients in the intensive functional rehabilitation unit and patients in the Montreal Geriatric University Institute geriatric outpatient clinic: Pilot clinical trial; First posted date: March 6, 2024; prospectively registered; https://clinicaltrials.gov/study/NCT06296199