Supporting Social Engagement in Long-Term Care Through Paired Socially Assistive Robot-Virtual Reality Activities for Older Adults with Cognitive Impairment and Apathy.
7 affiliations
- 1Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA.
- 2Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN, USA.
- 3Department of Computer Science, Vanderbilt University, Nashville, TN, USA.
- 4College of Nursing, University of Utah, Salt Lake City, UT, USA.
- 5Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- 6Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
- 7College of Nursing, The Ohio State University, Columbus, OH, USA.
Abstract
Introduction
Older adults living in long-term care settings, particularly those with cognitive impairment and apathy, frequently experience reduced social engagement. Socially assistive robots and virtual reality systems may help support engagement, but little is known about whether they can sustain engagement during real-world deployment while also facilitating interaction between older adults. This study examined whether socially structured socially assistive robot-virtual reality (SAR-VR) systems could sustain engagement and support human-human interaction during repeated use in long-term care settings.Methods
This analysis focused on the SAR-VR intervention arm of a larger eight-week study and included 60 older adults with cognitive impairment from 23 long-term care sites. Participants were exposed to two SAR-VR systems featuring different robot embodiments (dog-like and humanoid), roles, and activities. Across 756 repeated intervention sessions, engagement was observationally assessed using observed ratings of attention, activity attitude, robot attitude, and conversational targeting.Results
Sustained attention and activity attitudes remained consistently positive across both SAR-VR systems over repeated exposure. Peer-to-peer and research-staff directed speech occurred across both systems. While robot-directed speech was more common in the dog-like condition, partner-directed communication remained stable, indicating that increased human-robot interaction did not occur at the expense of human-human interaction. Baseline cognitive functioning was associated with attentional engagement but not with attitudinal evaluations. Baseline technology acceptance did not strongly predict post-interaction impressions. Participants who anthropomorphized the robots at baseline demonstrated more positive engagement during sessions.Discussion
These findings suggest that socially structured SAR-VR systems can sustain meaningful engagement while preserving peer interaction in naturalistic dementia care. The results also support the feasibility of designing SAR-VR activities around shared goals and coordinated actions to promote reciprocal human engagement, while recognizing that the study design does not allow definitive conclusions about clinical efficacy or the effects of specific robot features.
Related
- Structured exercise, cognitive–social engagement, and cognitive impairment‐free life expectancy across four longitudinal aging cohorts
- Development of the Japanese Version of the Alzheimer's Disease Cooperative Study—Activities of Daily Living in Mild Cognitive Impairment Scale
- Supporting engagement, behavior change, and equitable self-management in menstrual and menopausal health: A multi-agent digital-health framework
- Preserving Clinical Reasoning in ChatGPT-Integrated Medical Education: From AI Use to Cognitive Engagement.
- Prolonging breath-hold duration in radiotherapy using cognitive engagement
BibTeX
@article{migovich2026supporting,
title = {{Supporting Social Engagement in Long-Term Care Through Paired Socially Assistive Robot-Virtual Reality Activities for Older Adults with Cognitive Impairment and Apathy.}},
author = {Miroslava Migovich and Ritam Ghosh and Nibraas Khan and Cathy A Maxwell and Paul A Newhouse and Douglas W Scharre and Alai Tan and Judith A Tate and Lorraine C Mion and Nilanjan Sarkar},
journal = {Clinical interventions in aging},
year = {2026},
month = oct,
doi = {10.2147/cia.s618715},
url = {https://europepmc.org/article/MED/42893253},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Supporting Social Engagement in Long-Term Care Through Paired Socially Assistive Robot-Virtual Reality Activities for Older Adults with Cognitive Impairment and Apathy.
AU - Miroslava Migovich
AU - Ritam Ghosh
AU - Nibraas Khan
AU - Cathy A Maxwell
AU - Paul A Newhouse
AU - Douglas W Scharre
AU - Alai Tan
AU - Judith A Tate
AU - Lorraine C Mion
AU - Nilanjan Sarkar
PY - 2026
DA - 2026/10/13
JO - Clinical interventions in aging
DO - 10.2147/cia.s618715
UR - https://europepmc.org/article/MED/42893253
AB - Introduction Older adults living in long-term care settings, particularly those with cognitive impairment and apathy, frequently experience reduced social engagement. Socially assistive robots and virtual reality systems may help support engagement, but little is known about whether they can sustain engagement during real-world deployment while also facilitating interaction between older adults. This study examined whether socially structured socially assistive robot-virtual reality (SAR-VR) systems could sustain engagement and support human-human interaction during repeated use in long-term care settings.Methods This analysis focused on the SAR-VR intervention arm of a larger eight-week study and included 60 older adults with cognitive impairment from 23 long-term care sites. Participants were exposed to two SAR-VR systems featuring different robot embodiments (dog-like and humanoid), roles, and activities. Across 756 repeated intervention sessions, engagement was observationally assessed using observed ratings of attention, activity attitude, robot attitude, and conversational targeting.Results Sustained attention and activity attitudes remained consistently positive across both SAR-VR systems over repeated exposure. Peer-to-peer and research-staff directed speech occurred across both systems. While robot-directed speech was more common in the dog-like condition, partner-directed communication remained stable, indicating that increased human-robot interaction did not occur at the expense of human-human interaction. Baseline cognitive functioning was associated with attentional engagement but not with attitudinal evaluations. Baseline technology acceptance did not strongly predict post-interaction impressions. Participants who anthropomorphized the robots at baseline demonstrated more positive engagement during sessions.Discussion These findings suggest that socially structured SAR-VR systems can sustain meaningful engagement while preserving peer interaction in naturalistic dementia care. The results also support the feasibility of designing SAR-VR activities around shared goals and coordinated actions to promote reciprocal human engagement, while recognizing that the study design does not allow definitive conclusions about clinical efficacy or the effects of specific robot features.
SN - 1176-9092
SN - 1178-1998
ER -