An elderly person visits a Tokyo temple, remarking on the scenery to a companion. The next day, they plant a tree and show a guest around their garden. On other days, they craft a ceramic bowl, build a dresser or stroll down a city street. They do this all without leaving home. 

Experiences like these will take place in virtual reality (VR) as part of a five-year project led by Saleh Kalantari, the Lois and Mel Tukman Assistant Professor in the Department of Human Centered Design, to improve social engagement and well-being in older adults with cognitive impairment. The project is supported by a $3.8 million grant from the National Institute on Aging, a division of the National Institutes of Health.

Loneliness is widespread among older generations. Last year, more than one-third of US adults between the ages of 50 and 80 said they felt isolated from others often or some of the time. Losing a partner or friends, retiring or struggling with medical problems can make it challenging for people to stay socially engaged as they age. The issue has gotten worse amid an aging population and pandemic-related restrictions.

The effects of feeling alone go deeper than mood. Research shows that lack of social connection can harm the health of older adults, increasing the risk of cognitive decline and even death. “This isn’t just a personal issue,” Kalantari said. “It’s a societal one with significant economic costs, including healthcare expenses and lost productivity.”  

Kalantari directs Cornell’s Design and Augmented Intelligence Lab, where his research group investigates human-technology partnerships in the design process and human spatial experiences in both virtual and real-world contexts. He saw the interplay between loneliness and aging first-hand with his grandfather, who started experiencing cognitive issues in his eighties. “It was heartbreaking to see someone who was once so engaged with his community start to feel isolated and disconnected,” he said. 

That experience partly inspired Kalantari’s new project, Social Engaging Restorative Virtual Environment (SERVE), which will examine whether VR can help older adults with mild cognitive impairment feel less lonely, have a higher quality of life and boost their cognitive abilities. Kalantari and his team will work with more than 120 adults aged 65 and older who have minor problems with memory or thinking, introducing them to virtual environments where they can interact with a trained peer volunteers without cognitive issues. Two colleagues from Weill Cornell Medicine are also principal investigators working with Kalantari: Walter Boot, professor of psychology in medicine, and Sara Czaja, professor of gerontology in medicine.

Research has already shown that VR can improve cognitive abilities and well-being in older adults, but most studies focus on physical and cognitive rehabilitation. Kalantari thinks the technology can also help older adults feel more socially engaged, which in turn could improve well-being and reduce cognitive decline. Compared to video chats or traditional computer programs, VR is more immersive, personalized and interactive. 

“VR can break down many of the physical and social barriers these individuals face,” Kalantari said. “It’s about feeling like you’re truly with someone, which can significantly reduce feelings of isolation.”

Kalantari and his team are currently building a prototype of their VR program and plan to vet it through focus groups later this year. The research builds on several pilot studies the team published in recent years as part of a multi-site project led by Czaja that received a $14.7-million grant from the National Institutes of Health. One study found that interactive gardening and watching nature videos in VR improved mood and cognitive engagement in older adults. Another, which allowed participants to talk to volunteers while exploring VR environments, showed that the technology could promote social connection (some participants wanted to continue conversations after the experiment ended). 

The upcoming study will build on these insights by recruiting a larger sample and targeting older people with mild cognitive impairment. Part of the goal will be to understand how and why certain kinds of VR content work best for older adults with cognitive issues. 

“When we see which design element seems most effective, it will serve as a guideline for future studies,” said Bill Xu, a Ph.D. student in human behavior and design who has worked on all three of Kalantari’s VR studies. “If we can design a system that works for this group, the general older population should also be able to use it.”