HEALTH

How Music and Virtual Reality can Transform Dementia Care

Infographic about Dementia. Image credit: Jo Williams for St. Peter’s Hospital, UK

Dementia is a collective term for a range of cognitive disorders, manifesting through memory loss or other cognitive changes, and difficulty performing everyday tasks. Alzheimer's disease is the most common cause, responsible for 60-70% of cases, and its effects are profound; as nerve cells in the brain deteriorate, cognitive function declines, and the individual’s ability to maintain independence and engage with the world becomes increasingly impaired.

With dementia affecting over 55 million people globally, the search for innovative, non-pharmacological treatments has never been more urgent. Traditional medical approaches, whilst making progress in this difficult-to-treat arena, leave room for more creative therapies to help transform dementia care. Among the promising options are music and virtual reality (VR) — two powerful tools that, while distinct, both tap into the brain’s remarkable ability to respond to stimuli and evoke memories.

In this piece we speak with Professor Felicity Baker (co-founder) and Dr Sanka Amadoru (advisory committee co-chair) from MATCH (Music Attuned Technology Care eHealth), and with Dr. Lora Appel, Chief Executive Officer and Founder of caregiVR about how their innovative research projects are reshaping dementia care, and how the fusion of technology and creativity can bring profound emotional relief to those affected.

MATCH is a music therapy training program linked with a mobile app that helps people with dementia and their carers by using music strategically to improve care and enhance wellbeing. The research currently being conducted is investigating evidence-based music therapy combined with AI and wearable sensors to provide real-time support to individuals with dementia. The project is currently at trial stage.

The second approach to dementia treatment that we examine here comes from caregiVR, a business built upon years of collective research into the benefits of VR therapy, in collaboration with physicians, senior’s advocates and entrepreneurs. Through a headset, seniors enjoy immersive, multi-sensory experiences that are safe, evidence-based and personalised.

MATCH

Professor Felicity Baker who leads Creative Arts and Music Therapy Research, specialising in music therapy, neurorehabilitation, dementia and songwriting. Image credit: University of Melbourne.

Dr Sanka Amadoru co-chairs the MATCH advisory committee, is a director of Aria Health and works at Austin Health on dementia trials. Image credit: digitalhealth.gov.au

MATCH is a music therapy informed training program and mobile app designed to guide carers of people living with dementia in the strategic use of music to support care and enhance wellbeing. Image credit: Attuned Music

Professor Felicity Baker and Dr Sanka Amadoru, how does MATCH use music to support people with dementia?

MATCH is a project funded by the Medical Research Future Fund (offered by the Australian Government) and Google’s AI for Social Good grant. It aims to develop and deliver a new consumer-centred music program for people living with dementia in the community, in residential aged care and during the often-stressful transition period from home to an aged care residence. Based at the University of Melbourne, MATCH offers a paradigm shift in the way music and dementia technology is combined: using evidence-based music therapy combined with AI and wearable sensors to help people living with dementia manage symptoms such as agitation and anxiety.

We are developing a device, similar to a smartwatch, that can monitor movement, heart rate and other biomarkers. By identifying changes in agitation levels, we aim to match the right music with the type and severity of symptoms and by doing so, the personalised playlists aim to calm, engage and regulate. This non-pharmacological approach addresses both individual wellbeing and caregiver burden, offering a scalable tool for dementia care across aged care facilities and at home.

What stage of research is MATCH currently at? Are there additional benefits that this technology can address?

The MATCH team is conducting research into ways in which the app is supporting the wellbeing needs not only of those living with dementia, but also those of aged care staff, to document how the app may contribute to greater staff retention. We are planning a cultural adaptation of the app for the Chinese, Indian and Malay elderly populations and their families. These initiatives are enabling us to create a robust product which we hope to make available to the public by the end of 2025. In the meantime you can register to participate and be informed of updates via MATCH.

"Good preventative health through midlife is crucial to decrease the risk of neurocognitive disorders and dementia. Making primary care more accessible and effective in supporting people’s health and lifestyle improvements is one important approach. A newer insight is that hearing loss is one of the biggest modifiable midlife risk factors for dementia. Hearing loss needs better prevention, identification and treatment, supported by public health messaging and healthcare education. As we get older, social isolation, air pollution and treating hearing loss are the three most important factors to decrease dementia risk."

Professor Felicity Baker and Dr Sanka Amadoru

How can music be used to help people experiencing negative emotional changes associated with dementia, and what role does it play in supporting families affected by dementia, especially given the complexities of caregiving?

Music plays a profound role in managing emotional challenges like agitation, irritability and depression in people with dementia. By using preferred music to help people gain access to memory, grounding or presence, MATCH can soothe distress and enhance mood. Importantly, it provides families with a meaningful way to connect, transforming caregiving into moments of joy and shared memories. This strengthens relationships while offering caregivers an intuitive tool to navigate the complexities of care with compassion and ease.

You have mentioned that healthy ageing starts in early and midlife with public health measures. What specific policy changes or public health initiatives do you think would have the greatest impact on improving ageing outcomes, particularly in preventing cognitive decline and dementia?

Good preventative health through midlife is crucial to decrease the risk of neurocognitive disorders and dementia. Making primary care more accessible and effective in supporting people’s health and lifestyle improvements is one important approach. A newer insight is that hearing loss is one of the biggest modifiable midlife risk factors for dementia. Hearing loss needs better prevention, identification and treatment, supported by public health messaging and healthcare education. As we get older, social isolation, air pollution and treating hearing loss are the three most important factors to decrease dementia risk.

How do you see the evolution of care for people with dementia in the next 10 to 20 years on a global scale?

Age is one of the most important risk factors for dementia, but one that can't be modified. Globally, the world's population is ageing, and the healthcare and aged care workforces are likely to face shortfalls in being able to support the growing needs of older people living with dementia. Three things may help with this: firstly, a greater shift to preventative measures to reduce the risk of dementia. Secondly, increased support for people living with dementia to allow them to live well for longer at home, decreasing the need for residential care. Thirdly, there’s a clear opportunity to develop digital solutions for more efficient and effective care.

caregiVR

Dr. Lora Appel is leading healthcare into an exciting new realm. Image credit: Tim Fraser at KITE Studio

caregiVR was the runner-up at the Chrysalis Challenge Pitch Competition in 2024. Dr. Lora Appel and her team celebrating the award. Image credit: Dr. Lora Appel

Personalised, immersive virtual reality therapy via caregiVR unlocks new ways to connect and explore. Image credit: caregiVR

Dr. Appel, your research into using VR to improve the quality of life for people living with dementia is important and inspiring. Could you please share how the team came to explore VR as a therapeutic tool, and then integrating it into dementia care?

The inspiration for using VR as a therapeutic tool in dementia care initially came from a visiting lecturer at our clinical research unit way back in 2014. They posed an intriguing question: could cutting down trees in the virtual world reduce paper consumption in the real world? This led me to think more deeply about the power of visual perception in influencing real-world outcomes.

Delving further into the research, I found that exposure to natural environments has significant mental and physiological benefits. This sparked another question: could simulated natural environments, delivered through VR, provide similar benefits? Could VR be used to improve mood, reduce anxiety, or even shorten hospital stays for patients who are unable to access nature in their daily lives?

The concept of using VR to simulate nature eventually broadened to include social interaction as well, which led me to think not just about hospitalised patients, but also about seniors living in care homes. Many of these individuals are confined to indoor spaces with limited access to outdoor experiences or social activities. As I shared these ideas with colleagues, the response was overwhelmingly positive—it resonated with everyone. We saw real potential to enhance the lives of seniors, particularly those living with dementia. I feel there’s no effective solution for dementia as yet, despite a considerable amount of money being thrown at the problem. In terms of integrating VR into dementia care, the commercialisation process became an important next step.

How can VR be used to support emotional changes—such as agitation, irritability and depression—among people with dementia, and what role does it play in fostering meaningful connections within families affected by dementia, especially given the complexities of caregiving?

VR can offer calming, familiar or nostalgic experiences, which may evoke positive emotions and help regulate mood. By providing these therapeutic experiences, VR allows people with dementia to engage more meaningfully with their surroundings and loved ones. For families, VR can serve as a tool to create shared experiences, fostering connections through guided activities or memories. This can alleviate some of the stress for caregivers by providing moments of interaction that feel more rewarding and less frustrating.

Participants and partner agencies from my research often wanted to access “my product” after the study phase but I had nothing to offer them. Having come from a business background, and having built practical applications earlier in my career, I knew I could create something they would love. caregiVR is the result of my collaboration and research with physicians, seniors advocates and entrepreneurs who also saw the value and uniqueness of this product.

How does caregiVR work?

caregiVR is a personalised, clinically validated VR platform designed specifically for seniors. It addresses major challenges such as social isolation, loneliness and behavioral and psychological symptoms of dementia (BPSD), including aggression and agitation. By offering immersive, multi-sensory VR experiences tailored to individual abilities, preferences and therapeutic goals, caregiVR helps reduce feelings of isolation, improves mood and enhances overall well-being.

For those living in care facilities, caregiVR optimises staff resources by facilitating broader engagement in resident wellness and improves operational efficiency through reductions in patient agitation that otherwise leads to delays in care, staff burnout and costly workplace violence. We have proven that VR is safe for seniors of all physical and cognitive abilities through a decade of our own peer-reviewed research.

caregiVR also empowers mental health benefits that stem from social connection, allowing seniors to connect and talk virtually with loved ones who can share experiences remotely. In our studies, this social aspect of VR therapy stimulated conversations and helped participants to feel more curious and adventurous as well as less lonely.

"Finally, collaboration across sectors—between healthcare providers, technology developers, policymakers and of course users—will be key to ensuring that VR solutions are implementable and sustainable. By pooling resources, sharing knowledge and working toward common goals, we can bridge the gap between innovation and accessibility, ultimately ensuring that more individuals benefit from these transformative therapies."

Dr. Lora Appel

Are there any differences in response based on the severity of dementia? For example, how do individuals in the early stages respond to VR compared to those in later stages?

In the early stages, individuals may be more capable of actively engaging with VR and may respond well to more complex experiences that offer cognitive stimulation or emotional engagement. These individuals may use VR to recall memories or engage in problem-solving activities. However, in the later stages, the response tends to shift; people may benefit from simpler, sensory-driven experiences that focus on providing comfort and reducing agitation. For those with advanced dementia, VR can serve as a soothing tool, offering sensory stimulation through sound and visuals, even when verbal communication is limited.

Are there particular sensory elements in the VR environments (like sound, visuals or haptic feedback) that are truly important for maximising the therapeutic effects for people living with dementia?

This is an area of active research, and there are several sensory elements in VR environments that could play a key role in enhancing therapeutic outcomes for individuals with dementia.

Our team recently conducted a study that explored the impact of integrating olfactory (smell) cues with the visual environment in VR, initially focusing on healthcare providers. This approach is particularly promising, as the sense of smell can be deeply tied to memory and can serve as a powerful trigger for reminiscence, especially for individuals with memory loss.

Sound, and music in particular, are other vital elements. Music is universally enjoyed and has the unique ability to connect individuals with their past and cultural roots, often bringing a sense of comfort and recognition.

Haptic feedback (technology that can create an experience of touch), if thoughtfully designed, could also be transformative. Touch therapy has been shown to be especially beneficial for individuals with more advanced dementia, as many people experience a decline in physical interactions with family members and caregivers, particularly in institutional settings. Physical touch remains a critical factor for well-being, and providing a controlled, therapeutic touch experience through VR may offer a meaningful way to restore some of that essential connection.

How do you see VR becoming more widely available for use in the broader population, and what strategies are required for winning over policy makers, regarding perceived cost barriers to this approach?

To make VR therapy more widely available in healthcare, particularly for senior care and people living with dementia, requires a multifaceted approach.

Firstly, it’s important to communicate and emphasise the growing raft of evidence supporting the effectiveness of VR in improving health outcomes. As more research demonstrates the benefits—such as reducing anxiety, improving mood and even reducing the length of hospital stays—healthcare providers and policymakers will be more inclined to allocate funding for VR solutions. Demonstrating a clear return on investment, particularly in terms of reducing healthcare costs in the long run, can help build a compelling case for integrating VR therapy into broader care models.

Secondly, we need to work on making VR technology more affordable and scalable. This could involve partnering with VR companies to create more cost-effective, user-friendly devices designed specifically for healthcare settings. As the technology matures, the cost of VR hardware is expected to continue to decrease. In addition, developing standardised protocols for using VR in dementia care could help reduce training costs and improve implementation efficiency. This is another avenue I’m working on: creating a basic education/training certificate for healthcare professionals to be comfortable and capable of administering VR therapy in an effective way.

Thirdly, we need to expand access through public and private funding, grants and health insurance cover. Policymakers can advocate for reimbursement models that include VR-based therapies as part of standard care—part of the whole 'social prescribing movement’—for dementia and other age-related conditions. This could help offset the initial costs for healthcare providers and make it easier for seniors in long-term care settings to access VR therapy.

Finally, collaboration across sectors—between healthcare providers, technology developers, policymakers and of course users—will be key to ensuring that VR solutions are implementable and sustainable. By pooling resources, sharing knowledge and working toward common goals, we can bridge the gap between innovation and accessibility, ultimately ensuring that more individuals benefit from these transformative therapies.

Professor Felicity Baker leads Creative Arts and Music Therapy Research, specialising in music therapy, neurorehabilitation, dementia and songwriting. In 2024, she co-founded Attuned Music, a MedTech spin-out from the University of Melbourne, focused on scaling music-based health technologies for dementia. In 2023, she received the Marles Medal for research impact. As Associate Editor of Journal of Music Therapy, she has published nine books and over 200 articles, including Leadership and Management of Clinical Trials in Creative Arts Therapies (2022, Palgrave).

Dr. Sanka Amadoru is a geriatrician specialising in cognitive health, dementia and older persons' mental health. He co-chairs the MATCH advisory committee via eHealth, directs Aria Health in Melbourne, and works at Austin Health on dementia trials. His research focuses on digital health and aged care innovation. He advocates for equitable healthcare access for rural Australians, First Nations communities, and LGBTIQ+ individuals as well as advising the Australian Government on aged care policy.

Dr. Lora Appel is an Associate Professor of Health Informatics at the Faculty of Health at York University, Toronto, Canada. She is Adjunct Researcher at Michael Garron Hospital and an Affiliate Scientist at KITE, Toronto Rehabilitation, University Health Network - the largest medical research organisation in Canada. Lora heads the Prescribing Virtual Reality (VRx) lab which designs and conducts studies that introduce and evaluate XR interventions for patients, caregivers and healthcare providers in different settings, ranging from acute-care hospitals, long-term care homes to community centres and private residences. She received several grants from the Centre for Aging in Brain Health innovation and Canadian Institutes for Health Research to pursue this work in ageing and dementia care. More recently her research has expanded into novel uses of VR for other patient populations and clinical conditions, such as those living with epilepsy, specialised dentistry with stroke patients and low-vision therapy for paediatric oncology patients and seniors with AMD. Dr. Appel has published in premier journals like the American Journal of Medicine, the International Journal of Medical Informatics and Frontiers in Medicine. She has given talks at Harvard medical school and the Royal College of Physicians in London, and her work with VR has resulted in several national media appearances. Lora is passionate about creating technological interventions that are preventative, holistic and tailored to the individual, with a special focus on sensory-health.