PhD Scientific Days 2025

Poster Session II. - L: Mental Health Sciences

Virtual Nature and Guided Paths: Exploring relaxation-induced stress relief and cognitive modulation in hospitalized older adults

Name of the presenter

Lajkó Patrícia

Institute/workplace of the presenter

Semmelweis University, Center for Geriatric Care and Nursing Science

Authors

Lajkó Patrícia^1,2, Márton Lilla^1,2, Fekete Márta^1,3, Virág Andrea¹, Markovics Dorina¹, Gadó Klára^1,3, Gonda Xénia^4,5

1: Semmelweis University, Center for Geriatric Care and Nursing Science, Budapest, Hungary
2: Semmelweis University, School of PhD Studies, Budapest, Hungary
3: Semmelweis University, Faculty of Health Studies - Department of Clinical Sciences, Budapest, Hungary.
4: Semmelweis University, Department of Psychiatry and Psychotherapy, Budapest, Hungary
5: Semmelweis University, Department of Clinical Psychology, Budapest, Hungary

Text of the abstract

Introduction
Hospitalized older adults often experience elevated stress, cognitive underperformance, and emotional dysregulation due to environmental deprivation, perceived helplessness, and reduced autonomy. Traditional cognitive assessments may not reflect the patient's true potential in such a context. Relaxation-based interventions, especially those delivered through immersive environments—may temporarily improve mood and cognitive functioning.
Aims
This study aims to compare the effects of two active relaxation interventions—guided imagery (top-down) and nature-based VR immersion (bottom-up)—in hospitalized older adults with heterogeneous neurocognitive profiles. We explore how different cognitive statuses influence affective, cognitive, and autonomic responses, and whether specific profiles benefit more from one modality than the other.
Methods
This is a prospective, randomized, controlled trial with a parallel-group design. Participants (≥65 years, hospitalized ≥2 weeks) undergo baseline assessment (MoCA, TMT-A/B, HADS, STAI, HRV, ADL, ITQ, presence questionnaire). After a 2-week TAU period, they are randomized into VR or guided imagery groups. Each group receives 4 sessions over 2 weeks. Autonomic changes (HRV), affective state (HADS, STAI), and cognitive performance (TMT, MoCA) are reassessed post-intervention. Additional qualitative data (verbal imagery recall, presence scores) and cluster-based neurocognitive profiles are analyzed to explore differential responses.
Results
Preliminary data suggest that individuals with milder cognitive impairment show stronger parasympathetic activation and affective improvement in the guided imagery group, while those with more pronounced memory and abstraction deficits (e.g., probable AD) respond more positively to VR. The level of immersive tendency (ITQ) and self-reported presence also appear to moderate the effect of the intervention.
Conclusion
Neurocognitive profile may moderate the impact of relaxation interventions in hospitalized older adults. Bottom-up VR experiences may compensate for impaired imagery capacity, whereas guided imagery may be more effective for patients with preserved internal visualization. Personalized application of immersive interventions could enhance well-being and improve ecological validity of bedside cognitive evaluations.
This research received no external funding.