Robert Konrad ^1,2 Carina Güttler ^1,3 Natalie Öhl ⁴ Christian Heidl ⁵ Stefanie Scholz ⁶ Christian Bauer ^1,2*

• ¹ University of Applied Sciences Würzburg-Schweinfurt, Wuerzburg, Germany
• ² Institute of Rescue, Emergency and Disaster Management, Technical University of Applied Sciences Würzburg-Schweinfurt, Nürnberg, Germany
• ³ University Hospital Würzburg, Würzburg, Bavaria, Germany
• ⁴ University of Erlangen Nuremberg, Erlangen, Bavaria, Germany
• ⁵ Private University for Health Sciences, Medical Informatics and Technology (UMIT), Hall in Tirol, Austria
• ⁶ Wilhelm Löhe University of Applied Sciences, Fürth, Bavaria, Germany

Introduction: Tovertafel ® is a VR-based serious game for dementia care (SGDC) that aims to stimulate residents affected by dementia in nursing homes, promote social and cognitive skills and reduce apathy. The aim of this study is to investigate the effects of using Tovertafel ® on apathy, social interaction and social activity of people with dementia (PWD) in long-term inpatient care in Germany.In this monocentric intervention study, 25 residents of an inpatient long-term care facility with moderate or severe dementia had two weekly applications of Tovertafel ® over a period of eight weeks. Effects on the residents' social interaction and activity were recorded before (T1), during (T2) and one hour after (T3) each intervention using the Engagement of a Person with Dementia Scale (EPWDS). The degree of apathy was assessed using the Apathy Evaluation Scale (AES). Effects of Tovertafel ® were examined using a simple repeated measures analysis of variance (ANOVA).Results: 13 residents with moderate (52 %) and 12 residents with severe dementia (48 %) were included. Results showed that residents' apathy changed over the course of the trial and was partially reduced. ANOVA revealed significant changes in the positive expression of social participation in the overall group between individual observation times (p<0.001; T1: MW=2.67, SD=1.352; T2: MW=3.66, SD=1.365; T3: MW=3.10, SD=1.300) and a significantly lower negative expression of social participation at T2 (MW=1.09, SD=0.358) than at T1 (MW=1.19, SD=0.579; p=0.028). There was a significantly higher positive expression of behavioral involvement in the overall group at T3 (MW=1.17, SD=0.552) than at T1 (p=0.003) or T2 (p=0.045). Analyses did not find any significant interaction between observation times and degree of dementia.Discussion: Results of the study show that the use of Tovertafel ® over a period of two months had significant effects on apathy, social activity and social interaction in people with moderate or severe dementia. Symptoms of apathy could be reduced and social interaction and activity increased. However, due to limitations of the study design and special circumstances of the COVID-19 pandemic situation, findings might be overestimated and must be interpreted with care. Further research is necessary.