By Al Dickenson
For the tens of millions of Americans affected by Alzheimer’s disease and related dementias (ADRD) and their caregivers, there is frequently a lot of pain associated with reminiscing about the past. However, by using virtual reality as a non-pharmacological option to stimulate memories and conversations, Yura Lee, Ph.D., an associate professor at the University of Wisconsin-Milwaukee’s Helen Bader School of Social Welfare and her co-investigators hope to further the study of dementia care through the “Going Home” project, funded by the Alzheimer’s Association.
One of Lee’s co-investigators, Zhi Zheng, an assistant professor of Electrical Engineering at the University of Notre Dame, was very excited about this project. “I worked at UWM Biomedical Engineering from 2017 to 2019, where I initiated collaborations with Dr. Yura Lee. We share a strong passion for developing advanced technology for dementia care. It is vital that older adults with Alzheimer’s disease and related dementias (ADRD) are not left behind in benefiting from rapidly evolving interactive technologies such as virtual reality and artificial intelligence. Through these technologies, we aim to deliver more affordable, scalable, and personalized care for older adults while reducing the burden on caregivers.”
To further explain her research and goals, Lee agreed to be interviewed regarding this project, and her co-investigators also provided comments.
This interview has been edited for length and clarity.
What is your background and connection to this work?
My research focuses on individuals living with Alzheimer’s disease and related dementias (ADRD), as well as their caregivers. This passion stems from my own experience — my grandfather, who raised me when I was young and to whom I was incredibly close, was diagnosed with Alzheimer’s disease many years ago. I became his primary caregiver, and that role profoundly shaped my perspective. It was both emotionally challenging but deeply meaningful, and it continues to drive my commitment to gerontological social work.
My research centers on two key areas. First, I study identifying risk and protective factors for ADRD and age-related cognitive decline. My work is largely guided by the cognitive reserve theory, and I’ve examined a range of factors on cognitive health like education, life transitions such as retirement and widowhood, multiple chronic conditions, self-perceptions of aging, and late-life engagement in mental, physical, and social activities. I also look at sociocultural influences such as acculturation and social support to better understand bio-psychosocial mechanisms that help elucidate pathways to health disparities in cognitive health.
Second, I explore the needs and challenges faced by dementia caregivers, with the goal of developing support programs that incorporate assistive technology. For example, I am currently leading the “Going Home” project, which is funded by the Alzheimer’s Association. I am collaborating with faculty from electrical engineering at the University of Notre Dame (Zhi Zheng, PhD) and neurology at the University of Wisconsin–Madison School of Medicine and Public Health (Dr. Elias Granadillo). It’s a reminiscence-based intervention using virtual reality to help Asian immigrants with dementia and their family caregivers bring back meaningful memories of their home.
Please provide a brief overview of what the “Going Home” project is?
Going Home is a technology-based, culturally responsive reminiscence program designed for Asian immigrants with dementia and their family caregivers.
Reminiscence intervention is considered as one of the most popular non-pharmacological treatments for persons with dementia by prompting them to share life stories and recall memories.
The “Going Home” project is a reminiscence-based intervention using virtual reality to help Asian immigrants with dementia and their family caregivers bring back meaningful memories of their home.
Many Asian immigrants maintain strong ties to their homeland and hope to visit, but geographical, financial, and health challenges often make this difficult. Reminiscence intervention can have synergistic effects when combined with technology by simulating real-life 3D environments to alleviate the sense of longing for home more effectively than conventional photo-based interventions.
This “Going Home intervention will engage both the person with dementia and the caregiver in a collaborative process with the study team to create a virtual home in their memory. Participants will brainstorm, share stories, and provide constant feedback as the study team visualizes the virtual home they long for and hope to revisit. For each family, the “Going Home” project will consist of six sessions over six weeks.
This pilot study aims to 1) design and develop the “Going Home” reminiscence program using VR for Asian immigrants with dementia and their family caregivers and 2) test the feasibility, acceptability, and preliminary outcomes of the intervention.
Our research team includes myself from UWM, Dr. Zhi Zheng, an assistant professor of electrical engineering from the University of Notre Dame, and Dr. Elias Granadillo, an assistant professor of neurology from the University of Wisconsin-Madison School of Medicine and Public Health.
What drew you to studying this project?
One of the key motivators was the striking disparity in dementia prevalence among Asian Americans. Older Asian adults represent more than 8% of dementia cases, even though they make up less than 6% of the U.S. population. Despite this, Asian immigrants often have limited access to dementia care interventions. There are several contributing factors — recruitment challenges, social isolation due to migration, cultural and language barriers, and a general lack of awareness or understanding of ADRD within some communities.
Our team recognized the need to address these gaps. Raising public awareness and developing culturally responsive interventions for Asian immigrants with dementia is essential — not only to improve care outcomes, but also to reduce bias against ethnic minority groups and encourage greater participation in future clinical trials. This project is a meaningful step in that direction.
Why is this an important topic to study, and why now in particular?
Approximately 7 million Americans are affected by ADRD. Reminiscence intervention — prompting individuals to share life stories and recall memories — is a widely used non-pharmacological approach that can enhance quality of life, cognition, communication, and mood among people with dementia. Many older immigrants who have left their homeland maintain strong ties and long to revisit their home country someday. However, geographical distance, financial constraints, and health issues often make this difficult.
Combining reminiscence intervention with virtual reality (VR) technology can create a powerful synergy by simulating 3D environments, alleviating the sense of longing for home more effectively than conventional photo-based interventions. Research indicates that VR is a safe and well-received tool, promoting audiovisual engagement and positive experiences for people with dementia.
Research indicates that VR is a safe and well-received tool, promoting audiovisual engagement and positive experiences for people with dementia.
Despite these benefits, there has been a lack of reminiscence interventions specifically targeting Asian immigrants with dementia. To our knowledge, no U.S.-based study has focused on using VR to virtually revisit their former homes. Additionally, existing VR-based reminiscence interventions have typically been pre-designed by researchers — based on prompts from caregivers — without actively involving people with dementia in creating the VR environment.
Our team aims to address this gap by designing and developing a VR-based reminiscence intervention called “Going Home” for Asian immigrants with dementia. The study will pilot test the project’s feasibility, acceptability, and preliminary outcomes.
I know there may be limited understanding of what the research indicates right now, but what do you anticipate the results to be, if you are comfortable sharing.
Our long-term goal is to improve the quality of life for underserved populations affected by Alzheimer’s disease and related dementias.
Our central hypothesis is that the “Going Home” intervention will be both feasible and acceptable for Asian immigrants with dementia and their caregivers. We hopefully anticipate that the intervention will lead to improvements in several key areas: first, mood, cognition, behavioral and psychological symptoms of dementia, and overall quality of life among people with dementia; second, positive caregiving experience, mood, and self-efficacy among caregivers; and third, the quality of the dyadic relationship between the person with dementia and their caregiver.
While recent medication breakthroughs are promising, their limitations and side effects underscore the need for fresh perspectives.
We also believe this project lays the foundation for future randomized controlled trials to evaluate the efficacy of the “Going Home” intervention. By culturally tailoring dementia care, the study aims to enhance the quality of life for Asian immigrants with dementia and their caregivers. The “Going Home” program also holds potential for adaptation across other underserved populations, improving access to dementia care and supporting more inclusive recruitment in future clinical trials.
Can you tell us a bit about the grant application and acceptance process?
This project is supported by the Alzheimer’s Association Research Grant to Promote Diversity (AARG-D). The application process begins with the submission of a Letter of Intent. If the letter is approved in the following review, applicants are invited to submit a full proposal.
Could you also tell us a little about your co-investigators? Perhaps a little information on their backgrounds and research focuses would be beneficial.
Our team has built a strong collaborative foundation over many years, particularly in developing dementia interventions that incorporate assistive technology. I have expertise in ADRD research and have longstanding partnerships with community organizations in Milwaukee. My co-investigator, Dr. Zhi Zheng, contributes deep expertise in virtual reality technology. We’re also fortunate to have Dr. Elias Granadillo, a geriatric neurologist, as our team consultant. He brings extensive clinical experience with ADRD populations and provides essential guidance on participant eligibility, recruitment strategies, safety protocols, and monitoring for potential adverse outcomes.
Lee’s co-investigators are also eager to see where this research leads. Dr. Elias Granadillo, who works with non-pharmacological alternatives to help manage cognitive disorders, notes that “while recent medication breakthroughs are promising, their limitations and side effects underscore the need for fresh perspectives.” He continued: “That’s why I’m excited about cutting-edge approaches like non-invasive brain stimulation, computer-based cognitive training, and virtual reality – innovative tools that offer new hope for improving patient outcomes and enhancing quality of life.”