A Virtual Reality-Based Horticultural Planting Program for Elderly With Subthreshold Depression

NCT07275034 | Not Yet Recruiting

• 1 other identifier: K2025-06-025
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Subthreshold depression represents a state of psychological sub-health between normal individuals and clinical depression. It constitutes a high-risk stage for developing clinical depression and a critical phase for alleviating depressive symptoms. However, current research predominantly focuses on treating depression in the elderly, with insufficient attention to interventions for high-risk populations or limited to cross-sectional investigations of subthreshold depression risk factors. Therefore, prioritizing subthreshold depression in the elderly and implementing early interventions is essential. A 2024 article in The Lancet suggests that subthreshold depression treatment should prioritize psychotherapy and lifestyle adjustments over medication. Horticultural therapy, an interdisciplinary approach integrating horticulture, medicine, and psychology, demonstrates unique advantages over traditional medical treatments. In practical application, however, limited resources may hinder adequate support for horticultural activities, compromising activity quality, reducing therapeutic efficacy, and restricting the widespread adoption of horticultural therapy. Integrating VR technology with horticultural therapy can provide patients with more comprehensive, personalized, and effective mental health treatment plans, empowering them toward healthier, more positive lives. Therefore, the research team designed a VR horticultural intervention system for elderly individuals with subthreshold depression based on the Social Participation Competence Framework.

Conditions

Subthreshold Depression

Keywords

older adults; Subthreshold Depression; virutal reality; Gardening

Outcome Measures

Primary Outcomes (1)

• Subthreshold Depression

  The Center for Epidemiological Surveys Depression Scale (CES-D) was developed by Rirodiff at the National Institute of Mental Health in the United States. It is designed for screening depressive symptoms in older adults, comprising 20 items. Each question assesses one symptom, covering 20 distinct symptoms in total. The total score ranges from 0 to 60 points. A score ≤15 indicates no depressive symptoms, 16-19 suggests possible depressive symptoms, and ≥20 confirms depressive symptoms. The Cronbach's alpha coefficient for the Chinese population is 0.90. It is one of the most commonly used subthreshold depression epidemiological survey tools, with existing studies defining CES-D ≥16 as subthreshold depression. Translated with DeepL.com (free version)

  The intervention was conducted in November 2025, and the evaluation time was 0,4,9 weeks .

Secondary Outcomes (8)

• General cognitive function

  The intervention was conducted in September 2025, and the evaluation time was 0,4,9 weeks separately.

• Anxiety Condition

  The intervention was conducted in November 2025, and the evaluation time was 0,4,9 weeks separately

• Activities of Daily Living

  The intervention was conducted in September 2025, and the evaluation time was 0,4,9 weeks separately.

• Social Support

  The intervention was conducted in September 2025, and the evaluation time was 0,4,9 weeks separately.

• Sleep Quality

  The intervention was conducted in September 2025, and the evaluation time was 0,4,9 weeks separately.

Study Arms (2)

Virtual Reality Intervention

EXPERIMENTAL

This group utilized a virtual reality intervention system based on horticultural planting, designed and developed by the research team.

Other: Virtual Reality Garden System

Routine Care

EXPERIMENTAL

This arm of seniors maintains their daily routines and participates regularly in the nursing home's daily activities.

Other: Routine Care

Interventions

Virtual Reality Garden System OTHER

The system comprised six tasks. Task One was an individual task involving planting tomatoes by completing eight subtasks (tilling, sowing, fertilizing, watering, secondary fertilization, secondary watering, pest control, harvesting) in a virtual garden. Tasks Two through Five were two-player online cooperative tasks. Task 2 involves corn cultivation, with one participant planting while the other observes; Task 3 requires two participants to simultaneously plant strawberries in parallel within the virtual garden; Task 4 involves collaborative sunflower planting between two participants; Task 5 has experienced elderly participants assisting less experienced individuals in completing planting tasks; Task 6 enables three participants to share the joy of planting together in the virtual garden.

Virtual Reality Intervention

Routine Care OTHER

This arm of seniors maintains their daily routines and participates regularly in the nursing home's daily activities.

Routine Care

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 60 years
• Meets subthreshold depression diagnostic criteria: CES-D score ≥ 16 on the Center for Epidemiological Survey, Depression Scale (CES-D) used in epidemiological surveys (this criterion is widely adopted in comparable studies)
• No communication barriers in vision, hearing, or speech
• Informed consent

You may not qualify if:

• Insulin dependent diabetes
• Thyroid disease
• Recent exposure to a major traumatic stress event, with no risk of suicide
• Currently participating in other similar studies
• Clinically diagnosed with mental disorders such as depression or schizophrenia
• Currently taking antidepressant medication
• Severe cognitive impairment
• Severe physical illness or organic disorder with impaired self-care abilities

Sponsors & Collaborators

• Fujian Medical University: lead

Study Sites (1)

Nursing school of Fujian Medical university

Fujian, Fuzhou, 350001, China

Location

Central Study Contacts

zhengmin wang

CONTACT

+8615983607639; mintianjian00@163.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Study Director

Study Record Dates

• First Submitted: November 27, 2025
• First Posted: December 10, 2025
• Study Start: February 1, 2026
• Primary Completion: March 20, 2026
• Study Completion: April 20, 2026
• Last Updated: December 10, 2025

Record last verified: 2025-10

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL

Locations

CN (1)