JMIR Publications

ABSTRACT

Background:

Alzheimer's disease (AD) is incurable, but it is possible to intervene and slow down the progression of dementia during periods of mild cognitive impairment (MCI) through virtual reality (VR) technology.

Objective:

This study aims to analyze the effects of a VR intervention on the outcomes of older adults with MCI.

Methods:

A total of 4 web-based databases were searched for randomized controlled trials assessing the self-reported outcomes of VR-based technology on cognition, mood, quality of life, and physical fitness in older adults with MCI. Two reviewers independently screened the search results and reference lists of the identified papers and related reviews. Data on the intervention components and delivery and behavioral change techniques used were extracted. A meta-analysis, risk of bias sensitivity analysis, and subgroup analysis were performed where appropriate. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the quality of evidence.

Results:

A total of 18 studies involving 722 older adults with MCI were included in this review. VR was delivered through different immersion levels with VR cognitive training, VR physical training, or VR cognitive-motor dual-task training. Studies reported significant improvements in performance and memory (SMD 0.20; 95% CI 0.02 to 0.38), attention and information processing speed (SMD 0.25; 95% CI 0.06 to 0.45), and executive function (SMD 0.22; 95% CI 0.02 to 0.42) showed significant improvements. VR without therapist involvement showed significant improvements in performance and memory as well as attention and information processing speed; VR cognitive training also resulted in significant improvements in attention and information processing speed in individuals with MCI. Additionally, immersive VR had a significant impact on improving attention, information processing speed, and executive function. The effects of the intervention were very small in terms of general cognitive function, language proficiency, visuospatial abilities, depression, daily living ability, muscle performance, and gait and balance. According to the GRADE approach, the quality of evidence was rated as moderate in the areas of general cognitive function, performance and memory, attention and information processing speed, executive function, and gait and balance, and as low and very low in the areas of verbal ability, visuospatial abilities, depression, ability to perform daily living, and muscle performance.

Conclusions:

VR-based interventions may result in improvement in performance and memory, attention and information processing speed, and executive function in older adults with MCI. This improvement is related to the presence or absence of a therapist during the intervention, the content of the VR intervention, and the VR immersion effect. The quality of evidence is moderate to low, and further research is required to confirm the findings of the review and assess the effects of VR technology on other health-related outcomes.