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Accepted for/Published in: JMIR Aging

Date Submitted: Nov 15, 2025
Date Accepted: Jan 16, 2026

The final, peer-reviewed published version of this preprint can be found here:

Effects of a Virtual Reality–Based Natural Environment Intervention on Attention and Mood in Community-Dwelling Older Adults: Randomized Controlled Trial

Chou CC, Lin JN, Yu CP, Chen CW, Yeh AY, Lin YK

Effects of a Virtual Reality–Based Natural Environment Intervention on Attention and Mood in Community-Dwelling Older Adults: Randomized Controlled Trial

JMIR Aging 2026;9:e87861

DOI: 10.2196/87861

PMID: 41740958

PMCID: 12980055

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Effects of a virtual reality–based natural environment intervention on attention and mood in community-dwelling older adults: a randomized controlled study

  • Cheng-Chen Chou; 
  • Jong-Ni Lin; 
  • Chia-Pin Yu; 
  • Chi-Wen Chen; 
  • An-Yun Yeh; 
  • Yen-Kuang Lin

ABSTRACT

Background:

Aging is frequently accompanied by cognitive decline, psychological stress, and emotional challenges, underscoring the need for accessible strategies that support mental restoration. Although exposure to natural environments has demonstrated benefits for attention and emotional well-being, many older adults face barriers to accessing real nature due to mobility, environmental, or health-related limitations. Virtual natural environments may offer a scalable alternative by digitally simulating nature-based experiences.

Objective:

This study examined whether a single session of virtual nature exposure could improve attention and mood in community-dwelling older adults.

Methods:

A randomized controlled trial with a three-group, pre–post design was conducted. A total of 120 community-dwelling adults aged ≥60 years in northern Taiwan were randomly assigned to one of three groups: virtual nature, actual nature, or urban environment. Participants engaged in a 20-minute exposure session based on group assignment. Attention performance, perceived attention restoration, mood, and heart rate variability were assessed before and after the session. Data were analyzed using generalized estimating equations.

Results:

Compared with the urban environment group, the virtual nature group showed significant improvements in attention and in both positive and negative mood scores. No significant differences were observed in physiological outcomes. The actual nature group demonstrated a significant improvement in positive mood compared with the urban group.

Conclusions:

A single session of virtual nature exposure may enhance attention and mood among community-dwelling older adults, suggesting its potential as an accessible restorative strategy. Additional studies using longer intervention periods and follow-up assessments are needed to further evaluate the sustained benefits of virtual nature interventions for mental well-being in older populations. Clinical Trial: ClinicalTrials.gov: NCT05803460


 Citation

Please cite as:

Chou CC, Lin JN, Yu CP, Chen CW, Yeh AY, Lin YK

Effects of a Virtual Reality–Based Natural Environment Intervention on Attention and Mood in Community-Dwelling Older Adults: Randomized Controlled Trial

JMIR Aging 2026;9:e87861

DOI: 10.2196/87861

PMID: 41740958

PMCID: 12980055

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