JMIR Publications

ABSTRACT

Background:

Population aging is a global phenomenon accompanied by age-related declines in attention and emotional well-being. Exposure to natural environments has been shown to support cognitive and psychological restoration; however, many older adults face barriers to accessing authentic natural environments. Virtual natural environments may offer an accessible alternative, yet evidence among community-dwelling older adults remains limited.

Objective:

This study examined the immediate effects of a single-session virtual nature exposure on attention, mood, and physiological indicators of stress among community-dwelling older adults, compared with actual nature and urban environments.

Methods:

A randomized controlled trial with a three-group, pre–post design was conducted among 120 community-dwelling adults aged 65 years and older in northern Taiwan. Participants were randomly assigned to one of three groups: a virtual nature group, an actual nature group, or an urban environment group, and then completed a single 20-minute exposure session. Attention performance, mood, and physiological indicators were assessed before and immediately after the intervention. Intervention effects were analyzed using generalized estimating equations, focusing on group-by-time interaction effects.

Results:

Compared with the urban environment group, the virtual nature group demonstrated a significantly greater improvement in attentional capacity as measured by the Digit Span Test (B = 1.00, 95% CI 0.19–1.80; p=.015) and significant improvements in both positive affect (B = 2.82, 95% CI 0.02–5.62; p=.048) and negative affect (B = −2.22, 95% CI −4.05 to −0.39; p=.017). The actual nature group showed a significant improvement in positive affect compared with the urban group but did not demonstrate significant improvements in attention. No significant group-by-time interaction effects were observed for physiological indicators. No adverse events were reported.

Conclusions:

A single 20-minute virtual nature exposure was associated with immediate improvements in attention and mood among community-dwelling older adults, whereas physiological effects were not detected. These findings suggest that virtual nature may serve as an accessible, short-term restorative strategy, particularly when access to real nature is limited. Larger, multi-session trials with longer follow-up are needed to evaluate the sustained effects of virtual nature interventions for mental well-being in older populations. Clinical Trial: ClinicalTrials.gov: NCT05803460