JMIR Publications

ABSTRACT

Background:

Uptake of mild cognitive impairment (MCI) and dementia screening among community-dwelling older adults remains low in global, shaped by limited dementia literacy, fear, stigma, and difficulties navigating services. Virtual reality (VR)-assisted education may enhance engagement, but mechanisms and contextual conditions influencing screening intentions require further understanding.

Objective:

To explore older adults’ understandings and attitudes regarding MCI and screening after exposure to a community-based VR-assisted cognitive health education intervention, and to examine how the intervention influenced information, motivation, and behavioral skills related to screening using the Information-Motivation-Behavioral Skills (IMB) model.

Methods:

The participants were recruited from nine intervention communities on August 23, 2025 through purposive sampling and snowball sampling. The semi-structured interview was conducted, and the qualitative data were analyzed using the thematic analysis method, with the themes mapped to the IMB domain.

Results:

Based on the interview analysis of 22 MCI elderly, three themes and seventeen sub-themes were obtained. In the information domain, participants reported misunderstanding and lack of knowledge about MCI, fear and stigma associated with screening, the relationship between MCI and dementia, knowledge acquisition and clarification, inappropriate timing of education, information overload, and fascination with details. In the motivation domain, participants reported women's interest in participating in the intervention，reduce stigma and change cognitive incentives for screening，the negation of self-management value，vulnerable health awareness，and pessimistic outlook on treatment. In the behavioral skills domain, there are three sub-topics: knowledge to action, community-based referral, and unwilling to change old habits.

Conclusions:

VR-assisted cognitive health education may improve dementia literacy and reduce stigma-related avoidance, but translation into screening behavior depends on practical navigation support. Community nurses and primary care teams are pivotal in integrating VR sessions with clear referral pathways and follow-up to convert readiness into screening uptake. Clinical Trial: This study was approved by the Ethics Committee of the First Affiliated Hospi tal of Nanjing Medical University (No. 2025-SR-015), and registered at Chinese Clinical Trials.gov (ChiCTR2500104626).