Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Abstract

Background: Mild cognitive impairment (MCI) and dementia result in cognitive decline which can negatively impact everyday functional abilities and quality of life. Virtual reality (VR) interventions could benefit the cognitive abilities of people with MCI and dementia, but evidence is inconclusive. Objective: To investigate the efficacy of VR training on global and domain-specific cognition, activities of daily living and quality of life. To explore the influence of priori moderators (e.g., immersion type, training type) on the effects of VR training. Adverse effects of VR training were also considered. Methods: A systematic literature search was conducted on all major databases for randomized control trial studies. Two separate meta-analyses were performed on studies with people with MCI and dementia. Results: Sixteen studies with people with MCI and four studies with people with dementia were included in each meta-analysis. Results showed moderate to large effects of VR training on global cognition, attention, memory, and construction and motor performance in people with MCI. Immersion and training type were found to be significant moderators of the effect of VR training on global cognition. For people with dementia, results showed moderate to large improvements after VR training on global cognition, memory, and executive function, but a subgroup analysis was not possible. Conclusion: Our findings suggest that VR training is an effective treatment for both people with MCI and dementia. These results contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.

Therapeutic Application of Virtual Reality in the Rehabilitation of Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

“…However, there was no significant improvement in the subcategories such as global cognition (MD = −1.15, 95% CI: −2.83 to 0.53), executive function (MD = −2.56, 95% CI: −8.94 to 3.82), working memory (MD = 0.08, 95% CI: −0.93 to 1.10), memory function (MD = −0.26, 95% CI: −0.73 to 0.22), and attention (MD = −0.61, 95% CI: −1.26 to 0.05) when compared with the control group. Our results differed from those reported in previous meta-analyses [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], which showed significant improvements in global cognition. A previous meta-analysis showed significant improvements in executive function [ 19 , 20 , 21 ] and memory function [ 15 , 19 ].…”

“…With the development of VR technology, many studies have been conducted on MCI, and numerous systematic reviews have been published [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ]. Systematic reviews have suggested that semi-immersive VR was more effective than immersive VR, and it showed significant improvement in global cognitive function and short-term memory.…”

Fully-immersive virtual reality instrumental activities of daily living training for mild dementia: a feasibility study

“…While most previous studies used semi-immersive VR techniques (30), this study showed that fully immersive VR, which utilizes an environment that is closer to reality, also shows similarly high levels of satisfaction.…”

“…It is well known that VR is safe and acceptable in people with mild cognitive impairment and dementia. However, in a review by Papaioannou et al, most studies utilized a non-immersive type (30). There is not much data on the fully-immersive type.…”

Immersive virtual reality for improving cognitive deficits in children with ADHD: a systematic review and meta-analysis

“…Due to the occlusion of the external environment, immersive VR environments can be designed to closely replicate the cognitive demands of the real world, as such the tasks delivered in these environments are more ecologically valid than those delivered via non-immersive VR (Kober et al 2012 ). Therefore, the expectations are that immersive VR would lead to greater therapeutical improvements (Voinescu et al 2021b ; Papaioannou et al 2022 ). For this reason, immersive VR is considered a potential alternative intervention for children with ADHD.…”