The effectiveness of virtual reality for people with mild cognitive impairment or dementia: a meta-analysis

Abstract

Background Virtual Reality (VR) is increasingly used in health-related fields and interventions using VR have the potential to be powerful tools in patient management. The aim of this study was to synthesize the effects of VR interventions for people with mild cognitive impairment (MCI) or dementia. Methods Electronic databases were searched to identify studies that used an experimental design to investigate VR intervention outcomes for patients with MCI or dementia. Studies were excluded if the intervention did not focus on VR, if relevant quantitative outcomes were not reported, or if the intended study purpose was assessment or diagnosis. Data were extracted and analyzed from studies that met criteria. To synthesize the intervention effect sizes (ES), we used random effects models to accommodate heterogeneity in the main effect and sub-group analyses. To identify the potential reason for heterogeneity and compare ES according to the moderator variables, subgroup analyses were conducted based on study characteristics and intervention outcomes. Results Data from eleven studies that met eligibility criteria were analyzed. VR intervention delivered to participants with MCI or dementia produced small to medium effects (ES = 0.29, CI = 0.16, 0.42). The ES for studies using semi-immersive technology (ES = 0.37, CI = 0.25, 0.49) was greater than the studies using full-immersive VR (ES = 0.03, CI = -0.14, 0.21). The results showed small-to-medium effects for VR interventions affecting key outcome variables such as cognition (ES = 0.42, CI = 0.24, 0.60) and physical fitness (ES = 0.41, CI = 0.16, 0.65). Conclusion VR interventions, particularly of the semi-immersive type, are useful for people with MCI or dementia. These results should contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.

Older Adults With Cognitive and/or Physical Impairments Can Benefit From Immersive Virtual Reality Experiences: A Feasibility Study

“…A number of studies have been published on the use of immersive VR by healthy older adults (31,32), but very few have empirically examined the feasibility of introducing immersive VR in rehab or long-term care settings (33,34). Even in studies that do evaluate VR as an intervention for older adults with cognitive and physical impairments (35), these studies most frequently describe VR interventions that involve viewing 3D environments on a computer screen and 3D wall-based projected images, but not HMDs. More recently, anecdotal evidence suggests that VR HMDs may also be an effective way to alleviate stress, depression, and anxiety in seniors with age-related conditions (36-39); however, to date there have been no empirical studies that have formalized and quantified the feasibility and effectiveness of immersive VR (viewed through a HMD) in an older adult population with cognitive and/ or physical impairments.…”

Cognitive training in fully immersive virtual reality improves visuospatial function and fronto-occipital functional connectivity in a pre-dementia state: A randomized controlled trial

“…VR can offer interventions in exible and real-world-like environments, facilitating visuospatial function through learning and transference outcomes [14], and highlighting a role for cognitive training in a virtual environment in basic research and clinical practice. Still, there is lack of knowledge and a dearth of experiments on cognitive training using VR, especially the fully immersive type [15,16], so further studies are needed to ascertain its potential therapeutic e cacy.…”

“…Sample calculation was based on a recent meta-analysis on the effectiveness of VR for people with MCI or dementia that produced small-to-medium effect sizes using random-effects model (effect size = 0.29) from a total of 11 studies [15]. Assuming an attrition rate of 20%, a total sample size of 32 patients (16 per treatment arm) would provide 0.8 power and at two-sided alpha error of 0.05.…”

“…First, the small sample size and short training period were the main limitations. Although sample sizes in studies investigating the effects of cognitive training are increasing [80], most VR trials still rely on small sample sizes and are conducted over a short duration of time, especially those using fully virtual environments [15]. Short clinical trial periods in previous studies investigating the effect of computerized cognitive training programs have also been a limiting factor in the eld as a whole [80].…”

“…Third, the lack of an active control group in the present study is another limitation. Some previous trials have included active control groups receiving psycho-education, cognitive therapy, face-to-face music therapy, or pen-and-paper cognitive training for comparisons with a VR training group [15,57]. In the future, various active control groups should be considered to con rm the effectiveness of VR cognitive training.…”