Virtual Reality and Exercise Training Enhance Brain, Cognitive, and Physical Health in Older Adults with Mild Cognitive Impairment

Abstract

We investigated the effectiveness of virtual-reality-based cognitive training (VRCT) and exercise on the brain, cognitive, physical and activity of older adults with mild cognitive impairment (MCI). Methods: This study included 99 participants (70.8 ± 5.4) with MCI in the VRCT, exercise, and control groups. The VRCT consisted of a series of games targeting different brain functions such as executive function, memory, and attention. Twenty-four sessions of VRCT (three days/week) were performed, and each session was 100 min long. Exercise intervention consisted of aerobic and resistance trainings performed in 24 sessions for 60 min (2 times/week for 12 weeks). Global cognitive function was measured using the Mini-Mental State Examination (MMSE) test. Resting-state electroencephalography (EEG) of the neural oscillatory activity in different frequency bands was performed. Physical function was measured using handgrip strength (HGS) and gait speed. Results: After the intervention period, VRCT significantly improved the MMSE scores (p < 0.05), and the exercise group had significantly improved HGS and MMSE scores (p < 0.05) compared to baseline. One-way analysis of variance (ANOVA) of resting-state EEG showed a decreased theta/beta power ratio (TBR) (p < 0.05) in the central region of the brain in the exercise group compared to the control group. Although not statistically significant, the VRCT group also showed a decreased TBR compared to the control group. The analysis of covariance (ANCOVA) test showed a significant decrease in theta band power in the VRCT group compared to the exercise group and a decrease in delta/alpha ratio in the exercise group compared to the VRCT group. Conclusion: Our findings suggest that VRCT and exercise training enhances brain, cognitive, and physical health in older adults with MCI. Further studies with a larger population sample to identify the effect of VRCT in combination with exercise training are required to yield peak benefits for patients with MCI.

Changes in EEG Activity and Cognition Related to Physical Activity in Older Adults: A Systematic Review

“…In this regard, it has been reported that in older adults with mild cognitive impairment, aerobic and resistance training interventions for 24 weeks significantly reduced theta/beta ratio, which reflects improvements in attention-related functions, in the temporal and parietal lobes, and in the delta/alpha ratio, which is associated with cognitive impairment, in the frontal, temporal, and parietal areas [58]. Furthermore, Dimitrova et al [59] emphasized that just 20 min of moderate exercise increases the EEG amplitude from 320 to 700 ms at the Cz site and enhances executive task performance in older adults.…”

Variations in Theta/Beta Ratio and Cognitive Performance in Subpopulations of Subjects with ADHD Symptoms: Towards Neuropsychological Profiling for Patient Subgrouping

“…It is difficult to determine the cause of the difference in brain activity observed in the two ADHD subgroups. An increased theta/beta ratio has been observed in conditions such as cognitive impairment in elder people [ 52 , 53 ], and in Lewy body disease [ 54 ]. Furthermore, a study on P300 and the theta/beta ratio suggests that it could be used as a marker of cognitive processing capacity [ 55 ].…”

Efficacy of virtual reality-based training programs and games on the improvement of cognitive disorders in patients: a systematic review and meta-analysis

“… Park, 2022 [ 39 ] Korea Older adults with MCI Joystick, computer 56 (23/33) CG = 72.04 ± 2.42 EG = 71.93 ± 3.11 VR-based training programs (a VR-based spatial cognitive task crafted to enhance spatial memory (32 sessions)). A VR-based spatial cognitive task crafted to enhance spatial memory (24 sessions) 56 sessions, 45 min a session, 3 days a week for 8 weeks Zheng, 2022 [ 47 ] China Older people with dementia A Kinect sensor and a console 38 (9/29) CG = 84.26 ± 5.48 EG = 81.74 ± 5.79 Game (using the Kinect game Fruit Ninja as an exercise intervention to enhance hand-eye coordination and motor skills) Receiving usual therapy, including One h/day, 5 days/week for 8 weeks Yang, 2022 [ 40 ] Korea Older adults with MCI An Oculus VR headset (Oculus quest headset) and two wireless hand controllers 66 (9/57) CG = 72.7 ± 5.6 EG = 72.6 ± 5.4 Game (Four games encompassing various brain domains, such as attention and working memory) Educational seminars focusing on health-related subjects, including advice on nutrition and exercise for preventing geriatric diseases. A total of 24 sessions (each VR training session lasted for 100 min) for eight weeks.…”