Effects of Virtual Reality-Based Activities of Daily Living Rehabilitation Training in Older Adults With Cognitive Frailty and Activities of Daily Living Impairments: A Randomized Controlled Trial.

OBJECTIVES

Cognitive frailty, which is notably prevalent in nursing homes, correlates with a range of adverse health outcomes; however, interventions targeting this population are scarce, particularly those addressing activities of daily living (ADLs). The objective of this study was to evaluate the effects of virtual reality-based ADL rehabilitation training on older adults with cognitive frailty and ADL impairments.

DESIGN

A 2-arm randomized controlled trial.

SETTING AND PARTICIPANTS

Older adults with cognitive frailty and mild ADL impairments in a nursing home.

METHODS

Sixty-six eligible participants were equally randomized into intervention and control groups. The intervention involved 45-minute sessions conducted twice weekly for 12 weeks. Outcomes evaluated included ADL performance, cognition, frailty, depression, and quality of life. Assessments were performed at baseline, 6 weeks (T1), and 12 weeks (T2).

RESULTS

There was no statistically significant difference between the 2 groups at baseline. The mean age of the participants was 80.20 ± 9.14 years, and most were women (54.55%). Compared with the control group, the intervention group showed significant improvements in ADLs (T1: β = 6.33, T2: β = 12.79), basic ADLs (T1: β = 4.09, T2: β = 6.97), instrumental ADLs (T1: β = 2.24, T2: β = 4.12), cognition (T1: β = 3.67, T2: β = 4.42), frailty (T1: β = -0.76, T2: β = -1.27), and mental component summary of quality of life (T1: β = 8.49, T2: β = 16.44) at T1 and T2. By T2, significant improvements were observed in depression (T2: β = -2.06) and physical component summary of quality of life (T2: β = 8.52).

CONCLUSIONS AND IMPLICATIONS

For older adults with cognitive frailty and mild ADL impairments residing in a nursing home, the virtual reality-based ADL rehabilitation program was safe and effective. Following the 12-week intervention, significant improvements were observed in ADL performance, cognition, frailty, depression, and quality of life.