Yang Qin, Zhang Liuxin, Chang Fangyuan, Yang Hongyi, Chen Bin, Liu Zhao
School of Design, Shanghai Jiao Tong University, Shanghai, China.
J Med Internet Res. 2025 Jan 10;27:e59195. doi: 10.2196/59195.
Alzheimer disease is incurable, but it is possible to intervene and slow down the progression of dementia during periods of mild cognitive impairment (MCI) through virtual reality (VR) technology.
This study aimed to analyze the effects of VR interventions on older adults with MCI. The examined outcomes include cognitive abilities, mood, quality of life, and physical fitness, including general cognitive function, memory performance, attention and information processing speed, executive function, language proficiency, visuospatial abilities, depression, daily mobility of individuals, muscle performance, and gait and balance.
A total of 4 web-based databases (Web of Science, PubMed, Embase, and Ovid) were searched up to December 30, 2023, for randomized controlled trials assessing the self-reported outcomes of VR-based technology on cognition, mood, quality of life, and physical fitness in older adults (aged ≥55 years) with MCI. Two reviewers independently screened the search results and reference lists of the identified papers and related reviews. Data on the intervention components and delivery and behavioral change techniques used were extracted. A meta-analysis, risk-of-bias sensitivity analysis, and subgroup analysis were performed where appropriate to explore potential moderators. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the quality of evidence.
This review analyzed 18 studies involving 722 older adults with MCI. VR was delivered through different immersion levels with VR cognitive training, VR physical training, or VR cognitive-motor dual-task training. VR interventions showed significant improvements in memory (standardized mean difference [SMD] 0.2, 95% CI 0.02-0.38), attention and information processing speed (SMD 0.25, 95% CI 0.06-0.45), and executive function (SMD 0.22, 95% CI 0.02-0.42). VR without therapist involvement improved memory as well as attention and information processing speed. VR cognitive training also resulted in significant improvements in attention and information processing speed in older adults with MCI (SMD 0.31, 95% CI 0.05-0.58). In addition, immersive VR had a significant impact on improving attention and information processing speed (SMD 0.25; 95% CI 0.01-0.50) and executive function (SMD 0.25; 95% CI 0.00-0.50). However, the effects of the intervention were very small in terms of general cognitive function, language proficiency, visuospatial abilities, depression, daily living ability, muscle performance, and gait and balance. Quality of evidence varied, with moderate ratings for certain cognitive functions and low ratings for others, based on the GRADE approach.
VR interventions can improve memory, attention and information processing speed, and executive function in older adults with MCI. The quality of evidence is moderate to low, and further research is needed to confirm these findings and explore additional health-related outcomes.
阿尔茨海默病无法治愈，但在轻度认知障碍（MCI）阶段，通过虚拟现实（VR）技术进行干预并减缓痴呆症进展是有可能的。
本研究旨在分析VR干预对患有MCI的老年人的影响。所考察的结果包括认知能力、情绪、生活质量和身体素质，具体有一般认知功能、记忆表现、注意力和信息处理速度、执行功能、语言能力、视觉空间能力、抑郁、个体日常活动能力、肌肉表现以及步态和平衡。
截至2023年12月30日，共检索了4个基于网络的数据库（科学网、PubMed、Embase和Ovid），以查找评估基于VR技术对55岁及以上患有MCI的老年人的认知、情绪、生活质量和身体素质的自我报告结果的随机对照试验。两名评审员独立筛选检索结果以及已识别论文和相关综述的参考文献列表。提取了关于干预成分、实施方式和所使用的行为改变技术的数据。在适当情况下进行荟萃分析、偏倚风险敏感性分析和亚组分析，以探索潜在的调节因素。采用推荐分级、评估、制定和评价（GRADE）方法评估证据质量。
本综述分析了18项研究，涉及722名患有MCI的老年人。VR通过不同沉浸程度的VR认知训练、VR体能训练或VR认知 - 运动双任务训练来实施。VR干预在记忆（标准化均数差[SMD] 0.2，95%可信区间0.02 - 0.38）、注意力和信息处理速度（SMD 0.25，95%可信区间0.06 - 0.45）以及执行功能（SMD 0.22，95%可信区间0.02 - 0.42）方面显示出显著改善。无治疗师参与的VR改善了记忆以及注意力和信息处理速度。VR认知训练在患有MCI的老年人中也导致注意力和信息处理速度有显著改善（SMD 0.31，95%可信区间0.05 - 0.58）。此外，沉浸式VR对改善注意力和信息处理速度（SMD 0.25；95%可信区间0.01 - 0.50）和执行功能（SMD 0.25；95%可信区间0.00 - 0.50）有显著影响。然而，就一般认知功能、语言能力、视觉空间能力、抑郁、日常生活能力、肌肉表现以及步态和平衡而言，干预效果非常小。证据质量各不相同，根据GRADE方法，某些认知功能的评级为中等，其他功能的评级为低等。
VR干预可改善患有MCI的老年人的记忆、注意力和信息处理速度以及执行功能。证据质量为中等至低等，需要进一步研究来证实这些发现并探索其他与健康相关的结果。
