The effect of virtual reality on executive function in older adults with mild cognitive impairment: A systematic review and meta‐analysis

Abstract

AbstractBackgroundVirtual reality (VR) ‐ a computer simulation of a real or imagined three‐dimensional (3‐D) environment, which allows users to have the same experiences they would get in a similar real situation, has stimulated the interest of researchers and clinicians since its first use in 1994. Compared to traditional pen‐and‐paper training, it is symbolized as a systematic and controllable intervention that makes use of data visualization and provides immediate feedback based on the participants’ performance. VR is usually categorized into three types according to the form of connection with the physical world, and includes non‐immersive, semi‐immersive, and full‐immersive VR.MethodThis review aimed to summarize the currently available premium evidence to determine the effect of virtual reality (VR) on executive function (EF) in older adults with mild cognitive impairment (MCI), and to detect what level of immersive VR would be the most beneficial. Five electronic databases, namely, PubMed, Embase, PsycINFO, CINAHL and Cochrane Library were searched. Our research team screened the studies and extracted data according to our inclusion criteria. The methodological quality of each study was rated using the PEDro scale. When three or more studies reported the same outcome, a meta‐analysis was conducted using Review manager 5.4.1ResultFinally, 14 randomized controlled trials with a total of 518 participants were included. VR training had an overall positive effect on cognitive flexibility, global cognitive function, attention, and short‐term memory compared to the control groups. Additionally, semi‐immersive VR was more effective in improving cognitive flexibility compared to the other two types of VR. The application of non‐immersive level of VR had a significant effect on global cognitive function, attention, short‐term memory, and cognitive flexibility.ConclusionVR may be effective in improving EF in older adults with MCI. However, the level of immersive VR that would be the most beneficial on EF still needs to be investigated with a greater number of well‐designed studies.