Abstract
The purpose of this study was to investigate the effects of virtual reality-based cognitive–motor rehabilitation (VRCMR) on the rehabilitation motivation and cognitive function in older adults. This study enrolled 40 older adults with mild cognitive impairment (MCI), living in the community. The subjects were randomly assigned to a VRCMR group (n = 20) or a conventional cognitive rehabilitation (CCR) group (n = 20). The VRCMR group underwent VRCMR using MOTOcog, a computer recognition program, whereas the CCR group underwent conventional cognitive rehabilitation, which included puzzles, wood blocks, card play, stick construction activity, and maze activity. Both interventions were performed 30 min per day, 5 days/week, for 6 weeks. This study performed a cognitive assessment using the Montreal Cognitive Assessment (MoCA) scale, Trail Making Test A and B (TMT-A/B), and Digit Span Test forward and backward (DST-forward/backward). In addition, a 0-to-10 numeric rating self-report scale was used to assess interest and motivation during the rehabilitation training. After the intervention, the VRCMR group showed a significantly greater improvement in the MoCA (p = 0.045), TMT-A (p = 0.039), TMT-B (p = 0.040), and DST-forward (p = 0.011) scores compared to the CCR group, but not in the DST-backward score (p = 0.424). In addition, subjects in the experimental group had significantly higher interest (p = 0.03) and motivation (p = 0.03) than those in the control group. Cohen’s d effect size was 0.4, 0.3, 0.35, 0.4, and 0.5 for the MoCA, TMT-A, TMT-B, DST-forward, and DST-backward tests, respectively. This study demonstrates that VRCMR enhances motivation for rehabilitation and cognitive function in older adults with MCI better than CCR.
Highlights
Mild cognitive impairment (MCI) has been identified as a preclinical stage of dementia and is an important predictive risk factor for dementia [1]
The conversion rate to dementia in patients with MCI varies depending on diagnostic criteria and evaluation tools, it is estimated at 10–15% per year [2]
There were no significant differences between the groups based on general characteristics, Montreal Cognitive Assessment (MoCA) (p = 0.460), TMT-A (p = 0.83), TMT-B (p = 0.35), DST-forward (p = 0.50), and DST-backward (p = 0.75) scores
Summary
Mild cognitive impairment (MCI) has been identified as a preclinical stage of dementia and is an important predictive risk factor for dementia [1]. The conversion rate to dementia in patients with MCI varies depending on diagnostic criteria and evaluation tools, it is estimated at 10–15% per year [2]. This is significantly higher than the conversion rate of 1–2% in normal adults over 65 years of age [3,4]. Attention and memory are important cognitive functions in elderly adults, which significantly decline with the development of dementia [6]. A decrease in cognitive function is related to decreased self-esteem, depression, and impaired ability to perform daily activities in elderly adults with MCI
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