Virtual reality-based cognitive training in mild cognitive impairment: a systematic review

Introduction Mild cognitive impairment (MCI) is recognized as a transitional phase preceding dementia and represents a crucial window for intervention. Conventional cognitive training (CCT) often lacks engagement and sustained participation, limiting its effectiveness in slowing cognitive decline. Virtual reality-based cognitive training (VRCT) has emerged as a promising alternative, offering immersive and interactive environments that may enhance cognitive training outcomes in older adults. Methods This systematic review aims to compare the effectiveness of VRCT with CCT in individuals with MCI. A systematic search was conducted using Web of Science and PubMed, yielding 2,256 initial records. After removal of duplicates and application of eligibility criteria, seven randomized controlled trials (RCTs) were included. Key outcomes assessed included the DSM cognitive domain, general cognition, functional autonomies, and psychoaffective status. Risk of bias was evaluated using the Cochrane RoB 2 tool. Results VRCT demonstrated enhanced effectiveness compared to conventional interventions in improving cognitive domains, and in particular general cognition, complex attention, and perceptual-motor function compared with CCT. Discussion VRCT shows promise as an engaging and potentially effective intervention for individuals with MCI. Despite encouraging results, further high-quality, multicenter trials with standardized outcome measures and long-term follow-up are needed to establish its clinical utility and generalizability.