{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:29:10Z","timestamp":1788881350008,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objectives<\/jats:title>\n Virtual reality (VR) has emerged as a promising non-pharmacological approach for supporting cognitive health in older adults. However, the overall magnitude of its effects and the extent to which outcomes vary by cognitive status, intervention duration, and immersion level remain uncertain.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Randomized controlled trials (RCTs) were searched in Web of Science, PubMed, Scopus, Embase, Cochrane Library, and Wanfang Database from database inception to September 24, 2025, without language restrictions. Eligible studies included older adults receiving VR-based training compared with routine rehabilitation, conventional training, no intervention, or non-VR controls. Outcomes were classified as global cognition, TMT-based executive\/attention-related performance, and functional mobility. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses were conducted using standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses were interpreted as exploratory.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Ten RCTs involving 749 participants were included. VR-based training significantly improved global cognition (SMD\u202f=\u202f0.49, 95% CI: 0.25\u20130.73,\n p<\/jats:italic>\n \u202f&lt;\u202f0.0001), with moderate heterogeneity (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f50%). Functional mobility, analyzed as a secondary outcome, also improved (SMD\u202f=\u202f0.39, 95% CI: 0.05\u20130.73,\n p<\/jats:italic>\n \u202f=\u202f0.02; I\n 2<\/jats:sup>\n \u202f=\u202f56%). Only one trial reported TMT-based executive\/attention-related outcomes using TMT-A and TMT-B. Because these outcomes were derived from the same study population, they were not interpreted as evidence from independent studies; the findings suggested a favorable direction of effect but were considered preliminary. Exploratory subgroup analyses suggested possible variation by cognitive status, intervention duration, and immersion level, but several comparisons were based on small numbers of studies.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n VR-based training may improve global cognition in older adults and may also benefit functional mobility. Evidence for TMT-based executive\/attention-related performance remains preliminary. Current evidence is insufficient to support firm conclusions regarding optimal intervention duration, preferred immersion level, or subgroup superiority. Larger, well-designed RCTs with standardized outcome classification and longer follow-up are needed.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251208123<\/jats:ext-link>\n , Identifier: CRD420251208123.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1823497","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:47:44Z","timestamp":1779252464000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The effects of virtual reality training on cognitive function in older adults: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Yeqin","family":"Lian","sequence":"first","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Sport and Health, Shinhan University","place":["Dongducheon, Gyeonggi, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changzhou","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Physical Education, Shanghai University of Sport","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref1","year":"2018"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"3906","DOI":"10.1111\/jgs.18553","article-title":"In too deep? A systematic literature review of fully-immersive virtual reality and cybersickness among older adults","volume":"71","author":"Drazich","year":"2023","journal-title":"J Am Geriatr Soc"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1496382","DOI":"10.3389\/fneur.2025.1496382","article-title":"Effects of virtual reality-based interventions on cognitive function, emotional state, and quality of life in patients with mild cognitive impairment: a meta-analysis","volume":"16","author":"Li","year":"2025","journal-title":"Front Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1002\/gps.5474","article-title":"Predementia constructs: mild cognitive impairment or mild neurocognitive disorder? A narrative review","volume":"36","author":"Bermejo-Pareja","year":"2021","journal-title":"Int J Geriatr Psychiatry"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1080\/15622975.2019.1696473","article-title":"Management of mild cognitive impairment (MCI): the need for national and international guidelines","volume":"21","author":"Kasper","year":"2020","journal-title":"World J Biol Psychiatry"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"351","DOI":"10.31887\/DCNS.2004.6.4\/jgolomb","article-title":"Mild cognitive impairment: historical development and summary of research","volume":"6","author":"Golomb","year":"2004","journal-title":"Dialogues Clin Neurosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1186\/s12877-025-05967-w","article-title":"The global prevalence of mild cognitive impairment in geriatric population with emphasis on influential factors: a systematic review and meta-analysis","volume":"25","author":"Salari","year":"2025","journal-title":"BMC Geriatr"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1159\/000357374","article-title":"High prevalence of mild cognitive impairment in the elderly: a community-based study in four cities of the Hebei province, China","volume":"42","author":"Xu","year":"2014","journal-title":"Neuroepidemiology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1016\/S2468-2667(20)30185-7","article-title":"Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study","volume":"5","author":"Jia","year":"2020","journal-title":"Lancet Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1212\/WNL.0000000000004826","article-title":"Practice guideline update summary: mild cognitive impairment [RETIRED]: report of the guideline development, dissemination, and implementation Subcommittee of the American Academy of neurology","volume":"90","author":"Petersen","year":"2018","journal-title":"Neurology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s10055-022-00639-1","article-title":"Participatory design and evaluation of virtual reality physical rehabilitation for people living with dementia","volume":"27","author":"Matsangidou","year":"2022","journal-title":"Virtual Reality"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"910","DOI":"10.3390\/brainsci15090910","article-title":"Effects of cognitive training with virtual reality in older adults: a systematic review","volume":"15","author":"Navarro-Ramos","year":"2025","journal-title":"Brain Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1037\/neu0000405","article-title":"Is clinical virtual reality ready for primetime?","volume":"31","author":"Rizzo","year":"2017","journal-title":"Neuropsychology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e59195","DOI":"10.2196\/59195","article-title":"Virtual reality interventions for older adults with mild cognitive impairment: systematic review and Meta-analysis of randomized controlled trials","volume":"27","author":"Yang","year":"2025","journal-title":"J Med Internet Res"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"105941","DOI":"10.1016\/j.jamda.2025.105941","article-title":"Comparative efficacy of various of virtual reality technologies on cognitive function in older adults with mild cognitive impairment: a systematic review and network Meta-analysis","volume":"26","author":"Qin","year":"2025","journal-title":"J Am Med Dir Assoc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/02692155231213476","article-title":"Effects of immersive and non-immersive virtual reality-based rehabilitation training on cognition, motor function, and daily functioning in patients with mild cognitive impairment or dementia: a systematic review and meta-analysis","volume":"38","author":"Ren","year":"2024","journal-title":"Clin Rehabil"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.3389\/fpsyg.2019.02509","article-title":"Immersive versus non-immersive experience: exploring the feasibility of memory assessment through 360 degrees technology","volume":"10","author":"Ventura","year":"2019","journal-title":"Front Psychol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1111\/jocn.17375","article-title":"Virtual reality-based reminiscence therapy for older adults to improve psychological well-being and cognition: a systematic review","volume":"35","author":"Ng","year":"2024","journal-title":"J Clin Nurs"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1080\/13607863.2022.2076202","article-title":"The effect of virtual reality on executive function in older adults with mild cognitive impairment: a systematic review and meta-analysis","volume":"27","author":"Yu","year":"2023","journal-title":"Aging Ment Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1467697","DOI":"10.3389\/fnhum.2024.1467697","article-title":"Effects of fully immersive virtual reality training on cognitive function in patients with mild cognitive impairment: a systematic review and meta-analysis","volume":"18","author":"Yu","year":"2024","journal-title":"Front Hum Neurosci"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1089\/cyber.2019.0271","article-title":"Virtual reality-based cognitive stimulation to improve cognitive functioning in community elderly: a controlled study","volume":"23","author":"Gamito","year":"2020","journal-title":"Cyberpsychol Behav Soc Netw"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.3390\/jcm9051283","article-title":"The effect of a virtual reality-based intervention program on cognition in older adults with mild cognitive impairment: a randomized control trial","volume":"9","author":"Thapa","year":"2020","journal-title":"J Clin Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"101708","DOI":"10.1016\/j.arr.2022.101708","article-title":"Effects of virtual reality combined cognitive and physical interventions on cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis","volume":"81","author":"Yan","year":"2022","journal-title":"Ageing Res Rev"},{"key":"ref24","year":"2024"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/s40279-015-0379-7","article-title":"In search of the ideal resistance training program to improve glycemic control and its indication for patients with type 2 diabetes mellitus: a systematic review and Meta-analysis","volume":"46","author":"Ishiguro","year":"2016","journal-title":"Sports Med"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/0895-4356(92)90054-q","article-title":"Variance imputation for overviews of clinical trials with continuous response","volume":"45","author":"Follmann","year":"1992","journal-title":"J Clin Epidemiol"},{"key":"ref28","volume-title":"Cochrane Handbook for systematic Reviews of Interventions","year":"2024"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1620\/tjem.238.1","article-title":"A new approach to improve cognition, muscle strength, and postural balance in community-dwelling elderly with a 3-D virtual reality kayak program","volume":"238","author":"Park","year":"2016","journal-title":"Tohoku J Exp Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"8005","DOI":"10.3390\/ijerph18158005","article-title":"Effect of virtual reality exercises on the cognitive status and dual motor task performance of the aging population","volume":"18","author":"Nobari","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"282","DOI":"10.3389\/fnagi.2018.00282","article-title":"Effects of combined physical and cognitive virtual reality-based training on cognitive impairment and oxidative stress in MCI patients: a pilot study","volume":"10","author":"Mrakic-Sposta","year":"2018","journal-title":"Front Aging Neurosci"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e28400","DOI":"10.2196\/28400","article-title":"Feasibility and effects of virtual reality motor-cognitive training in community-dwelling older people with cognitive frailty: pilot randomized controlled trial","volume":"9","author":"Kwan","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e57809","DOI":"10.2196\/57809","article-title":"Effects of virtual reality motor-cognitive training for older people with cognitive frailty: multicentered randomized controlled trial","volume":"26","author":"Kwan","year":"2024","journal-title":"J Med Internet Res"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1589\/jpts.29.1137","article-title":"The effect of cognitive-motor dual task training with the biorescue force platform on cognition, balance and dual task performance in institutionalized older adults: a randomized controlled trial","volume":"29","author":"Delbroek","year":"2017","journal-title":"J Phys Ther Sci"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"20552076251328491","DOI":"10.1177\/20552076251328491","article-title":"Effects of immersive leisure-based virtual reality cognitive training on cognitive and physical function in community-based older adults: a randomized controlled trial","volume":"11","author":"Chuang","year":"2025","journal-title":"Digit Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1123\/japa.2018-0020","article-title":"The effects of virtual kayak paddling exercise on postural balance, muscle performance, and cognitive function in older adults with mild cognitive impairment: a randomized controlled trial","volume":"27","author":"Choi","year":"2019","journal-title":"J Aging Phys Act"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1186\/s12984-024-01422-w","article-title":"Effects of a dual intervention (motor and virtual reality-based cognitive) on cognition in patients with mild cognitive impairment: a single-blind, randomized controlled trial","volume":"21","author":"Buele","year":"2024","journal-title":"J Neuroeng Rehabil"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1823497\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T04:47:54Z","timestamp":1779252474000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1823497\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":37,"alternative-id":["10.3389\/fpubh.2026.1823497"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1823497","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]},"article-number":"1823497"}}