Effects of Virtual Reality-Based Interventions on Cognitive Function, Emotional State, and Quality of Life in Patients with Mild Cognitive Impairment: A Meta-Analysis

Xiaohan Li ¹ Yuting Zhang ² Lifeng Tang ^1,3 Lin Ye ¹ Min Tang ^1*

• ¹ Ningbo Rehabilitation Hospital, Ningbo, China
• ² Ningbo University, Ningbo, Zhejiang Province, China
• ³ Gannan Medical University, Ganzhou, Jiangxi Province, China

Objectives: This meta-analysis aims to systematically evaluate the effects of virtual reality (VR)-based interventions on cognitive function, emotional state, and quality of life in patients with mild cognitive impairment (MCI).Methods: A comprehensive literature search was conducted using five databases from their inception to June 2024. The inclusion criteria focused on randomized controlled trials (RCTs) that examined VR-based interventions in adults aged 60 or older diagnosed with MCI. The primary outcome was cognitive function, while secondary outcomes included emotional state, quality of life, and dynamic balance. To investigate potential sources of heterogeneity, subgroup analyses and meta-regression were conducted. Publication bias was assessed using funnel plots and Egger’s regression test. A “trim and fill” method was employed to adjust for any detected publication bias. The certainty of the evidence was evaluated using the GRADE framework with the GRADEpro GDT software.Results: A total of 30 RCTs involving 1,365 participants from 9 countries across 4 continents were included. The meta-analysis revealed that VR-based interventions significantly improved global cognition, as assessed by the Montreal Cognitive Assessment (MoCA; SMD = 0.82, 95% CI: 0.27 to 1.38, P = 0.003, GRADE: moderate) and the Mini-Mental State Examination (MMSE; SMD = 0.83, 95% CI: 0.40 to 1.26, P = 0.0001, GRADE: low). Additionally, VR interventions enhanced attention, as measured by the Digit Span Backward (DSB; SMD = 0.61, 95% CI: 0.21 to 1.02, P = 0.003, GRADE: low) and Digit Span Forward (DSF; SMD = 0.89, 95% CI: 0.34 to 1.45, P = 0.002, GRADE: low). Improvements were also observed in quality of life, as indicated by scores on the Instrumental Activities of Daily Living (IADL; SMD = 0.22, 95% CI: 0.00 to 0.45, P = 0.049, GRADE: moderate). Conclusions: The findings indicate that VR interventions can significantly improve global cognition, attention, and quality of life in individuals with MCI. Subgroup analyses further revealed that optimal cognitive outcomes were associated with semi-immersive VR, session durations of ≤ 60 minutes, intervention frequencies exceeding twice per week, studies conducted in Asia and Europe, and participant groups with a male proportion of ≤ 40%.