Effect of Virtual Reality-Based Cognitive-Motor Training for Community-Dwelling Older Adults With Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

BACKGROUND

Virtual reality (VR)-based cognitive-motor training has emerged as a promising nonpharmacological intervention for older adults with mild cognitive impairment (MCI). However, evidence regarding its effectiveness in community-dwelling populations remains inconclusive.

AIM: The aim of this study is to evaluate the effectiveness of VR-based cognitive-motor training on cognitive and functional outcomes in community-dwelling older adults with MCI.

STUDY

DESIGN

A comprehensive literature search was conducted in PubMed, Embase, MEDLINE, CINAHL Complete, PsycINFO, Scopus, and the Cochrane Library from inception to October 15, 2025. The quality of included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Risk of bias was assessed using the revised Cochrane Risk of Bias tool. Meta-analysis was conducted using random-effects models.

RESULTS

A total of 15 studies involving 706 participants were included, with 362 participants receiving VR-based cognitive-motor training and 344 receiving control intervention. Compared with control interventions, VR-based cognitive-motor training was associated with significant improvement in global cognition measured using the Montreal Cognitive Assessment. However, no significant improvement was observed for the Mini-Mental State Examination. Borderline improvement was found for executive function measured by Trail Making Test Part B. No significant effects were observed for instrumental activities of daily living, depressive symptoms, or walking performance. Substantial heterogeneity was observed across studies.

CONCLUSIONS

VR-based cognitive-motor training may improve global cognition in community-dwelling older adults with MCI. However, evidence for functional outcomes remains limited, and findings should be interpreted cautiously because of substantial heterogeneity across studies.

RELEVANCE TO CLINICAL PRACTICE: VR-based cognitive-motor interventions may provide feasible nonpharmacological approaches for gerontological, community, and rehabilitation nursing practice. Nurses may support implementation through patient and caregiver education, adherence monitoring, and continuity of cognitive care in community settings.