In mild cognitive impairment (MCI), individuals show measurable limitations in memory or other cognitive abilities, but are still largely independent in daily life. Since medications have so far been only moderately effective, non-pharmacological approaches are increasingly becoming the focus of research. Virtual reality (VR) is one of them. A research team from Hunan Normal University in China analyzed 11 randomized controlled trials with a total of 500 participants to investigate the benefits of VR applications for cognitive rehabilitation in people with MCI.
Two approaches, one goal
In their analysis, the researchers distinguished between two forms of VR interventions: structured cognitive training in virtual environments on the one hand, and VR-based games on the other. In cognitive training, affected individuals complete targeted exercises, such as virtual shopping or spatial tasks. VR games, on the other hand, rely on stories, puzzles, and game mechanics where cognitive demands are embedded in the gameplay. Both approaches showed statistically significant improvements in cognitive performance in the evaluation. VR games showed a trend towards a stronger effect than structured training.
The more lifelike, the more effective
A particularly insightful finding concerns the extent to which the virtual environment creates a genuine sense of immersion through optical, acoustic, and tactile stimuli. Researchers distinguished three levels: from simple screen applications and VR headsets to realistic systems that capture head and hand movements, thus enabling a natural experience in the virtual world. The result is clear: the deeper the level of immersion in the game world, the greater the cognitive improvement.
„The use of virtual reality-based exercises and games can not only be fun but also help improve cognitive performance in MCI.“
Lisa Laininger, digiDEM Bavaria-Sciencerhin
Why games may have a better impact
The authors explain the slight advantage of game-based VR by the higher motivation that games generate in participants. Narrative elements, rewards, and an adapted difficulty level can promote regular use, which is crucial for long-term therapeutic success. Structured training, on the other hand, targets individual cognitive areas more specifically but can be perceived as less motivating.
The authors expressly point out limitations: The included studies only covered short periods of four to twelve weeks, making it impossible to draw conclusions about long-term effects. Furthermore, eight out of eleven studies originated from South Korea, which limits generalizability to other populations. Further studies with larger participant numbers and longer observation periods are described as necessary.
Tip for practice: VR applications can be meaningfully integrated into a therapeutic concept for people with MCI, especially when the introduction is supervised and tailored to individual abilities. The earlier, the better. If you are wondering whether a close person is experiencing cognitive changes, digiDEM Bayern offers with the digiDEM IQCODE a free, scientifically validated online questionnaire that allows patients and their relatives to assess the memory performance of a loved one – as a first important step towards further diagnostics.
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