Comparative Efficacy of Various of Virtual Reality Technologies on Cognitive Function in Older Adults With Mild...

To compare and rank the effectiveness of various virtual reality (VR) technologies for cognitive function in older adults with mild cognitive impairment (MCI) and to evaluate the effects of VR on cognition.

Systematic review with a network meta-analysis (NMA) of randomized controlled trials.

Older people with MCI.

A systematic review and NMA were conducted following Preferred Reporting Items of Systematic Reviews and Meta-Analyses-Network-Meta-Analyses guidelines and registered in PROSPERO (CRD42025639654). Nine databases including PubMed, Web of Science, CINAHL, Embase, Scopus, Cochrane Library, China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database, were searched from inception through January 2025 for randomized controlled trials evaluating VR interventions in older adults (≥60 years) with MCI. Two evaluators independently selected and evaluated eligible studies of changes in cognition in older adults with MCI after VR-based intervention.

Twelve randomized controlled trials involving 529 participants were included. Compared with attention-control groups, all types of VR significantly improved global cognition. Semi-immersive VR and nonimmersive VR demonstrated greater efficacy than immersive VR. Surface under the cumulative ranking curve values ranked semi-immersive VR highest (87.8%), followed by nonimmersive VR (84.2%) and immersive VR (43.6%).

Semi-immersive VR was found to be the most effective in improving global cognition in older adults with MCI, followed by nonimmersive and immersive VR. All types of VR interventions significantly improved global cognition compared with attention-control groups. Further large-scale and long-term randomized controlled trials are needed to validate these findings and guide clinical implementation. It provides actionable guidance for clinicians managing older adults with MCI, facilitating optimized implementation of VR-based interventions through modality selection.