Effects of a Virtual Reality-Based Natural Environment Intervention on Attention and Mood in Community-Dwelling Older...

Aging is a phenomenon accompanied by declines in attention and emotional well-being. Exposure to natural environments has been shown to support cognitive and psychological restoration; however, many older adults face barriers to accessing authentic natural environments. Virtual natural environments may offer an accessible alternative, but evidence from community-dwelling older adults remains limited.

This study examined the immediate effects of a single-session virtual or actual-nature exposure on attention, mood, and physiological indicators of stress among community-dwelling older adults compared with actual-nature and urban environments.

A randomized controlled trial with a 3-group, pre-post design was conducted among 120 community-dwelling adults aged 65 years and older in northern Taiwan. Participants were randomly assigned to 1 of 3 groups: a virtual-nature group, an actual-nature group, or an actual-urban environment group. Then, they completed a single 20-minute exposure session. Attentional performance, mood, and physiological indicators were assessed before and immediately after the intervention. Intervention effects were analyzed using generalized estimating equations, focusing on group-by-time interaction effects.

Compared with the urban environment group, the virtual-nature group demonstrated a significantly greater improvement in attentional capacity, as measured by the digit span test (B=1.00, 95% CI 0.19-1.80; P=.02), and significant improvements in both positive affect (B=2.82, 95% CI 0.02-5.62; P=.048) and negative affect (B=-2.22, 95% CI -4.05 to -0.39; P=.02). The actual-nature group showed a significant improvement in positive affect compared with the urban group (B=3.92, 95% CI 1.65-6.19; P=.001) but did not demonstrate a significant improvement in attention. No significant group-by-time interaction effects were observed for physiological indicators. No adverse events were reported.

A single 20-minute virtual-nature exposure was associated with immediate improvements in attention and mood among community-dwelling older adults, whereas physiological effects were not detected. These findings suggest that virtual nature may serve as an accessible, short-term restorative strategy, particularly when access to real nature is limited. Larger, multisession trials with longer follow-ups are needed to evaluate the sustained effects of virtual-nature interventions for mental well-being in older populations.

ClinicalTrials.gov NCT05803460; https://clinicaltrials.gov/study/NCT05803460.