Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Nov 29;19(23):15875.
doi: 10.3390/ijerph192315875.

Ecological Effects of VR-Based Cognitive Training on ADL and IADL in MCI and AD patients: A Systematic Review and Meta-Analysis

Changlae Son  1 , Jin-Hyuck Park  2
Affiliations
Meta-Analysis

Ecological Effects of VR-Based Cognitive Training on ADL and IADL in MCI and AD patients: A Systematic Review and Meta-Analysis

Changlae Son et al. Int J Environ Res Public Health. .

Abstract

Declines in activities of daily living (ADL) and instrumental activities of daily living (IADL) performances due to cognitive impairments hinder mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients' independent and safe daily lives. In order to prevent and treat this, several cognitive interventions have been implemented, but their ecological validity was not ensured due to that their contents are far from real life. Virtual reality (VR) can resemble real life with immersive stimuli, but there have been few studies confirming its ecological effects on ADL and IADL. Therefore, this study conducted a meta-analysis of VR-based cognitive training to investigate its ecological effects on ADL and IADL in MCI and AD patients. From February 2012 to February 2022, a search was conducted for articles published in PubMed, Cochrane, Science Direct, and Web of Science. Quality assessment was assessed by the PEDro scale, and the Cochrane Collaboration tool was used to assess risk of bias. Publication bias was assessed by Egger's regression. Five studies that met inclusion criteria were included in this study. The VR-based cognitive training showed significant effects on ADL and IADL in both MCI and AD patients. When comparing effects in each group, both MCI and AD patients showed significant effects on ADL and IADL, but MCI patients showed lower effects on ADL and IADL than AD patients. The results indicated that VR-based cognitive training would be beneficial to improve ADL and IADL in MCI and AD patients, suggesting that VR-based cognitive training is ecologically valid.

Keywords: Alzheimer’s disease; activities of daily living; cognitive training; cognitive treatment; instrumental activities of daily living; mild cognitive impairment; virtual reality.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Article screening flow chart.
Figure 2
Figure 2
Risk of bias summary. Park., (2021) [14], Oliveira et al., (2021) [19], Liao et al., (2020) [20], Hughes et al., (2014) [21], Man et al., (2012) [22].
Figure 3
Figure 3
Forest plot demonstrating the efficacy of VR-based cognitive training on IADL in MCI and AD patients. Park., (2021) [14], Oliveira et al., (2021) [19], Liao et al., (2020) [20], Hughes et al., (2014) [21], Man et al., (2012) [22].
Figure 4
Figure 4
Sensitivity analysis of the IADL effect of using VR-based cognitive intervention on MCI and AD patients (I²= 0). Park., (2021) [14], Oliveira et al., (2021) [19], Liao et al., (2020) [20], Hughes et al., (2014) [21], Man et al., (2012) [22].
Figure 5
Figure 5
Publication bias of the included articles.
See this image and copyright information in PMC

References

    1. Petersen R.C. Mild cognitive impairment. Continuum. 2016;22:404–418. - PMC - PubMed
    1. Tangalos E.G., Petersen R.C. Mild cognitive impairment in geriatrics. Clin. Geriatr. Med. 2018;34:563–589. doi: 10.1016/j.cger.2018.06.005. - DOI - PubMed
    1. Petersen R.C., Roberts R.O., Knopman D.S., Boeve B.F., Geda Y.E., Ivnik R.J., Smith G.E., Jack C.R. Mild Cognitive Impairment: Ten Years Later. Arch. Neurol. 2009;66:1447–1455. doi: 10.1001/archneurol.2009.266. - DOI - PMC - PubMed
    1. Jefferson A.L., Byerly L.K., Vanderhill S., Lambe S., Wong S., Ozonoff A., Karlawish J.H. Characterization of activities of daily living in individuals with mild cognitive impairment. Am. J. Geriatr. Psychiatry. 2008;16:375–383. doi: 10.1097/JGP.0b013e318162f197. - DOI - PMC - PubMed
    1. Lehrner J., Moser D., Klug S., Gleiß A., Auff E., Dal-bianco P., Pusswald G. Subjective memory complaints, depressive symptoms and cognition in patients attending a memory outpatients clinic. Int. Psychogeriatr. 2014;26:463–473. doi: 10.1017/S1041610213002263. - DOI - PubMed

Publication types