Improvements of visuospatial function and frontal‐occipital connectivity after cognitive training using virtual reality in old adults with subjective cognitive decline and mild cognitive impairment

Abstract Introduction Cognitive intervention is believed as a potential therapy to prevent incident dementia. Previous studies using virtual reality (VR)‐assisted cognitive training have shown inconsistent results with minimal effect for patients with mild cognitive impairment (MCI). We investigated the hypothesis that fully immersive VR‐assisted cognitive training would be effective in multidomain cognition, psychological symptoms, and brain connectivity in old adults with subjective cognitive decline (SCD) and MCI. Methods Participants were randomly assigned as VR group (n=23; SCD=13 and MCI=10) and control group (n=18; SCD=13 and MCI=5). VR group participants conducted a multi‐domain cognitive training program using fully immersive 3D VR twice a week for a month. Both groups were evaluated of their cognitive function, psychological states, and resting‐state functional magnetic resonance imaging (fMRI) before and after the program. Results After the VR cognitive training, the VR group showed improvements in the Rey‐Osterrieth complex figure test (RCFT) copy (p<0.001), positive and negative affect schedule‐positive affect (p<0.001), and apathy evaluation scale (p=0.006) compared to control group. Seed‐based correlation analyses on fMRI results showed that improvement in RCFT copy was associated with activation in the frontal‐occipital connectivity in the VR group compared to the control group. Conclusion We found that the fully immersive 3D VR program had positive effects on visuospatial function, positive affect, apathy, and the frontal‐occipital connectivity in old adults with SCD and MCI. Future trials using VR cognitive training with larger sample sizes, selected participants, and longer duration may find extended improvements in multidomain cognition, psychological aspects, and evidence in the brain activation.