Effects of Virtual Reality Interventions on Cognitive Function and Physical Performance in Older Adults: A Systematic Review and Meta-analysis

Abstract

Background: Interventions including virtual reality (VR) are being utilized more frequently to assist older persons with functional training and rehabilitation. However, there is still conflicting information about how they affect depression symptoms, cognitive function, and physical performance, and it is unclear how helpful various VR-related modalities are overall in older populations. Methods: A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, Wanfang, and SinoMed were searched from database inception to November 2025. Randomized controlled trials investigating VR interventions in adults aged ≥ 60 years were included. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool. Meta-analysis was performed using RevMan 5.4. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated using fixed-or random-effects models according to heterogeneity. Results: Ten randomized controlled trials involving 823 older adults were included. VR interventions were associated with significant improvements in mobility performance compared with control conditions (SMD = − 0.92, 95% CI − 1.52 to − 0.33,P= 0.002). No statistically significant overall effect was observed for cognitive function (SMD = 0.27, 95% CI − 0.07 to 0.60,P= 0.12) or depressive symptoms (SMD = − 0.48, 95% CI − 1.12 to 0.16, P = 0.14). Sensitivity analyses suggested a potential beneficial effect of VR on cognitive outcomes after exclusion of highly heterogeneous studies (SMD = 0.37, 95% CI 0.01 to 0.73, P = 0.04). Substantial heterogeneity was identified across studies. Conclusion: VR interventions may improve mobility in older adults and could provide modest benefits for cognitive function; however, current evidence regarding depressive symptoms remains inconclusive. Further large-scale, high-quality randomized controlled trials are required to clarify the long-term efficacy of VR interventions in older populations.