Effects of Cognitive Training with Virtual Reality in Older Adults: A Systematic Review

Background/Objective: The use of immersive virtual reality (VR) for cognitive training in older adults has shown promising results in recent years. However, the number of well-designed studies remains limited, and variability in methodologies makes it difficult to draw generalizable conclusions. This systematic review aims to examine the effects of VR-based cognitive training in older adults, describe the technological characteristics of these interventions, identify current gaps in the literature, and suggest future research directions. Methods: Following PRISMA guidelines, a search was conducted across major databases (PubMed, PsycINFO, Scopus, ProQuest, ACM, and Web of Science) from 2018 to 2025. The database search identified 156 studies, of which 12 met the inclusion criteria after screening and eligibility assessment. Across these studies, a total of 3202 older adult participants (aged 60 years or older) were included. Interventions varied in duration from 4 to 36 sessions, targeting domains such as memory, executive function, attention, and global cognition. Most interventions were based on cognitive training, with a few employing cognitive stimulation or cognitive rehabilitation approaches. Quality was assessed using the Effective Public Health Practice Project tool. Results: Most studies reported positive effects of VR interventions on cognitive domains such as attention, executive functions, and global cognition. Fewer studies showed improvements in memory. The majority used head-mounted displays connected to computers and custom-built software, often without public access. Sample sizes were generally small, and blinding procedures were often unclear. The average methodological quality was moderate. Conclusions: Immersive VR has potential as an effective tool for cognitive training in older adults. Future research should include larger randomized controlled trials, long-term follow-up, standardized intervention protocols, and the development of accessible software to enable replication and broader application in clinical and community settings.