Development and Validation of Virtual Reality Cognitive Training for Older Adults with Mild Cognitive Impairment: Protocol for a Mixed-Methods Program Evaluation Study

Abstract

I-Chen Chen,1 Ching-Yi Wu,2– 4 Yi-Ling Hu,2,* Yen-Ming Huang5– 7,* 1Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan; 2Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan; 3Healthy Aging Research Center, Chang Gung University, Taoyuan City, Taiwan; 4Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan; 5Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, Taiwan; 6School of Pharmacy, College of Medicine, National Taiwan University, Taipei City, Taiwan; 7Department of Pharmacy, National Taiwan University Hospital, Taipei City, Taiwan*These authors contributed equally to this workCorrespondence: Yen-Ming Huang, Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, No. 33, Linsen South Road, Zhongzheng District, Taipei City, 100025, Taiwan, Tel/Fax [phone], Email [email protected] Yi-Ling Hu, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, 259, Wunhua 1st Road, Gueishan Township, Taoyuan City, Taiwan, Tel [phone] Ext.:3057, Email [email protected]: As research on cognitive training methods for older adults with mild cognitive impairment (MCI) progresses, fully immersive virtual reality cognitive training (fi-VRCT) has shown promise in enhancing cognitive function. However, its effectiveness in improving instrumental activities of daily living (IADL) and fostering independence is still unclear. This study aims to address these uncertainties by developing and validating a fi-VRCT program focused on IADL, with the goal of enhancing both cognitive function and IADL performance in older adults with MCI.Methods and Analysis: This mixed methods program evaluation study consists of three phases: feasibility, intervention, and extension. In the feasibility phase, we will implement fi-VRCT in real-world community settings and invite 20 older adults with MCI to participate in a single training session. Participants will provide feedback through questionnaires and individual interviews. The intervention phase will involve a double-blind, cluster-randomized controlled trial with 52 older adults with MCI, who will be randomly assigned to either the fi-VRCT or control groups. Both groups will complete 16 sessions over eight weeks, with cognitive and functional performance assessed at various intervals. During the extension phase, feedback will be gathered from 26 participants who underwent fi-VRCT through focus group interviews and ongoing questionnaires. Quantitative and qualitative findings will be synthesized to refine the fi-VRCT program and elucidate training outcomes. Ultimately, fi-VRCT has the potential to enhance cognitive and functional abilities in older adults with MCI in community settings.Ethics and Dissemination: Ethical approval has been obtained from the Research Ethics Committee at National Taiwan Normal University (202312EM009). The research findings will be disseminated through reputable, peer-reviewed journals and professional international conferences to engage and inform academic and clinical audiences.Trial Registration: NCT06392412.Keywords: cognitive training, instrumental activity of daily living, mild cognitive impairment, mixed-methods, older adults, virtual reality

Keywords

• cognitive training
• instrumental activity of daily living
• mild cognitive impairment
• mixed-methods
• older adults
• virtual reality.