Virtual Reality in Cognitive Rehabilitation: A Pilot Study on Usability and Preliminary Clinical Outcomes in Seniors with Mild Cognitive Impairment

Abstract

Abstract With the global population rapidly aging, cognitive decline, including mild cognitive impairment (MCI), is becoming increasingly common. MCI impacts essential cognitive functions like memory and attention, significantly reducing the quality of life for those affected and increasing the burden on healthcare systems. Virtual reality (VR) has emerged as a promising tool for enhancing cognitive rehabilitation by creating immersive and engaging environments. This pilot study aimed to evaluate the usability, acceptability, and preliminary cognitive benefits of VR-based cognitive stimulation exercises for older adults with MCI. The intervention consisted of eight VR and augmented reality sessions over 4 weeks, integrating interactive tasks and 360-degree videos tailored to enhance cognitive flexibility, visuospatial processing, and memory. Forty-five participants enrolled, with 40 completing the full intervention and final postevaluation, and usability feedback was collected from 42 participants, including two who completed partial sessions. Usability was assessed using an adapted System Usability Scale (SUS). Patients rated the VR content (81.9) and headset usability (86.5) highly reflecting strong engagement and comfort. Four healthcare professionals also provided a high SUS score (85.2), emphasizing the program’s clinical relevance and feasibility for integration into rehabilitation workflows. Cognitive assessments indicated a modest improvement in Trail Making Test A scores (p = 0.037), which may suggest enhanced cognitive flexibility. Other measures, including Mini-Mental State Examination, Montreal Cognitive Assessment, Digit Span, and Symbol Digit Modalities Test, showed trends toward improvement but did not reach statistical significance. These exploratory findings align with the short duration of the intervention and the study’s feasibility focus. The iterative, user-centered design process ensured the intervention was accessible, safe, and adaptable to participants’ needs and clinical workflow. These findings suggest that VR-based cognitive stimulation programs are highly usable and acceptable and show potential for improving cognitive performance in older adults with MCI. Further research with larger sample sizes and longer intervention periods is warranted to evaluate clinical impact and functional outcomes.