A systematic review on the effectiveness of virtual reality cognitive training (VRCT) and computer-based cognitive training (CBCT) for individuals with mild cognitive impairment (MCI)

Background: Technological advancement and enhanced education level of aging population demand more effective and evidence-based cognitive trainings. Besides conventional computer-based cognitive training (CBCT), immersive virtual reality cognitive training (VRCT) has been gaining popularity over the last decade.
Method: The overall aim of this study is to assess the effectiveness on VRCT and CBCT in five specific cognitive domains [i.e. global cognitive function (GCF), memory (Mem), executive function (EF), language (Lang) and visuospatial skills (VS)] of individuals with mild cognitive impairment. The specific objectives were to: a) identify advantages and limitations of VRCT and CBCT; b) observe and report the trend of cognitive trainings; and c) suggest future research directions.
Result: Systematic review was performed on 320 studies were yielded from five electronic databases. 18 randomized controlled trials met the PRISMA criteria, with 10 related to VRCT and 8 related to CBCT. Random-effect model was used in determining the main effect of cognitive training in 5 specific cognitive domains.
Conclusion: VRCT provided the largest effect size on VS and Lang while the smallest on EF. CBCT provided the largest effect size on Mem and Lang while the smallest on EF. VRCT and CBCT generate an opposite effect on VS. VRCT outweighs CBCT in treatment effectiveness of GCF, EF, Lang and VS. More immersive-and-interactive experiences in VRCT may help individuals with MCI better engage in real-life experiences which supports skills generalization and reduces external distractions. CBCT tends to improve Mem but no definite conclusions can be made. Further investigation with more stringent research design and specific protocol are required to reach consensus about the optimum intervention regime.