Effects of Virtual Reality–Based Activities of Daily Living Rehabilitation Training in Older Adults With Cognitive Frailty and Activities of Daily Living Impairments: A Randomized Controlled Trial

Objectives

Cognitive frailty, which is notably prevalent in nursing homes, correlates with a range of adverse health outcomes; however, interventions targeting this population are scarce, particularly those addressing activities of daily living (ADLs). The objective of this study was to evaluate the effects of virtual reality–based ADL rehabilitation training on older adults with cognitive frailty and ADL impairments.

Design

A 2-arm randomized controlled trial.

Setting and Participants

Older adults with cognitive frailty and mild ADL impairments in a nursing home.

Methods

Sixty-six eligible participants were equally randomized into intervention and control groups. The intervention involved 45-minute sessions conducted twice weekly for 12 weeks. Outcomes evaluated included ADL performance, cognition, frailty, depression, and quality of life. Assessments were performed at baseline, 6 weeks (T1), and 12 weeks (T2).

Results

There was no statistically significant difference between the 2 groups at baseline. The mean age of the participants was 80.20 ± 9.14 years, and most were women (54.55%). Compared with the control group, the intervention group showed significant improvements in ADLs (T1: β = 6.33, T2: β = 12.79), basic ADLs (T1: β = 4.09, T2: β = 6.97), instrumental ADLs (T1: β = 2.24, T2: β = 4.12), cognition (T1: β = 3.67, T2: β = 4.42), frailty (T1: β = −0.76, T2: β = −1.27), and mental component summary of quality of life (T1: β = 8.49, T2: β = 16.44) at T1 and T2. By T2, significant improvements were observed in depression (T2: β = −2.06) and physical component summary of quality of life (T2: β = 8.52).

Conclusions and Implications

For older adults with cognitive frailty and mild ADL impairments residing in a nursing home, the virtual reality–based ADL rehabilitation program was safe and effective. Following the 12-week intervention, significant improvements were observed in ADL performance, cognition, frailty, depression, and quality of life.