To compare the Virtual Reality based cognitive training with the conventional approach used for treating patients with mild cognitive impairment.

The increase in human longevity has brought new dilemmas about the treatment of diseases mostly associated with aging. In the neurological field, the use of new technologies such as Virtual Reality has shown an alternative approach for treating patients with cognitive impairment, but its efficacy on the improvement of cognitive skills such as perception, attention, memory and executive functions remains unclear. 

Medline, Cochrane, and Web of Science databases were systematically searched until October 02, 2024, for Randomized Controlled Trials comparing traditional cognitive training with cognitive training based on Virtual Reality for treating patients with mild cognitive impairment. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I2 statistics. RStudio, version 4.3.2., was used for statistical analysis.

16 randomized controlled trials and 1034 patients were included, of whom 478 (46%) underwent VR-based cognitive training. Compared with the conventional cognitive therapy for mild cognitive impairment, VR cognitive training achieved better rates of improvement in cognitive processing speed and attention, measured by the Trail Making Test (TMT) part A (MD -3.86; 95% CI -6.64 to -1.08; P = 0.006585; I2 = 0%), and in patients instrumental activities of daily living (IADL) (MD 1.57; 95% CI 0.97 to 2.16; P = <0.000001;  I2 = 29%). The Montreal Cognitive Assessment (MoCA), Mini-Mental Status Examination (MMSE), Trail Making Test Part B (TMT-B), Digit Span Forward (DSF), and Digit Span Backward (DSB) did not reach a statistically significant difference between groups.

In this meta-analysis, consistent results suggest that VR-based cognitive training shows better results in the treatment of patients with mild cognitive impairment in comparison to conventional training.