Immersive virtual reality for older adults with mild cognitive impairment, dementia, or cognitive frailty: a systematic review and narrative synthesis (2019–2025)

Immersive and semi-immersive VR interventions appear feasible for supervised delivery in older adults with MCI or cognitive frailty and may be associated with improvements in cognitive and mobility outcomes. Evidence for emotional and behavioral outcomes in institutional settings is promising but preliminary. Programs with adequate exposure (2-3 sessions/week for 8-12 weeks; ≥ 15 total hours), adaptive challenge, and supervision were most frequently associated with positive outcomes. Larger multicenter randomized trials with standardized outcomes and embedded implementation and economic evaluations are needed.