Effects of a virtual reality–based multimodal training program on cognitive and physical functions in community-dwelling adults aged 60 years and older: a randomized pre–post controlled study

Age-related declines in cognitive and physical functions threaten functional independence and healthy aging. Multimodal training that integrates cognitive and physical components has been proposed as an effective strategy to address these challenges. This study aimed to evaluate the effects of a virtual reality (VR)–based multimodal training program on cognitive and physical functions in community-dwelling adults aged 60 years and older. This study employed a randomized, assessor-blinded, pre–post controlled design. A total of 57 community-dwelling adults aged ≥ 60 years were allocated to either a VR-based multimodal training group or a control group that maintained usual daily activities. The intervention consisted of VR-based multimodal training conducted twice weekly for 30 min per session over an 8-week period. Cognitive and physical functions were assessed at baseline and post-intervention, and both within-group changes and between-group differences were analyzed. Cognitive outcomes included global cognitive function, domain-specific cognitive measures, and motor–cognitive dual-task performance. Physical outcomes included measures of muscle strength, balance, mobility, cardiorespiratory endurance, and body composition. Compared with the control group, the intervention group demonstrated a significant improvement in cognitive processing speed, as measured by the Symbol Digit Substitution Test (change: 4.33 ± 6.58; p = 0.002), while overall global cognitive function was largely maintained. Significant improvements were also observed in multiple physical performance measures, including the Five Times Sit-to-Stand Test (change: −0.99 ± 0.99 s; p < 0.001), One-Leg Stand test (change: 7.75 ± 19.39 s; p = 0.003), and Two-Minute Step Test (change: 7.53 ± 12.46 steps; p = 0.002), all of which differed significantly from the control group (p < 0.05). An 8-week VR-based multimodal training program was associated with selective improvements in cognitive processing speed and consistent enhancements in physical performance among community-dwelling adults aged 60 years and older. Rather than inducing broad cognitive enhancement, VR-based multimodal training may support functional maintenance with domain-specific benefits. These findings suggest that structured VR-based multimodal training may serve as a complementary intervention for promoting functional independence and active aging, although further large-scale and comparative studies are warranted. UMIN Clinical Trials Registry (UMIN000055778), registered on October 8, 2024.