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Virtual Reality Reminiscence Therapy for MCI and Dementia:
Effects and Trends—A Narrative Review
Xiang Jinwei1, Pengcheng Du2*
1College of Mechanical and Electrical Engineering,Hohai University
2Faculty of Creative Industries, City University Malaysia
*Corresponding Author
DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000363
Received: 20 October 2025; Accepted: 27 October 2025; Published: 12 November 2025
ABSTRACT
Virtual reality–based reminiscence therapy (VR-RT) leverages immersive autobiographical recall with
multisensory and social features as a non-pharmacological option for older adults with MCI or dementia. This
narrative review synthesized eight studies (N=177; 2019–2022) across Asia, Europe, and Oceania/North
America, spanning RCTs, longitudinal, and exploratory designs. Psychological outcomes were consistently
favorable—depression/anxiety decreased while morale, well-being, and social participation improved—with
high acceptability and minimal adverse events; engagement and usability were strongest with personalized
content and supportive onboarding. Cognitive effects were heterogeneous: several studies showed maintenance
or short-term gains, others found no advantage over traditional reminiscence, and one longitudinal study
suggested stabilization during intervention with post-cessation decline. Overall, VR-RT appears safe, feasible,
and promising for mood and social connectedness, with preliminary evidence for cognitive stabilization but no
uniform superiority; larger multi-site RCTs with active controls, longer follow-up, multidimensional and
mechanism-focused outcomes, cost-effectiveness analyses, and designs emphasizing personalization,
multisensory/media integration, social-VR, and ergonomic, low-load interaction are needed. In parallel, this
review aims to chart emerging development trends and future directions for VR-RT.
Keywords：virtual reality; reminiscence therapy; dementia; mild cognitive impairment; mental well-being;
cognition
INTRODUCTION
With the rapid aging of the global population, dementia has emerged as a significant public health challenge.
The World Health Organization (WHO) reports that approximately 57 million people are living with dementia
worldwide, with Alzheimer’s disease (AD) accounting for 60–70% of all cases [1]. Dementia is a syndrome
characterized by a chronic and progressive deterioration of cognitive function. Mild Cognitive Impairment
(MCI) represents an intermediate state between normal aging and dementia and is considered a prodromal stage
of dementia, particularly AD. It is characterized by an objective decline in one or more cognitive domains—such
as memory, attention, executive function, and visuospatial abilities—which does not yet significantly interfere
with daily life activities [2]. Research indicates that approximately 5–15% of individuals with MCI progress to
dementia annually [2]. However, as about half of these individuals remain stable for up to five years, this
population represents a critical target for dementia prevention and an optimal window for early intervention [3].
Currently, a growing body of research is shifting toward non-pharmacological interventions,such as cognitive
training, exercise therapy, and virtual reality (VR) technology. These interventions aim to alleviate symptoms by
enhancing neuroplasticity and increasing cognitive reserve. For instance, systematic reviews have demonstrated
that both exercise and cognitive training can improve memory, attention, and executive functions in individuals
with MCI. Furthermore, combining VR with cognitive training has shown potential in promoting cognitive
recovery [4][5]. These approaches offer novel therapeutic strategies for delaying disease progression and
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enhancing quality of life, thereby underscoring the profound significance of conducting intervention studies in
MCI and dementia populations.
Reminiscence Therapy (RT), also known as “life review” therapy, was first proposed by psychiatrist Robert
Butler in 1963 [6]. This therapy involves the discussion of past activities, events, and experiences, using
multisensory cues such as photographs, household objects, familiar music, and olfactory triggers to evoke
autobiographical memories [7]. Recent studies have found that RT can enhance the quality of life, mood, and
social engagement of individuals with dementia and MCI, while also offering improvements in cognitive
function and reductions in depression and anxiety. Group reminiscence therapy, in particular, leverages social
interaction and emotional support to enhance self-esteem, alleviate loneliness, and improve subjective well-
being [8]. Therefore, RT serves not only as an enjoyable activity but also as a supplementary therapy to mitigate
symptoms and improve quality of life, representing an important non-pharmacological intervention option for
long-term care facilities and community-based care.
The technological tools for RT have evolved significantly. Initially, RT primarily relied on tangible prompts such
as physical photographs, household items, old newspapers, and music [7]. With the advancement of information
technology, these have been supplemented by digital and multimedia formats that integrate photos, videos,
music, and narration [8]. Research suggests that multimedia approaches can be more effective than traditional
prompts in improving quality of life and autobiographical memory while reducing depressive symptoms [9].
More recently, Virtual Reality (VR) has been introduced to RT, recreating familiar scenes or past eras in
immersive, three-dimensional environments. VR offers a greater sense of presence and interactivity than two-
dimensional screens, which can help stimulate long-term memory networks, promote emotional engagement,
and activate cognitive functions [10]. Studies indicate that VR-based reminiscence therapy can effectively reduce
anxiety and apathy, improve mood, and enhance verbal fluency [10][11]. Its immersive nature can elicit deeper
emotional connections and more vivid memory recall. This technological evolution—from tangible media to
digital multimedia and immersive VR—has provided a richer toolkit for improving the cognitive and emotional
states of individuals with MCI and dementia, laying the groundwork for future personalized intervention
research.
Previous studies have explored the potential of Virtual Reality Reminiscence Therapy (VR-RT) in enhancing
cognitive function, improving mood, and increasing quality of life. However, inconsistencies in study design,
intervention methods, and evaluation metrics have led to varied conclusions regarding the effectiveness of VR-
RT. Therefore, this paper aims to synthesize the current literature, identify effective trends, and provide direction
for future research and practice in VR-RT interventions.
Objectives
This review aims to achieve the following two objectives: (1) to synthesize the current empirical evidence
regarding the effects of Virtual Reality Reminiscence Therapy (VR-RT) on cognitive outcomes and mental well-
being; and (2) based on the existing literature, to summarize the technological trends and future research
directions of VR-RT in dementia care, thereby providing a theoretical and practical reference for the design and
implementation of subsequent interventions.
METHODS
Search Strategy and Selection Criteria
This study employs a narrative literature review methodology to summarize the effects of Virtual Reality-based
Reminiscence Therapy (VR-RT) on cognitive and mental health outcomes [12]. The search strategy was not
strictly systematic but was instead purposive. We began by consulting established high-quality, peer-reviewed
literature, such as the Cochrane Review on reminiscence therapy for dementia, to understand the existing
evidence base. Building on this foundation, we conducted targeted searches in major databases, including
PubMed, Scopus, and Google Scholar, using relevant keywords (e.g., “virtual reality reminiscence therapy”
“VR-RT” “dementia” and “MCI”). This was supplemented by manual screening of the reference lists of pertinent
reviews and studies to ensure comprehensive coverage of VR-RT research.
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The inclusion criteria for literature were as follows: (1) the study was published in English and had undergone
peer review; (2) the study population consisted of older adults with dementia, Mild Cognitive Impairment (MCI),
or loneliness; (3) the intervention involved reminiscence therapy implemented using virtual reality technology;
and (4) the outcome measures reported on cognitive function or mental health-related results (e.g., mood,
affective state). Studies that did not meet these population, intervention, or language requirements were
excluded.
Review Process
We initiated the review process by screening the titles and abstracts of the retrieved literature to exclude clearly
irrelevant studies. Subsequently, we obtained the full texts of potentially eligible articles for further evaluation.
The inclusion process was primarily conducted independently by the author according to the established criteria.
Any uncertainties were resolved through discussion to reach a consensus. Ultimately, a total of eight studies that
met the inclusion criteria were included as the basis for this review (their characteristics are detailed in the
Results section below).
Given the relatively limited number of studies included, we did not strictly adhere to the PRISMA guidelines by
creating a literature screening flowchart, nor did we conduct a formal methodological quality assessment of the
included studies (e.g., using scales such as the Mixed Methods Appraisal Tool, MMAT). This approach is
consistent with the qualitative and integrative nature of this narrative review; our priority was to distill
commonalities and differences from the findings rather than to perform a quantitative grading of the evidence
quality.
RESULTS
The literature search identified multiple relevant articles. After a rigorous screening process to exclude duplicates
and studies that did not meet the inclusion criteria, a final selection of eight empirical studies, comprising a total
of 177 older adult participants, was included for review. The study populations included patients with Mild
Cognitive Impairment (MCI) or dementia (five studies), as well as healthy or sub-healthy older adults (three
studies). Among these, two studies from Japan targeted the oldest-old and individuals with MCI, respectively
[15][18]; two studies from Taiwan focused on dementia patients in long-term care facilities [16][17]; one study
from South Korea utilized a digital reminiscence system [9]; and studies from the Netherlands [19], Australia
[13], and Canada [14] primarily conducted exploratory research on immersive VR reminiscence applications.
Overall, the publication years of the included studies ranged from 2019 to 2022, with a geographical distribution
spanning three Asian countries/regions (Japan, Taiwan, South Korea) and three Western countries (the
Netherlands, Australia, Canada), reflecting a diversity of cultural contexts and technological systems.
The study designs were predominantly quantitative. Three were randomized controlled trials (RCTs) [18][9][14],
while others were longitudinal observational or exploratory intervention studies [15][16]. Six studies featured a
control condition [15][16][18][9], and three were non-controlled studies focused on system development or
preliminary validation [13][17][19]. The studies generally demonstrated the positive effects of Virtual Reality
Reminiscence Therapy (VR-RT) in enhancing cognitive function, emotional states, and social engagement.
Moreover, most studies reported no significant adverse effects.
Psychological Outcomes of Virtual Reality Reminiscence Therapy
Multiple studies have demonstrated that Virtual Reality Reminiscence Therapy (VR-RT) contributes to the
improvement of mood and mental well-being among older adults. For instance, a randomized controlled trial by
Moon et al., involving 49 persons with dementia, compared digital VR-RT with conventional narrative therapy.
The results showed that after eight sessions over four weeks, the depression scores of the VR group were
significantly reduced, and this improvement was sustained four weeks post-intervention (between-group effect:
F=7.62, p=0.001, partial η²=0.17) [9]. Similarly, a three-month longitudinal study by Huang et al. on 20 patients
with dementia also observed a significant decrease in depression levels post-intervention (p=0.008) [16].
Furthermore, VR-RT has been shown to be effective in alleviating anxiety in older adults. A crossover trial by
Niki et al. with oldest-old adults (mean age 87, n=10) found that even a single, brief immersive VR reminiscence
experience could immediately reduce participants' state anxiety levels. The State-Trait Anxiety Inventory (STAI)
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scores decreased from approximately 36 to 27 after the first session and further down to 23 after the second
(P=0.001 after the first session, P<0.001 after the second) [15].
Table 1 Overview of VR-RT
VR-RT has also shown advantages in enhancing positive emotions and subjective well-being. In an eight-week
controlled study by Tominari et al. involving 52 older adults with MCI, although the VR group did not show a
significantly greater overall cognitive improvement compared to the photo-based control group (both groups
showed improved MMSE scores post-intervention, with no statistically significant between-group difference),
the VR group demonstrated a more substantial increase in subjective well-being. Specifically, their scores on the
revised Philadelphia Geriatric Center (PGC) Morale Scale improved significantly more than those of the control
group, which showed no marked change [18]. Similar findings have emerged from qualitative research.
Veldmeijer et al. conducted a VR reminiscence intervention with older adults experiencing loneliness (n=6), and
participants generally reported improved mood afterward. A typical feedback was, "It feels like a relief to talk
about this" [19]. Some participants even resumed hobbies or established new social connections following the
experience [19]. The study by Tsao et al. also confirmed that a combined VR/AR reminiscence therapy can
enhance the mental health and life satisfaction of older adults [17]. In summary, VR-RT can alleviate anxiety
and depression while boosting well-being and positive social emotions.
Although a few studies have noted that immersive scenes can occasionally trigger sad memories [19], the overall
consensus among researchers is that the therapy has a high safety profile, with positive emotional effects being
predominant.
Veldmeijer (2020) Netherlands Participatory Design Research (Prototype Development) 23 older adults (21 completed)
A 1950s–60s style living room environment, incorporating six
of the participant's nostalgic items (music, photos, etc.) to
trigger personal memories.
Baker (2020) Australia Participatory Action Research (PAR) 16 older adults (divided into 4 groups, 2-3 people per group)
Social VR Virtual Classroom: An environment where elderly
users gather as digital avatars, using virtual conversation
starters and personal nostalgic items to share school life
memories.
Sun (2024) Canada Mixed-Methods Exploratory Study (Co-design)
7 participants (3 patients with cognitive impairment + 3
caregivers + 1 nursing staff)
VR Reminiscence Therapy Prototype: A prototype for
feasibility testing in dementia care, allowing users to browse
personal photo albums and play beloved music/videos for a
multi-sensory experience.
Niki (2021) Japan Randomized Crossover Trial (Single-center) 10 nursing home residents (2-group crossover design)
Immersive VR Video: Two VR scenarios (live-action video
and computer-generated imagery) themed around nostalgic
scenes from Japan's Shōwa era (1955–1980), which
participants view immersively using an HMD (Head-Mounted
Display).
Huang (2022) Taiwan Longitudinal Observational Study 20 patients with dementia
VR Nostalgic Content (HTC VIVE Pro headset): A virtual
1960s–80s old Taiwanese village house scene that integrates
personal photos, narratives, and music. Users can perform
interactions such as turning on a radio to play music, looking
through photos, and feeding chickens.
Tsao (2019) Taiwan System Development Research None (System prototype design)
VR+AR Reminiscence System: Developed on Unity, this
system uses a mobile phone or VR glasses to present 3D
models of old Taiwanese architecture, triggering nostalgic
video/audio interactions. It aims
Study (Author, Year) Country/Region Study Design Sample (n, Grouping) System Overview
to stimulate the memories of
the elderly through multi-dimensional triggers.
Tominari (2021) Japan Randomized Controlled Trial (Double-blind) 52 participants (VR group 26, control group 26)
Tablet VR Panoramic Reminiscence: An intervention using an
iPad to display panoramic images for reminiscence, compared
with a traditional photo group; all participants were older
adults with Mild Cognitive Impairment (MCI).
Moon (2020) South Korea Randomized Controlled Trial (Double-blind) 49 participants (Digital RT group 25, control group 24)
Android Digital Reminiscence App: A mobile application
platform developed for group reminiscence therapy, allowing
multiple users to participate simultaneously and supporting the
upload of personal materials as digital content to trigger
memories.
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Cognitive Function Outcomes of Virtual Reality Reminiscence Therapy
The impact of VR-RT on cognitive function has yielded inconsistent results across studies. Some research
indicates that VR-RT can maintain or improve cognitive performance in older adults in the short term. In a study
by Tominari et al., 52 older adults with Mild Cognitive Impairment (MCI) were randomly assigned to an eight-
week reminiscence therapy using either VR panoramic images or traditional static photos. At the conclusion of
the intervention, the cognitive scores (e.g., MMSE) of both groups had improved from baseline, but the between-
group difference was not statistically significant. Notably, however, only the VR group showed a significant
trend of cognitive enhancement compared to their pre-intervention performance, while the improvement in the
photo group was more limited. This suggests that the immersive nature of VR reminiscence may offer some
cognitive benefits [18]. Conversely, in a four-week randomized controlled trial by Moon et al., no significant
differences were found in cognitive scale scores between the digital VR group and the conventional control
group (repeated measures ANOVA between-group effect: F=0.13, p=0.821) [9]. Furthermore, a three-month VR-
RT study by Huang et al. on 20 individuals with dementia found that cognitive function scores remained stable
and not significantly different from baseline immediately after the intervention. However, a follow-up
assessment 3-6 months after the intervention ceased revealed a trend of continued cognitive decline. This finding
suggests that VR intervention might play a role in stabilizing cognition during the treatment period (i.e., delaying
further decline), though it may not be sufficient to produce significant long-term cognitive improvement [16].
Beyond overall cognitive scores, some studies have observed that VR-RT positively influences specific cognitive
processes. A VR/AR reminiscence system developed by Tsao et al. demonstrated in a small-scale trial its
effectiveness in evoking past memories and stimulating cognitive engagement among older adults [17]. A design
study by Veldmeijer et al. also reported that unfamiliar retro objects presented within an immersive VR
environment unexpectedly activated participants' thinking and problem-solving abilities, a stimulus that helped
retrieve forgotten memory fragments [19]. Therefore, VR-RT can, to some extent, engage the cognitive
processing of older adults through rich sensory stimulation.
In conclusion, the current evidence suggests that VR-RT has a stabilizing or even mildly beneficial effect on
cognitive function during the intervention period, but it has not yet demonstrated a significant advantage over
traditional reminiscence methods. Given the limited sample sizes and varied results in the existing research, the
efficacy of VR-RT in enhancing cognitive function warrants further investigation.
Table 2 Psychological Outcomes of VR-RT
Table 3 Summary of the Cognitive Function Outcomes of VR-RT
Veldmeijer (2020) – (no cognitive measures) — — — No cognitive outcomes reported (design study)
Baker (2020) – (no cognitive measures) — — — No cognitive outcomes reported (design study)
Sun (2024) – (focus on usability/co-design) — — — Cognitive effects not assessed
Niki (2021) MMSE (Japanese version) 28.5 ± 1.8 – (not re-measured) – (not re-measured) High baseline cognition; no follow-up measure
Huang (2022) Center for Epidemiologic Studies Depression Scale (CES-D) MMSE 15.57 ± 4.76; CASI 58.80 ± 12.48; CDR 6.50 ± 1.61 MMSE 16.29 ± 4.07; CASI 57.50 ± 12.40; CDR 6.86 ± 1.28 MMSE Δp=.67; CASI Δp=.50; CDR Δp=.10 (all ns) No significant immediate change in cognition
Tsao (2019) None — — — No cognitive outcomes reported
Tominari (2021) Revised Philadelphia Geriatric Center Morale Scale (PGC) VR: 12.56 ± 3.90; Control: 14.20 ± 2.75 VR: 13.52 ± 2.93;
Study (Author, Year) Psychological Assessment Tool Pre-intervention (mean ± SD) Post-intervention (mean ± SD) Statistical results (p-value, significance) Interpretation
Control: 13.48 ± 2.90
VR group pre–post p<.01; control p=.08; between-group
p=.45
VR group showed significant MMSE gain; control did not
Moon (2020) Depression Scale (name not specified) – (data not reported) – (data not reported) F=0.13, p=.821 (no significant change) No significant cognitive change
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Table 4 Summary of Impacts
Other Impacts of Virtual Reality Reminiscence Therapy
VR-RT has generally demonstrated high levels of acceptability and engagement among participants. In the
controlled trial by Moon et al., researchers additionally assessed engagement during the therapy sessions and
found that the digital VR group showed significantly higher levels of active engagement during the final session
compared to the control group [9]. A study in Australia by Baker et al. similarly indicated that VR helps to
enhance social participation among older adults. This five-month study involved 16 participants aged 70–81
using a social VR application called "School Days" to reminisce about their school experiences. Participants
were able to engage actively in virtual group discussions for extended periods, and even geographically dispersed
individuals established interactive connections through VR [13]. A co-design study by Veldmeijer et al. further
highlighted that the design process itself became a meaningful social activity. By co-creating nostalgic scenes,
participants rediscovered the experience of teamwork and a sense of social role, which helped alleviate their
feelings of loneliness and enhance their social motivation [19]. Furthermore, the validation results from the
VR/AR system developed by Tsao et al. showed that such immersive nostalgic experiences have the potential to
improve older adults' satisfaction with social interaction and positively impact their quality of life [17].
The subjective satisfaction of older participants with VR-RT is generally high, with most studies reporting
positive feedback on the VR experience. In the study by Niki et al., the satisfaction of oldest-old adults with a
single VR reminiscence session averaged 7–8 out of 10, with no participants reporting serious discomfort,
dizziness, or other side effects [15]. An exploratory study by Sun et al. documented participants' experiences,
with a common description from a person with dementia being, "It was like a fantasy world where you could see
the stars in the sky. I enjoyed it" [14]. This study also quantitatively assessed the system's usability and
immersion. The results showed that while the System Usability Scale (SUS) scores for persons with dementia
were lower (mean 53.3, around the 50th percentile), their care partners rated it higher (mean 80, at the 80th
percentile). The median SUS score for all participants was 69, which falls within the "good" usability range [14].
This suggests that with proper training and interface optimization, most older adults with cognitive impairments
can adequately operate VR equipment. Concurrently, the sense of presence and immersion provided by the VR
environment was validated, with the high level of immersion being considered a major advantage of VR-RT. It
enhances the enjoyment and appeal of the therapy, thereby encouraging emotional investment from the
participants.
Existing studies widely support the feasibility and safety of VR-RT in older populations. Most research reports
good participant adherence and no serious adverse events. For example, an immersive VR trial conducted with
a group of participants up to 87 years old did not result in any significant motion sickness or physical discomfort
[15]. The study by Sun et al. also indicated that, with some guidance, even older adults with cognitive
impairments could operate the VR system with minimal assistance [14]. Research teams have improved comfort
by adjusting the fit and weight of head-mounted displays and have recommended optimizations for the specific
needs of older users—for example, allowing the use of reading glasses to see the virtual display clearly and
simplifying the button functions on hand controllers to reduce operational difficulty [14]. Overall, these
empirical studies demonstrate that VR reminiscence therapy is user-friendly and well-accepted by older adults.
In addition to improving cognitive and mental health, VR-RT offers older populations richer immersive
experiences and opportunities for social interaction, serving as a valuable supplement to traditional reminiscence
therapy.
Study (Author, Year) Psychological Impact Cognitive Impact Other Impacts
Veldmeijer (2020) ↑ (Increased subjective well-being) → (No significant change) →
Baker (2020) ↑ (Enhanced social connection) → (No significant change) ↑ (Increased engagement)
Sun (2024) → (Not measured) → (Not measured) ↑ (System usability)
Niki (2021) ↓ (Significant decrease in anxiety) → (Not measured) →
Huang (2022) ↓ (Depression relief) → (No immediate change) →
Tsao (2019) → (Not measured) → (Not measured) ↑ (Social satisfaction)
Tominari (2021) ↑ (Increased subjective well-being) → (No difference between groups) →
Moon (2020) ↓ (Significant decrease in depression) → (No significant change) ↑ (Increased participation)
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DISCUSSION
The future development of Virtual Reality Reminiscence Therapy (VR-RT) is trending toward a
multidimensional deepening of its application. Future research and practice should advance synergistically
across five key directions: technological innovation, ntervention design, user-centered optimization,
methodological rigor, and exploration of underlying mechanisms.
Technological Innovation
The primary objective on the technological front is to enhance the system's immersion and usability while
expanding its application models. First, optimizing hardware and software to achieve higher-fidelity audiovisual
experiences, more intuitive controls, and cross-platform compatibility is fundamental to broadening the
technology's reach. Second, the emergence of social VR introduces a new dimension to interventions, allowing
geographically dispersed older adults to "gather" as virtual avatars for shared reminiscence activities. This holds
immense potential for fostering unique social interactions and alleviating loneliness. Finally, as a form of Digital
Therapeutics (DTx), VR-RT has an inherent advantage for remote implementation. In the post-pandemic era,
exploring its role as a highly accessible, cross-regional digital health solution is of great significance for
optimizing elderly care service models.
Intervention Design
The future of intervention design lies in integrating multi-modal interactions with highly personalized content
and optimizing intervention protocols. On one hand, incorporating multisensory elements within the VR
environment—such as music, historical footage, voice-overs, and interactive 3D objects—can more effectively
evoke deep-seated memories and enhance emotional resonance. On the other hand, personalization is crucial for
maximizing intervention efficacy. Achieving "tailor-made" immersive experiences is vital for the therapy's
success [10]. Furthermore, the "dosage" of the intervention—including its frequency, session duration, and
overall length—requires scientific optimization. Existing research suggests that the emotional benefits of short-
term interventions may not be sustainable. Therefore, future studies should systematically explore optimal
intervention protocols that can maintain long-term efficacy, for example, by incorporating consolidation phases
or adjusting the intervention density.
User-Centered Experience
Centering the design on the older adult user and optimizing their overall experience is paramount to the success
of the therapy. First, it is essential to lower the barrier to technology adoption. Simplifying hardware, designing
intuitive user interfaces, and providing thorough demonstrations, training, and on-site support for older adults
new to VR (especially those with MCI or AD) can effectively mitigate technology anxiety and improve
acceptance and confidence. Second, close attention must be paid to the user's physiological and psychological
comfort. This includes ensuring head-mounted displays are comfortable to wear, employing seated operation to
prevent cybersickness, and having care staff present to provide a sense of security and emotional support. Finally,
ethics and safety are non-negotiable. Given that reminiscence can trigger strong emotional responses (e.g.,
sadness, anxiety), research protocols must include clear risk management and mitigation strategies. The
therapeutic team must be equipped to promptly identify and address negative emotions, ensuring the entire
process is safe and beneficial for the user.
Methodological Rigor
To establish a solid evidence base for VR-RT, future research methodologies must adhere to higher standards.
First, this involves increasing sample sizes and employing rigorous study designs. Conducting multi-center,
large-scale randomized controlled trials (RCTs) is essential to validate the therapy's effectiveness, which will
help test its effects across different populations and care settings, thereby enhancing the robustness and
generalizability of the findings. Second, direct comparative effectiveness research should be conducted. Studies
should be designed to directly compare VR-RT with traditional reminiscence therapies (e.g., group discussions,
use of tangible props) to clearly delineate the specific added benefits conferred by VR technology. Third, cost-
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effectiveness analyses are needed. Systematically evaluating the economic investment and health outcomes of
VR-RT and comparing them with conventional interventions will provide crucial evidence for decisions
regarding its large-scale implementation.
Exploration of Underlying Mechanisms
Uncovering why and how VR-RT works is the theoretical cornerstone for guiding future practice optimization.
Current research has observed the advantages of VR in enhancing subjective well-being, but the underlying
mechanisms remain unclear. Future research should focus on two core pathways. The first is the cognitive-
affective mechanism: investigating how the immersion and rich sensory stimulation of VR influence cognitive
processes such as attention, memory retrieval, and emotional regulation to ultimately improve the mental state
of older adults. The second is the social interaction mechanism, particularly within social VR applications. It is
crucial to analyze how peer interactions in a virtual environment affect older adults' sense of social
connectedness, belonging, and overall mental health. Elucidating these deeper mechanisms will enable us to
design intervention protocols with greater precision, thereby maximizing their therapeutic efficacy.
CONCLUSION AND FUTURE OUTLOOK
In summary, Virtual Reality Reminiscence Therapy (VR-RT) has demonstrated a positive impact on the cognitive
and mental health outcomes in dementia care. A substantial body of empirical evidence indicates that VR-RT
can alleviate negative emotions such as anxiety, depression, and apathy in older patients, while enhancing their
mood, subjective well-being, and social engagement. Furthermore, interventions have been well-tolerated, with
no serious adverse effects reported. Regarding cognition, some studies have observed improvements from
baseline in cognitive assessments (e.g., total MMSE score, verbal fluency) following VR-RT intervention.
However, the results are inconsistent across studies, and VR-RT has not yet shown a universally significant
advantage over traditional reminiscence therapy.
Technologically, the application of RT is evolving from traditional tangible materials to digital multimedia and
now to immersive virtual environments, which leverage 3D scenes to provide a stronger sense of presence and
interactivity to evoke memories and emotions. Recent trends include the development of multisensory
reminiscence systems that integrate 360° panoramic imagery and augmented reality ; the creation of social VR
platforms that enable geographically dispersed older adults to participate in shared reminiscence act ivities ; and
the use of participatory design to involve persons with dementia and their care partners in the co-creation and
optimization of VR-RT protocols, thereby enhancing personalization and meaningfulness. Overall, as a
multisensory and interactive non-pharmacological intervention, VR-RT has shown significant effects in
improving the mental health and social satisfaction of older adults.
In terms of future research design, it is recommended to conduct larger-scale randomized controlled trials with
active control groups to compare the effects of VR with traditional reminiscence therapy. Additionally, extending
the follow-up period to assess long-term efficacy and incorporating multi-dimensional outcome measures—
including cognition, mood, and quality of life—are crucial next steps. Through continued exploration and
optimization in these directions, the intervention models and evidence base for VR-RT will be further
strengthened, providing more scientifically robust and effective support for promoting the cognitive function
and mental well-being of older adults.
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Page 4407 www.rsisinternational.org
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