This randomized controlled trial (RCT) examines the effectiveness of a culturally
tailored, nostalgia-based virtual reality (VR) program in promoting cognitive health and
emotional well-being among older adults (≥65 years) in northern Taiwan. The study is
designed in response to Taiwan's rapid transition into a super-aged society, where
dementia prevalence and caregiving burdens are expected to rise significantly. Mild
cognitive impairment (MCI) represents a critical transitional state with cognitive
plasticity, providing a valuable opportunity for early non-pharmacological intervention.
Theoretical Framework
The intervention is guided by Expectation Confirmation Theory (ECT), which emphasizes how
perceptions of usefulness, ease of use, and enjoyment influence participants'
satisfaction and long-term intention to adopt health-related technologies. This framework
allows the study to move beyond clinical outcomes and assess the feasibility and
sustainability of VR interventions among older adults.
Intervention Features
The Brain Health Nostalgic VR Program integrates reminiscence therapy with cognitive
training within immersive VR. The content is uniquely designed with Taiwan-specific
cultural elements, such as traditional wedding rituals, historical films, and familiar
objects from everyday life, to evoke strong nostalgic responses and enhance emotional
engagement.
Cognitive exercises are embedded in the VR environment and target seven
domains:Attention, Memory, Reasoning, Reading comprehension, Thinking skills, Imagination
and creativity, Observational skills.
Each weekly session lasts approximately 60-90 minutes, including preparation, VR exposure
(10-30 minutes depending on tolerance), discussion, and breaks. The intervention
continues for 12 times, with both short-term (8-12 weeks) and longer-term (24 weeks)
follow-up assessments. Sessions are delivered within participants' own care facilities to
ensure safety and comfort.
Distinguishing Characteristics
Unlike conventional reminiscence therapy, which often uses photos or group conversations,
the immersive VR environment minimizes external distractions and enhances the sense of
presence. This approach is expected to amplify the therapeutic benefits of reminiscence
by combining emotional stimulation with structured cognitive tasks.
Previous studies in Asia and Europe have shown promising results from VR-based
reminiscence and cognitive training, but most were limited by small sample sizes or
short-term pilot designs. This trial is one of the first large-scale, culturally adapted
RCTs in Taiwan, addressing both psychological outcomes (e.g., life satisfaction,
well-being, depressive symptoms) and cognitive performance in older adults with MCI or
mild dementia.
Anticipated Contributions
This study aims to:
Demonstrate the efficacy of a VR-based nostalgia and cognitive training program as an
innovative non-pharmacological intervention.
Provide empirical evidence on how culturally tailored VR content can enhance
reminiscence, reduce depressive symptoms, and improve cognitive functioning in older
adults.
Evaluate user acceptance and long-term adoption intentions, offering insights into the
scalability of digital health interventions in community and institutional settings.
By integrating cultural reminiscence, cognitive stimulation, and immersive VR technology,
this trial contributes to both the scientific evidence base and practical strategies for
dementia prevention, elderly mental health promotion, and caregiver burden reduction.
