This randomized controlled trial investigates the effects of a nostalgia-based cognitive training intervention delivered via Virtual Reality (VR) on emotional well-being and cognitive functioning among community-dwelling older adults (≥65 years) in northern Taiwan, specifically targeting those with mild cognitive impairment (MCI) or mild dementia. The study, conducted at National Taiwan Normal University, aims to assess whether engaging older adults in nostalgic VR experiences can enhance nostalgia proneness, life satisfaction, and psychological well-being, while also reducing depressive symptoms and improving cognitive functions. Participants who meet inclusion criteria (aged 65+, capable of communicating in Mandarin or Taiwanese, without severe psychiatric conditions, with sufficient vision/hearing) will be randomly assigned to either the experimental group receiving the "Brain Health Nostalgic VR Program" or a control group engaged in routine weekly activities. Each session, scheduled twice weekly, spans 25-35 minutes in total, including setup, support, and breaks, while the actual VR usage time is 15-25 minutes depending on individual tolerance. Research staff will provide close support and safety monitoring during all sessions. Pre- and post-intervention outcomes will be measured using standardized assessments: Southampton Nostalgia Scale (SNS), Short-Form Life Satisfaction Index (LSI-SF), Geriatric Depression Scale (GDS-15), Short-Form Chinese version of Ryff's Psychological Well-being Scale (PWB-18), and the Montreal Cognitive Assessment Taiwan Version (MoCA-T). The study emphasizes participant safety and data confidentiality throughout its duration. Findings aim to demonstrate VR's potential as a non-invasive, preventive strategy for cognitive decline and mental health enhancement among older populations.
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 session, scheduled twice weekly, lasts approximately 25-35 minutes, including preparation, VR exposure (15-25 minutes depending on tolerance), discussion, and breaks. The intervention continues for 12 sessions in total. Assessments are conducted at baseline, post-intervention (up to 8 weeks), and 3 months post-intervention. 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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
64
The "Brain Health Nostalgic VR Program" is a culturally tailored virtual reality intervention integrating nostalgic content from Taiwanese culture (e.g., vintage photographs, familiar objects, historical TV clips, traditional settings) with interactive cognitive training tasks. The program targets seven cognitive domains: attention, imagination and creativity, observation, memory, reasoning, reading comprehension, and thinking. Each session spans 25-35 minutes, with 15-25 minutes of actual VR use based on participant tolerance, each participant will use VR for no more than 30 minutes per session before taking a break. Participants receive 12 sessions, scheduled in principle twice weekly. The intervention is delivered individually at the participant's day-care center, with researcher support provided throughout.
National Taiwan Normal University
Taipei, Taipei City, Taiwan
Change in Cognitive Function Assessed by MoCA-T
Cognitive function will be measured using the Montreal Cognitive Assessment - Taiwan Version (MoCA-T), a validated tool for detecting mild cognitive impairment (MCI) and early dementia. The MoCA-T assesses multiple domains including memory, attention, executive function, language, and visuospatial skills. Score range: 0-30 Interpretation: Higher scores indicate better cognitive functioning. For the Taiwanese version, a cutoff score of 23/24 has been suggested as the optimal threshold for distinguishing MCI patients from cognitively normal controls.
Time frame: Baseline, post-intervention (up to 8 weeks), and 3 months post-intervention
Change in Nostalgia Proneness Assessed by Southampton Nostalgia Scale (SNS)
Change in Nostalgia Proneness Assessed by the Southampton Nostalgia Scale (SNS) Nostalgia proneness will be measured using the 7-item Southampton Nostalgia Scale (SNS), which evaluates both the importance/meaning of nostalgia (items 1-4) and the frequency of nostalgic experiences (items 5-7). Items 1-6 are rated on a 7-point Likert scale (1-7). Importance items range from 1 = not at all valuable/important to 7 = very valuable/important. General frequency items range from 1 = very rare to 7 = very frequent. Item 7 specifically assesses the concrete frequency of nostalgic experiences with options ranging from 1 = once or twice a year to 7 = at least once a day. The total score ranges from 7 to 49, with higher scores indicating a stronger proneness to nostalgia.
Time frame: Baseline, post-intervention (up to 8 weeks), and 3 months post-intervention
Change in Depression Symptoms Assessed by GDS-15
Depression levels will be measured using the 15-item Geriatric Depression Scale (GDS-15), a validated self-report tool for older adults. Items are scored dichotomously ("yes" = 1; "no" = 0), yielding a total score of 0-15, where higher scores indicating more severe depressive symptoms. The Chinese version has demonstrated acceptable psychometric properties among Taiwanese older adults.
Time frame: Baseline, post-intervention (up to 8 weeks), and 3 months post-intervention
Change in Psychological Well-being Assessed by PWB-18
Psychological well-being will be evaluated using the 18-item Short-Form Chinese version of Ryff's Psychological Well-being Scale (PWB-18), which measures six dimensions of well-being. All items are rated on a 6-point Likert-type scale ranging from 1 (strongly disagree) to 6 (strongly agree), yielding a total score ranging from 18 to 108, where higher scores indicate greater psychological well-being.
Time frame: Baseline, post-intervention (up to 8 weeks), and 3 months post-intervention
Change in Life Satisfaction Assessed by LSI-SF
Change in Life Satisfaction Assessed by the Life Satisfaction Index - Short Form (LSI-SF) Life satisfaction will be assessed using the 6-item Life Satisfaction Index - Short Form (LSI-SF), derived from the original Life Satisfaction Index-A (LSIA) by Neugarten et al. (1961). The items cover three domains: (1) zest vs. apathy, (2) resolution and fortitude, and (3) congruence between desired and achieved goals. One item ("Most of the things I do are boring or monotonous") is reverse-coded. Each item is scored dichotomously (0 = no, 1 = yes), yielding a total score ranging from 0 to 6. Higher scores indicate greater life satisfaction.
Time frame: Baseline, post-intervention (up to 8 weeks), and 3 months post-intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.