Exploratory Trial of VR Intervention on Neuroplasticity in Older Adults With Cognitive Frailty

Exploratory Trial on the Mechanisms of VR Intervention in Promoting Neuroplasticity Among Older Adults With Cognitive Frailty

To investigate the effects of VR based intervention on neuroplasticity in older adults with cognitive frailty.

This study is designed as a prospective, parallel-group, single-blind randomized controlled trial to be conducted at a senior care institution in Beijing from August to September 2025. Older adults with cognitive frailty will be randomly allocated using a computer-generated random sequence concealed in opaque sealed envelopes to either a VR-based intervention group or a control group. Allocation concealment will be maintained throughout the trial, and research staff responsible for data collection, assessment, and analysis will remain blinded to group assignments.

The intervention will comprise task-oriented VR activities specifically designed to stimulate cognitive and sensorimotor processes. Functional near-infrared spectroscopy (fNIRS) will be utilized to evaluate pre- and post-intervention neural activity, with a focus on cortical activation patterns, changes in network efficiency, and modulation of functional pathways.

This study aims to generate exploratory evidence regarding the mechanisms underlying VR-induced neuroplasticity in this population, thereby establishing a foundation for optimizing intervention parameters and targeting specific brain regions in subsequent large-scale trials.

Inclusion Criteria:

• Frailty Phenotype (FP) score between 1 and 5
• Subjective Cognitive Decline Questionnaire (SCD-Q9) score ≥ 5
• Montreal Cognitive Assessment (MoCA) score between 15 and 25
• Activities of Daily Living (ADL) score ≤ 26
• Age ≥ 60 years
• Submit written informed consent prior to participating in the study

Exclusion Criteria:

• Clinical diagnosis of Alzheimer's disease, other dementias, or neuropsychiatric disorders (e.g., cerebrovascular disease, Parkinson's disease, history of traumatic brain injury, brain tumors, epilepsy)
• Current use of medications or addictive substances that may impair cognition
• Presence of musculoskeletal disorders (e.g., osteoarthritis, fractures), cardiovascular disease, or liver/kidney dysfunction that prevent safe participation in exercise
• Severe sensory or speech impairments that hinder communication
• Severe motion sickness or vestibular disorders