The Benefits of Nostalgia-Based Virtual Reality Brain Health Interventions on Nostalgia Tendencies, Life Satisfaction, Psychological Well-Being, Depression Levels, and Cognitive Function in Older Adults

National Taiwan Normal University

Status: Invitation-only

Conditions: Mild Cognitive Impairment (MCI); Cognitive Decline; Dementia; Psychological Well-being

Treatments: Behavioral: Brain Health Nostalgic VR Program

Study type: Interventional

Funder types: Other

Identifiers

NCT06973551

202503HM026

Details and patient eligibility

About

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 weekly session spans 60-90 minutes in total, including setup, support, and breaks, while the actual VR usage time is 10-30 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.

Full description

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.

Enrollment: 90 estimated patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 65 years or older
• Able to communicate in Mandarin or Taiwanese
• Capable of wearing and operating a VR headset and handheld controllers
• Sufficient vision and hearing to interact with VR content (assistive devices permitted)
• Able to provide informed consent or have a legal guardian provide consent

Exclusion criteria

• Diagnosis of severe dementia or advanced neurodegenerative disease
• Severe psychiatric disorders (e.g., schizophrenia, bipolar disorder)
• Major visual or auditory impairments that would interfere with VR use, even with assistive devices
• Unconsciousness, inability to stay awake or focused for the session duration Inability to comply with study protocol or scheduled sessions

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

90 participants in 2 patient groups

Nostalgia-Based VR Cognitive Training

Experimental group

Description:

Participants in this arm will receive the "Brain Health Nostalgic VR Program," a culturally grounded virtual reality intervention integrating nostalgic elements representative of Taiwanese culture (e.g., old photographs, household objects, traditional media, and familiar scenarios) with interactive cognitive training. The training targets seven domains: attention, imagination and creativity, observation, memory, reasoning, reading comprehension, and thinking. Each weekly session spans 60-90 minutes in total, including setup, support, and breaks, while the actual VR usage time is 10-30 minutes depending on individual tolerance. The intervention is conducted weekly over 12 weeks at the participant's care facility, with full assistance and monitoring by the research team.

Treatment:

Behavioral: Brain Health Nostalgic VR Program

Routine Weekly Activities

No Intervention group

Description:

Participants in this arm will continue with their routine weekly activities provided by their respective long-term care facilities. These activities may include light physical exercise, social engagement, passive entertainment (e.g., watching TV), or unstructured leisure. No structured cognitive training or VR-related content will be administered. This arm serves as a control group for comparison with the experimental group receiving the nostalgia-based VR intervention.