Virtual Reality Multidomain Training for Older Adults With Cognitive Frailty

Participants will receive supervised virtual reality multidomain training twice weekly for 8 weeks, for a total of 16 sessions. Each session is planned to last approximately 45 minutes, including instruction, warm-up, intermittent VR training, breaks, and task transitions. The program combines cognitive training, physical exercise, nutrition education, and emotional support. Task difficulty and training duration will be adjusted according to individual abilities and tolerance.

A supervised VR program combining cognitive training, physical exercise, nutrition education, and emotional support. Participants attend two sessions weekly for 8 weeks, totaling 16 sessions. Each 45-minute session includes instruction, warm-up, approximately 25 minutes of intermittent VR training, and breaks. VR training includes approximately 10 minutes of cognitive training, 10 minutes of physical exercise, and 5 minutes of nutrition education or emotional support. Nutrition and emotional support activities alternate between the two weekly sessions. VR familiarization is provided before formal training. Task difficulty and training duration are adjusted to individual abilities and tolerance.

Participants will receive multidomain health education covering cognitive health, physical activity, nutrition, and emotional well-being.

Participants will receive multidomain health education covering cognitive health, physical activity, nutrition, and emotional well-being. The educational content addresses the same health domains as the VR intervention.

The Montreal Cognitive Assessment (MoCA) will be used to assess cognitive function. Total scores range from 0 to 30, with higher scores indicating better cognitive function.

The Short Physical Performance Battery (SPPB) will be used to assess lower-extremity physical function through standing balance, walking speed, and repeated chair stands. Total scores range from 0 to 12, with higher scores indicating better physical performance.

The Fried Frailty Phenotype (FFP) will be used to assess physical frailty based on five criteria: unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. Total scores range from 0 to 5, with higher scores indicating greater frailty.

The Timed Up and Go (TUG) test will be used to assess functional mobility. Participants rise from a chair, walk 3 meters, turn, walk back, and sit down. Completion time is recorded in seconds, with shorter times indicating better functional mobility.

The Patient Health Questionnaire-9 (PHQ-9) will be used to assess depressive symptoms over the preceding two weeks. Total scores range from 0 to 27, with higher scores indicating more severe depressive symptoms.