Cognitive Frailty
Conditions
Keywords
cognitive frailty, virtual reality
Brief summary
To investigate the effects of VR based intervention on neuroplasticity in older adults with cognitive frailty.
Detailed description
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.
Interventions
BEHAVIORALVR-Based Resistance Training Intervention
Participants in the intervention group will engage with a self-developed VR resistance training program entitled Kitten Crossing the Bridge. This program is designed to guide older adults through static lower-limb resistance exercises, while integrating rhythm control, spatial judgment, and visual feedback. The intervention will be administered over 4 weeks, with two sessions per week; each session will last approximately 20 minutes (excluding equipment setup and rest periods). All training sessions will be supervised by qualified staff to ensure participant safety and provide necessary support.
BEHAVIORALStandardized Leg-Raising Training
Participants in the control group will implement a standardized leg-raising exercise protocol, which is designed to match the intensity and rhythm of the VR-based intervention. Training will be guided by pre-recorded verbal prompts and demonstration videos developed by the research team, ensuring procedural uniformity. Each session will last approximately 20 minutes (excluding equipment setup and rest periods), with two sessions per week over a 4-week duration. All sessions will be supervised by trained staff, who will monitor participant adherence and ensure safety throughout the process.
Sponsors
Peking Union Medical College
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| fNIRS | Baseline, 2 Weeks, 4 Weeks | Neural activity during the intervention tasks will be recorded using a functional near-infrared spectroscopy (fNIRS) imaging system. A 24-channel NirLight fNIRS device (Huairui Medical Technology Co., Ltd., China) will be employed, with light sources operating at wavelengths of 760-850 nm and a sampling rate of 10 Hz. The probe configuration will primarily cover the frontal, parietal, and parts of the temporal and occipital lobes. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Cognitive function | Baseline, 4 Weeks | The Chinese version of the Addenbrooke's Cognitive Examination Ⅲ (ACE-Ⅲ) is a validated neuropsychological instrument designed to assess objective cognitive function across five domains: attention, memory, verbal fluency, language, and visuospatial ability. The total score ranges from 0 to 100, with higher scores indicating better cognitive function. The Beijing version of Montreal Cognitive Assessment (MoCA) is a classical screening tool for mild cognitive impairment that evaluates seven cognitive domains: visuospatial and executive function, naming, attention, language, abstraction, delayed recall, and orientation. The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. The Subjective Cognitive Decline Questionnaire (SCD-Q9) is a brief 9-item self-report questionnaire used to assess subjective cognitive symptoms in older adults. The total score ranges from 0 to 9, with higher scores reflecting more severe subjective cognitive decline. |
| Frailty | Baseline, 4 Weeks | Frailty will be evaluated using the Fried phenotype model, which defines physical frailty according to five components: slowness (gait speed), weakness (hand grip strength), unintentional weight loss, exhaustion, and low physical activity. Each component is scored as present or absent, and the total score ranges from 0 to 5. A score of 0 indicates non-frail, 1-2 indicates pre-frail, and 3 or more indicates frail. Higher scores reflect more severe frailty. |
Countries
China
Outcome results
None listed