The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality-based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality-based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval 0.17 to 0.68, I2 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval 0.06 to 0.65, I2 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality-based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed.

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