# Feasibility, Usability and Acceptance of a Multi-Component Cognitive Intervention Using Immersive Virtual Reality and Telemedicine in Individuals with Subjective Cognitive Decline

## TL;DR

A home-based virtual reality and telemedicine program for people with early cognitive decline is safe, easy to use, and well accepted.

## Contribution

This study demonstrates the feasibility and acceptability of a multi-component immersive virtual reality and telemedicine intervention for subjective cognitive decline.

## Key findings

- The intervention achieved 100% retention and 92% adherence, indicating strong feasibility.
- Participants reported excellent usability and high satisfaction with the program.
- Safety was confirmed with low cybersickness and moderate workload perception.

## Abstract

Background/Objectives: Dementia is a major global health challenge, with prevention strategies increasingly focusing on the preclinical stage of Subjective Cognitive Decline (SCD). This study aimed to evaluate the feasibility, usability, and acceptability of a 5-week immersive virtual reality and telemedicine-based multicomponent intervention, combining cognitive training with a health and lifestyle education program, in individuals with SCD. Methods: Thirty-nine individuals with SCD were randomly allocated to either the multi-component intervention (MC-I; n = 19) or the cognitive-only intervention (CO-I; n = 20). Both programs were delivered remotely via head-mounted displays and monitored through a telemedicine platform. Feasibility was assessed through retention, adherence, and safety measures. Post-intervention, participants completed the System Usability Scale (SUS), User Satisfaction Evaluation Questionnaire (USEQ), NASA Task Load Index (NASA-TLX), and Simulator Sickness Questionnaire (SSQ). Results: High feasibility was demonstrated by a 100% retention rate and 92% adherence. Both groups reported “excellent” usability (SUS mean: 84.04) and high satisfaction (USEQ mean: 26.7), with no significant differences between groups. The NASA-TLX reflected a moderate workload (mean: 56.1), characterized by high mental demand but low frustration. Safety was confirmed by remarkably low SSQ scores, indicating negligible cybersickness. Conclusions: The results provide strong preliminary evidence that a home-based, multi-component IVR intervention is safe, usable, and highly accepted by individuals with SCD. Integrating lifestyle education does not increase the perceived burden, supporting the scalability of this remote digital approach for dementia secondary prevention.