Cognitive Reserve Moderates the Effects of VR-Based and Conventional Cognitive Interventions in Older Adults

Population ageing has increased the need for accessible and effective interventions to support cognitive functioning in older adults. This study examined the effects of virtual reality-based cognitive stimulation (VR-CS), paper-and-pencil cognitive stimulation (PP-CS), and socioemotional skills training (SEST) in community-dwelling older adults, while exploring whether baseline cognitive reserve moderated intervention outcomes. Sixty-five older adults attending a community program were allocated to one of three intervention groups: VR-CS, PP-CS, or SEST. Participants completed pre- and post-intervention assessments of global cognitive functioning, subjective memory complaints, depressive symptoms, life satisfaction, and functional ability. Cognitive reserve was assessed at baseline using the Cognitive Reserve Questionnaire. Linear mixed-effects models showed a significant improvement in global cognitive functioning over time, with cognitive reserve moderating intervention effects across groups. Participants with lower and average cognitive reserve improved across all intervention modalities, whereas those with higher cognitive reserve showed cognitive gains mainly in the VR-CS and PP-CS groups. Subjective memory complaints increased in the SEST group, possibly reflecting enhanced self-awareness or metacognitive monitoring. No significant effects were observed for depressive symptoms or life satisfaction. These findings suggest that cognitive reserve may help identify which older adults benefit most from different intervention formats, supporting more personalized approaches to cognitive and socioemotional stimulation in community settings.