Characteristics of the reviewed studies (PICOT).

Immersive virtual reality (IVR) is an emerging therapeutic modality that engages older adults in psychological therapeutically oriented activities developed to improve their psychological well-being. This systematic review aims to investigate the effects of IVR psychological intervention on psychological symptoms and well-being. A systematic review and meta-analysis was conducted following the Cochrane Handbook for Systematic Reviews of Interventions. Six databases were searched, including Embase, PubMed, Web of Science, Scopus, CINAHL, and PsycINFO, covering the period from 2010 to December 2024. RevMan 5.3 was utilized for meta-analysis, and the Cochrane Risk of Bias tool was employed for quality assessment. Ten randomized controlled trials of 746 older adults were included. The IVR interventions employed reminiscence (40%), garden/forest therapy (40%), cognitive stimulation (10%), and multi-sensory stimulation to reduce psychological symptoms and improve self-perception (10%). Data pooling suggested that IVR interventions have significantly reduced depressive symptoms [n = 5; SMD = -0.83, 95%CI (-1.05, -0.60), I2 = 21%, p 2 = 70%, p = .006]. Synthesis without meta-analysis (SWiM) was conducted for stress and affect outcomes following SWiM guidance. In all three studies (100%), IVR produced statistically significant reductions in stress versus usual/standard care, and in both studies (100%), it yielded statistically significant improvements in affect—higher positive and lower negative affect—compared with the respective control conditions. IVR-based interventions could be an alternative method for alleviating the psychological symptoms of older adults.Registration: PROSPERO CRD42024575387沉浸式虚拟现实（Immersive Virtual Reality, IVR）是一类新兴治疗手段，通过引导老年人参与以心理治疗为导向的活动，助力其改善心理健康水平。本系统综述旨在探究沉浸式虚拟现实心理干预对老年人心理症状与心理健康的影响。研究严格遵循《Cochrane干预系统综述手册》开展系统综述与元分析（meta-analysis），共检索Embase、PubMed、Web of Science、Scopus、CINAHL及PsycINFO共6个数据库，检索时限设置为2010年至2024年12月。采用RevMan 5.3软件完成元分析，借助Cochrane偏倚风险工具（Cochrane Risk of Bias tool）进行研究质量评估。最终纳入10项随机对照试验，共计746名老年受试者。本次研究所采用的IVR干预方案涵盖回忆疗法（40%）、园艺/森林疗法（40%）、认知刺激（10%）与多感官刺激（10%），旨在缓解老年人心理症状并提升其自我感知能力。数据合并分析结果显示，IVR干预可显著降低抑郁症状[纳入研究数n=5；标准化均数差（Standardized Mean Difference, SMD）=-0.83，95%置信区间（Confidence Interval, CI）(-1.05, -0.60)，I²=21%，p 2 = 70%，p = 0.006]。针对压力与情感结局指标，研究遵循无元分析合成（Synthesis Without Meta-analysis, SWiM）指南开展非元分析合成。在全部3项研究（100%）中，相较于常规护理或标准护理组，IVR干预可显著降低受试者的压力水平；在两项相关研究（100%）中，相较于对应对照组，IVR干预可显著改善受试者的情感状态——提升正性情感水平，同时降低负性情感水平。综上，基于沉浸式虚拟现实的干预手段可作为缓解老年人心理症状的替代方案。本研究注册编号为PROSPERO CRD42024575387。