Effectiveness of Multisensory Technologies Interventions on Cognitive Flexibility in the Elderly Population: A Systematic Review

Introduction Cognitive flexibility (CF), the ability to adapt thinking and behavior in response to changing environmental demands, declines significantly with age. This decline compromises older adults' capacity to navigate daily challenges and maintain independence. Recent advances in multisensory technologies offer novel intervention approaches by simultaneously engaging multiple sensory pathways through immersive and ecological scenarios. Aim This systematic review evaluates the effectiveness of multisensory technology-based interventions in enhancing CF among healthy older adults (aged ≥ 60 years). Methods We conducted a systematic search in six databases following the PRISMA guidelines. Inclusion criteria encompassed randomized controlled trials (RCTs) and non-RCTs that evaluated multisensory technology interventions with CF as a measured outcome. The Cochrane Risk of Bias (RoB2 and ROBINS-I) and the Rating of Included Trials in the Efficacy-Effectiveness Spectrum tools were used to evaluate quality studies. Results Thirteen studies met the inclusion criteria. Findings revealed that immersive virtual reality systems yielded significantly greater improvements in CF compared to non-immersive systems. Composite interventions combining physical engagement with interactive digital tasks (e.g. balance boards) demonstrated moderate effectiveness. However, assessment methods are focused on only a few isolated components of CF, particularly task switching and set shifting paradigms. Conclusion Evidence suggests that multisensory technology interventions, especially immersive virtual reality systems, effectively enhance CF in older adults. These findings support the integration of these technologies into cognitive training. Future research should employ comprehensive CF assessments and extended follow-up periods to establish the long-term impact and real-world transferability of these interventions.