SYSTEMATIC REVIEW article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicEnvironmental Conditions and Healthy AgingView all 6 articles
Virtual Gardening as a Therapeutic Intervention for Aging Populations: A Systematic Review of Cognitive and Emotional Health Outcomes
Provisionally accepted
- 1Tongji University, Shanghai, China
- 2Macau University of Science and Technology, Taipa, Macao, SAR China
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Background: With the global population aging rapidly, cognitive decline and emotional distress have emerged as pressing public health concerns among older adults. Virtual reality (VR)-enabled gardening activities are gaining attention as an innovative approach to complement or substitute traditional horticultural therapy, particularly in contexts where direct contact with nature is limited. Despite growing interest, an up-to-date synthesis of the evidence remains limited. Methods: Adhering to PRISMA standards, this review examined peer-reviewed empirical studies published between 2000 and 2024 that assessed the cognitive and emotional impacts of VR-based gardening programs on older adults. Results: Findings indicate that such interventions can reduce depressive and anxiety symptoms, foster positive affect, and support functional independence and social connectedness. Some investigations also identified physiological improvements, including moderated heart rate and enhanced heart rate variability. Notable design trends involve multimodal delivery formats, the integration of culturally resonant and nostalgia-inducing visual cues, and interaction designs tailored to age-related needs. Nevertheless, recurrent methodological weaknesses were observed, such as limited sample diversity, overreliance on self-report data, small cohorts, and insufficient inquiry into the mechanisms driving observed benefits. Conclusion: VR-facilitated horticultural experiences appear to be a promising avenue for promoting mental well-being and cognitive resilience in older adults. Strengthening future studies through larger, more representative samples, rigorous randomized controlled trials, and combined physiological-psychological outcome measures will be crucial. Additionally, systematic testing of discrete intervention components and design features is needed to build a mechanism-driven framework that can guide standardized application in geriatric health care.
Keywords: virtual reality, Therapeutic garden, Horticultural intervention, Older adult, Cognition, emotion
Received: 14 Aug 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Zhang, Mao and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yi-Fan Zhang, 2333805@tongji.edu.cn
Guan-Qiang Wang, gqwang@must.edu.mo
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.