Abstract
<sec> <title>BACKGROUND</title> <p>Virtual reality (VR) technologies offer opportunities to assess and support activities of daily living in ecologically valid, controllable, and adaptable environments. However, many available systems remain theory-light, insufficiently personalised, and limited in their capacity to map cognitive processes onto everyday functional performance across age.</p> </sec> <sec> <title>OBJECTIVE</title> <p>This study aimed to develop and evaluate a cognitive-oriented framework for assessing the cognitive underpinnings of everyday kitchen-based activities in real and non-immersive VR environments, and to determine how performance varies by age and environment.</p> </sec> <sec> <title>METHODS</title> <p>A between-subjects experimental design was used. One hundred healthy participants were randomly assigned by age group and environment to four groups: older real environment (ORE; n=28; mean age 77, SD 4.75), younger real environment (YRE; n=24; mean age 27.61, SD 5.47), older VR environment (OVE; n=24; mean age 74.75, SD 5.33), and younger VR environment (YVE; n=24; mean age 21.29, SD 2.68). Participants completed a kitchen-based Multiple Errands Task comprising 6 errands and 54 activities in either a real kitchen or an equivalent non-immersive VR kitchen along with a brief neuropsychological assessment for older adults. Performance was scored for correct actions, completion time, and error types, including misses, order, executive, semantic, episodic, self-corrected, errand-order, and intrusion errors. General linear models tested effects of age group, environment, and their interaction; Pearson correlations, corrected using false discovery rate procedures, examined associations between neuropsychological measures and task performance.</p> </sec> <sec> <title>RESULTS</title> <p>Older adults completed fewer correct actions and made more total errors, misses, order errors, intrusions, and errand-order errors than younger adults. VR increased task demands: both age groups took longer in VR than in the real environment, and older adults were particularly slower in VR, yielding a significant Group × Environment interaction. Correctly performed actions were lower in older than younger adults, with older adults performing significantly better in the real environment than in VR, whereas younger adults’ accuracy was not significantly affected by environment. Interference did not significantly affect accuracy. Processing speed was positively associated with correct performance and negatively associated with total errors in the real environment; in older adults in VR, Mini-Mental State Examination scores correlated negatively with self-corrected errors (r=-.808, P<.001, n=24), and study time correlated positively with episodic errors (r=.641, P=.001, n=24). Older adults also made more task-related intrusions than younger adults across environments.</p> </sec> <sec> <title>CONCLUSIONS</title> <p>The VRAIS framework identified age-sensitive cognitive-functional performance patterns in real and VR contexts. Findings suggest that VR can reveal meaningful cognitive demands of everyday tasks, but ecological validity depends not only on environmental realism, but also on personal familiarity, lifelong behavioural schemas, and preparation. Theory-driven, adaptive, and person-centred VR systems may support more precise assessment and future cognitive rehabilitation for ageing and dementia-related functional decline.</p> </sec>