CareVR, a Virtual Reality assisted communication training programme to support informal carers of people with psychosis: a feasibility study.

The global aging population has led to a growing prevalence of cognitive disorders, ranging from mild cognitive impairment (MCI) (which frequently represents an early, at-risk stage) to advanced Alzheimer’s disease (AD) and other dementias, which significantly compromise quality of life in older adults and pose substantial challenges for healthcare systems worldwide [–]. Pharmacological treatments, including FDA-approved acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and NMDA receptor antagonists (memantine), offer only modest symptomatic benefits and do not meaningfully alter disease progression [–]. The widespread use of psychotropic medications, such as antipsychotics and antidepressants, for behavioral and psychological symptoms of dementia is hampered by limited efficacy and a risk of adverse effects in older patients []. These limitations highlight the urgent need for adjunctive therapies that are both safe and clinically effective []. Noninvasive neuromodulation technologies—including transcranial magnetic stimulation (TMS) [, ], transcranial direct current stimulation (tDCS) [–], and vagus nerve stimulation (VNS) [, ]—have emerged as promising adjunctive interventions for cognitive disorders. These techniques are characterized by favorable safety profiles, repeatability, and the potential to enhance neuroplasticity. A meta-analysis of 21 randomized controlled trials involving 806 patients with MCI or AD demonstrated that TMS significantly improved cognitive function compared with sham stimulation, with both short-term and sustained benefits (> 4 weeks follow-up). Notably, patients with mild to moderate cognitive impairment experienced greater improvements than those with severe deficits, and combining cognitive training with TMS did not provide additional benefit []. Knowledge, attitude, and practice (KAP) studies are widely used in public health to systematically assess what individuals know (perceived knowledge), how they feel (attitude), and what they do (practice) regarding a specific health topic. KAP assessments can guide the design of interventions to improve professional behavior and ultimately enhance patient outcomes [–]. Despite accumulating evidence supporting the use of noninvasive neuromodulation for cognitive disorders, few studies have examined healthcare professionals’ KAP regarding these interventions. Most existing research focuses on efficacy or technological advances, leaving a gap in understanding real-world awareness, acceptance, and usage in clinical practice [, ]. Identifying gaps, misconceptions, and barriers in healthcare professionals’ perceived knowledge and attitudes is critical to developing effective educational and implementation strategies [, ]. Therefore, this study aimed to investigate healthcare professionals’ perceived knowledge, attitudes, and practices regarding the use of noninvasive neuromodulation technologies as adjunctive treatments for cognitive disorders, providing evidence to inform future training, dissemination, and intervention strategies.