## 5 Conclusions  
The positive results of this proof-of-concept study provide a solid foundation for the design and implementation of larger-scale randomized controlled trials (RCTs) to validate the preliminary findings. Future RCTs should aim to assess the efficacy of VR interventions in improving cognitive and emotional outcomes in AD populations, with a particular focus on long-term effects. Building on the promising outcomes observed, further research could also explore the integration of VR with other non-pharmacological approaches, such as cognitive training or physical exercise, to potentially enhance its therapeutic impact. These next steps will contribute to establishing VR as an accessible and effective tool for cognitive rehabilitation in neurodegenerative conditions. An important issue related to VR immersions using the Oculus device is its high cost and relatively bulky design, which may reduce its accessibility for widespread use. This limitation could be addressed in future studies by adopting VR visors compatible with mobile phones. These devices are not only more affordable but also portable and easier to use, making them more accessible for patients and their caregivers. As current VR technology allows the translation of Oculus-programmed scenarios to smartphone-compatible formats, this approach could facilitate the testing of this paradigm and other similar interventions in diverse settings, including home environments, thereby increasing its feasibility and practicality. In our study, we utilized existing videos and music, adopting them to the cultural background of our participants and enhancing their aesthetic and evocative impact. The findings confirmed the validity of this approach. In future, the VR content could be fully tailored to the cultural and individual differences of the participants to further optimize the intervention's effectiveness and accessibility. For example, VR scenarios could be adapted to reflect familiar landscapes or cultural landmarks relevant to specific populations, such as local parks, iconic monuments, or traditional environments. Additionally, incorporating language customization and culturally specific auditory cues (e.g., traditional music or ambient sounds) could enhance the user experience. Personalizing content based on individual preferences, such as serene natural scenes for relaxation or interactive tasks for cognitive stimulation, might further improve engagement and therapeutic outcomes [44]. In summary, while this study underscores the promise of VR as a complementary therapeutic tool for improving emotional well-being in AD patients, it is noteworthy that even participants with lower MoCA scores, indicative of moderate dementia, and one participant with diagnosed AD, demonstrated positive outcomes. Despite challenges such as transient anxiety and sadness, all our participants recalled meaningful autobiographical memories, suggesting the potential of VR aesthetic immersions to evoke emotional and cognitive engagement even in the most advanced stages of cognitive decline. Quantitative analyses further support this observation: mood scores showed a significant improvement over time, with reductions in negative affect from pre- to mid-VR exposure and from pre- to post-VR, indicating a progressive enhancement in emotional well-being across the session. Interestingly, participants with lower MoCA scores seemed to have even more pronounced mood improvements, suggesting that those with a greater cognitive impairment may derive a particular benefit from this kind of intervention. The aesthetic quality of the VR experience, characterized by its immersive and visually engaging content, contributed to its overall effectiveness and user satisfaction, encouraging one to further expand the applications of VR for mood and cognitive rehabilitation in dementia.