Summary: Although exercise and mindfulness help seniors stay physically and mentally fit, they may not have as beneficial an impact on cognition as previously believed.
A large study investigating whether exercise and mindfulness training could boost cognitive function in older adults found no such improvement after either intervention.
Researchers from Washington University School of Medicine in St. Louis and the University of California, San Diego studied the cognitive effects of exercise, mindfulness training, or both for up to 18 months in older adults who reported age-related memory changes but who had not been diagnosed with any form of dementia.
The findings are published in JAMA.
“We know without a doubt that exercise is good for older people, that it can reduce the risk of heart problems, strengthen bones, improve mood and have other beneficial effects – and some have thought that it may also improve cognitive function,” said study first author Eric J. Lenze, MD, Wallace and Lucille Renard Professor and head of the University of Washington’s Department of Psychiatry.
“Similarly, mindfulness training is beneficial because it reduces stress, and stress can be bad for your brain. Therefore, we hypothesized that if older people exercised regularly, practiced mindfulness or did both, there might be cognitive benefits, but that’s not what we found.
Lenze and his colleagues still want to see if there may be cognitive effects over a longer period of time, so they plan to continue studying this group of older adults to find out if exercise and mindfulness could help prevent future cognitive declines. In this study, however, the practices did not boost cognitive function.
“So many older people are preoccupied with memory,” said lead author Julie Wetherell, Ph.D., professor of psychiatry at UC San Diego.
“It’s important that studies like ours develop and test behavioral interventions to try to provide them with neuroprotection and stress reduction as well as general health benefits.”
The researchers studied 585 adults between the ages of 65 and 84. None had been diagnosed with dementia, but all worried about minor memory problems and other age-related cognitive declines.
“Minor memory issues are often considered a normal part of aging, but it’s also normal for people to worry when they notice these issues,” said Lenze, who also directs the University’s Healthy Mind Lab. from Washington.
“The primary goal of our lab is to help older people stay healthy by focusing on maintaining their mental and cognitive health as they age, and we were eager to see if exercise and mindfulness could provide a cognitive boost in the same way they boost other aspects of their health.”
All study participants were considered cognitively normal for their age. The researchers tested them when they enrolled in the study, measuring memory and other aspects of thinking. They also performed brain imaging scans.
Participants were randomly assigned to one of four groups: a group in which subjects worked with trained exercise instructors; a group supervised by experts trained in the practice of mindfulness; a group that participated in regular exercise and mindfulness training; and a group that did neither, but met for occasional sessions focusing on general health education topics. The researchers performed memory tests and follow-up brain scans after six months and again after 18 months.
At six months and again at 18 months, all groups looked alike. All four groups performed slightly better on the tests, but the researchers believe this was due to practice effects, as the study subjects repeated tests similar to those they had taken before. Similarly, brain scans revealed no differences between the groups that would suggest a brain benefit from training.
Lenze said the study results don’t mean that exercise or mindfulness training won’t help improve cognitive function in older adults, only that these practices don’t appear to improve performance. cognition in healthy people without impairment.
“We don’t say, ‘Don’t exercise’ or, ‘Don’t practice mindfulness,'” Lenze explained.
“But we had thought that we might find a cognitive advantage in these older people. We did not do it. On the other hand, we have not studied whether exercise or mindfulness could be beneficial for older people who are impaired, due to dementia or disorders such as depression. I don’t think we can extrapolate from the data that these practices don’t help improve cognitive function in anyone.
Lenze said the researchers plan to continue following the group of adults who participated in this study.
“They continue to do exercise and mindfulness,” he said. “We didn’t see any improvements, but cognitive performance didn’t decline either. In the next phase of the study, we will continue to follow the same people for another five years to find out if exercise and mindfulness training might help slow or prevent future cognitive declines.
About this aging and cognition research news
Author: Jim Dryden
Contact: Jim Dryden – WUSTL
Image: Image is credited to WUSTL
Original research: Access closed.
“Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial” by Eric J. Lenze et al. JAMA
Effects of mindfulness training and exercise on cognitive function in older adults: a randomized clinical trial
Importance Episodic memory and executive function are key aspects of cognitive functioning that decline with age. This decline can be improved with lifestyle interventions.
Objective To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults.
Design, framework and participants This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California in San Diego). A total of 585 older adults (aged 65-84) with subjective cognitive problems, but not dementia, were randomized (enrollment November 19, 2015 to January 23, 2019; final follow-up March 16, 2020).
Speeches Participants were randomized to undergo the following interventions: MBSR with a goal of 60 minutes of daily meditation (n=150); exercising with aerobic, strength, and functional components with a goal of at least 300 minutes per week (n=138); MBSR and exercise combined (n=144); or a health education control group (n = 153). The interventions lasted 18 months and consisted of group classes and home practice.
Main results and measures The 2 primary outcomes were composites of episodic memory and executive function (normalized to a mean [SD] from 0 ; higher composite scores indicate better cognitive performance) from neuropsychological tests; the primary endpoint was 6 months and the secondary endpoint was 18 months. Five secondary outcomes were reported: hippocampal volume and dorsolateral prefrontal cortex thickness and area from structural magnetic resonance imaging and functional cognitive ability and self-reported cognitive problems.
Results Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, -0.04 point [95% CI, –0.15 to 0.07]; P= 0.50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, –0.04 to 0.17]; P= 0.23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 point [95% CI, –0.02 to 0.19]; P= 0.12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, –0.03 to 0.18]; P= 0.17) and there was no secondary 18-month endpoint intervention effect. There was no significant interaction between mindfulness training and exercise (P= .93 for memory and P= 0.29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed significant improvement with either intervention compared to those who did not receive the intervention.
Conclusions and relevance In older adults with subjective cognitive problems, mindfulness training, exercise, or both did not lead to significant differences in improving episodic memory or executive function at 6 months. The results do not support the use of these interventions to improve cognition in older adults with subjective cognitive problems.
Trial registration ClinicalTrials.gov ID: NCT02665481
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