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Summary: While exercise and mindfulness help older adults stay physically fit and mentally healthy, they may not have as strong a positive impact on cognition as previously thought.
Source: WUSTL
A large study that focused on whether exercise and mindfulness training could increase 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 changes in memory, but did not who have been diagnosed with some form of dementia.
The results are published in JAMA.
“We know without a doubt that exercise is good for older adults, that it reduces the risk of heart problems, strengthens bones, improves mood and can have other positive effects – and there is some speculation that it also improves cognitive function could,” said the study’s first author, Eric J. Lenze, MD, Wallace and Lucille Renard Professor and chief of the Department of Psychiatry at Washington University.
“Likewise, mindfulness training is beneficial because it reduces stress and stress can be bad for your brain. So we hypothesized that there might be cognitive benefits from older adults exercising regularly, practicing mindfulness, or both—but we didn’t find that.”
Lenze and his colleagues still want to see if there might be some cognitive effects over a longer period of time, so they plan to study this group of older adults further to see if exercise and mindfulness could help prevent future cognitive decline. However, in this study, the practices did not increase cognitive function.
“So many older adults are concerned about memory,” said senior author Julie Wetherell, Ph.D., professor of psychiatry at UC San Diego.
“It is important for studies like ours to 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 had concerns about minor memory problems and other age-related cognitive impairments.
“Minor memory problems are often thought of as a normal part of aging, but it’s also normal for people to worry when they notice these problems,” said Lenze, who also directs Washington University’s Healthy Mind Lab.
“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 curious to see if exercise and mindfulness provide a cognitive boost of the same.” way that other aspects could offer health.”
All study participants were considered cognitively normal for their age. The researchers tested them when they enrolled in the study by measuring memory and other aspects of thinking. They also performed imaging scans of the brain.
Participants were randomly assigned to one of four groups: a group in which volunteers worked with trained trainers; a group mentored by trained experts in the practice of mindfulness; a group that participated in regular movement and mindfulness training; and a group that did neither, but met for occasional sessions focused on general health education issues. Researchers performed memory tests and follow-up brain scans at six months and again at 18 months.
At six months and again at 18 months, all groups looked similar. All four groups performed slightly better on the tests, but the researchers believe this was due to practice effects, as study participants repeated similar tests as before. Likewise, the brain scans showed no differences between the groups that would indicate a brain benefit from the exercise.
Lenze said the study’s findings don’t mean that exercise or mindfulness training doesn’t help improve cognitive functioning in older adults, just that these practices don’t appear to increase cognitive functioning in healthy people without disabilities.
“We don’t say ‘don’t do exercises’ or ‘don’t do mindfulness,'” explained Lenze.
“But we thought we might find a cognitive advantage in these older adults. We are not. On the other hand, we did not examine whether exercise or mindfulness might benefit older adults are impaired, due to dementia or due to illnesses 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 follow up the group of adults who took part in this study.
“They’re still engaged in movement and mindfulness,” he said. “We didn’t see any improvements, but neither did cognitive performance decrease. In the next phase of the study, we will follow the same people for five more years to see if exercise and mindfulness training can help slow or prevent future cognitive decline.”
About this news from aging and cognition research
Author: Jim Dryden
Source: WUSTL
Contact: Jim Dryden—WUSTL
Picture: Image is credited to WUSTL
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Original research: Closed access.
“Effects of Mindfulness Training and Exercises on Cognitive Function in Older Adults: A Randomized Clinical Trial” by Eric J. Lenze et al. JAMA
abstract
Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial
meaning Episodic memory and executive functioning are essential aspects of cognitive function that decline with age. This decline can be ameliorated by lifestyle interventions.
objective To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improves cognitive function in older adults.
Design, setting and participants This 2 × 2 factorial randomized clinical trial was conducted at two sites in the US (Washington University in St. Louis and University of California, San Diego). A total of 585 older adults (65-84 years) with subjective cognitive problems but not dementia were randomized (enrollment November 19, 2015 to January 23, 2019; last follow-up March 16, 2020).
interventions Participants were randomized to undergo the following interventions: MBSR with a goal of 60 minutes of daily meditation (n=150); Training with aerobic, strength, and functional components with a goal of at least 300 minutes per week (n = 138); combined MBSR and exercise (n=144); or a health education control group (n=153). The interventions lasted 18 months and consisted of group-based classes and homework.
Main results and actions The 2 primary endpoints were composites of episodic memory and executive functioning (standardized to a mean [SD] from 0 [1]; higher composite scores indicate better cognitive performance) from neuropsychological tests; the primary endpoint was 6 months and the secondary endpoint was 18 months. There were 5 reported secondary endpoints: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns.
Results Among 585 randomized participants (mean age 71.5 years; 424 [72.5%] women), 568 (97.1%) completed the study over 6 months and 475 (81.2%) over 18 months. At 6 months, there was no significant effect of mindfulness training or exercises on episodic memory (MBSR vs. no MBSR: 0.44 vs. 0.48; mean difference -0.04 points [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 points [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 were no intervention effects at the secondary endpoint of 18 months. There was no significant interaction between mindfulness training and exercises (P= 0.93 for memory and P= .29 for executive function) after 6 months. Of the 5 predefined secondary endpoints, none showed significant improvement with any of the interventions compared to those who did not receive the intervention.
Conclusions and Relevance In older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive functioning at 6 months. The results do not support the use of these interventions to improve cognition in older adults with subjective cognitive concerns.
test registration ClinicalTrials.gov Identifier: NCT02665481
