Does mindfulness training, exercise, or both improve cognitive function in older adults who have subjective cognitive concerns but no dementia?
This study found no benefit of MBSR training, exercise, or a combination of both for improving cognitive function in older adults with subjective cognitive concerns but no dementia. Physical performance, including aerobic fitness and strength, as well as sleep quality significantly improved with exercise. MBSR did not significantly influence any independent variables, including self-reported mindfulness.
Plan de l'etude:
Randomized controlled trial (double-blinded)
The health benefits of mindfulness meditation have been enthusiastically communicated by national speakers and workshops for decades. These investigators identified 585 community-dwelling adults, aged 65 to 84 years, who responded positively to questions about whether they or others had noticed trouble with their memory. Eligible participants showed no cognitive impairment consistent with dementia on a standardized scoring tool. Study participants randomly received assignment (allocation concealed) to 1 of 4 intervention groups: (1) Mindfulness-based stress reduction (MBSR) alone, (2) exercise alone, (3) combined MBSR and exercise, or (4) health education (control). All interventions occurred for 18 months. The MBSR intervention consisted of 8 weekly 2.5-hour classes plus a half-day retreat on MBSR meditation practices and enhancement exercises, followed by 12 months of maintenance once-per-month MBSR classes. The exercise intervention consisted of facility-based, instructor-supervised 1.5-hour classes twice weekly for 6 months, followed by once-per-week classes for the 12-month maintenance period. Exercise sessions focused on aerobics, resistance training, and functional exercises with the goal of at least 300 minutes per week. The health education intervention consisted of classes with the same time commitment as the MBSR intervention but without any specific goals other than general information on living with chronic health conditions. Individuals who assessed outcomes remained masked to treatment group assignments. The primary outcomes were episodic memory and executive function assessed using previously validated scoring tools. Follow-up occurred for 93% of participants at 18 months.
Using intention-to-treat analysis, no significant group differences occurred for either of the primary outcomes at 6 months or 18 months. Physical performance, including aerobic fitness and strength, as well as sleep quality significantly improved with exercise. MBSR did not significantly influence any independent variables, including self-reported mindfulness.
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Professor of Family Medicine, UNC Chapel Hill