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Neither mindfulness training nor exercise improve memory or executive function in older adults
Clinical Question
Does mindfulness training, exercise, or both improve cognitive function in older adults who have subjective cognitive concerns but no dementia?
Bottom line
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. 1b
Reference
Study design: Randomized controlled trial (double-blinded)
Funding: Government
Setting: Population-based
Synopsis
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.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
Mild cognitive impairment
Important negative finding
Memory
I need to look more closely at the study. The problem I see in the design or reporting is that there was no assessment of adherence to the interventions. All of these measures need to be practiced regularly. In my experience the desire to change is not followed through with regular practice.
low dose exercise
The study used exercise sessions only times a week. If I was training to run 1/2 marathon or anything else, exercising twice a week will not be enough - Is it possible that in this study the amount of exercise was sub-optimal to obtain benefits in subjects with cognitive impairment? A type I error due to design failure? WE need better studies to reject the hypothesis.
Mindfullness, exercise do little to improve cognition in th
Important to know cognition not improved with exercise.
MBSR
This is a troubling outcome which challenges standard advice for decades. I am very concerned and we need replication to know how to move forward.
Impact assessment
Very good