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JAMA Dec 2022Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable 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, SETTING, AND PARTICIPANTS
This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020).
INTERVENTIONS
Participants were randomized to undergo the following interventions: MBSR with a target of 60 minutes daily of meditation (n = 150); exercise with aerobic, strength, and functional components with a target of at least 300 minutes weekly (n = 138); combined MBSR and exercise (n = 144); or a health education control group (n = 153). Interventions lasted 18 months and consisted of group-based classes and home practice.
MAIN OUTCOMES AND MEASURES
The 2 primary outcomes were composites of episodic memory and executive function (standardized to a mean [SD] of 0 [1]; higher composite scores indicate better cognitive performance) from neuropsychological testing; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: 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 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 points [95% CI, -0.15 to 0.07]; P = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, -0.04 to 0.17]; P = .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 = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, -0.03 to 0.18]; P = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (P = .93 for memory and P = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention.
CONCLUSIONS AND RELEVANCE
Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02665481.
Topics: Aged; Female; Humans; Male; Cognition; Executive Function; Exercise; Meditation; Mindfulness; Memory, Episodic; Exercise Therapy; Cognitive Aging; Healthy Lifestyle; Health Behavior; Stress, Psychological; Aged, 80 and over; Neuropsychological Tests; Cognitive Dysfunction; Magnetic Resonance Imaging
PubMed: 36511926
DOI: 10.1001/jama.2022.21680 -
Cell Reports. Medicine Jan 2023Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study... (Randomized Controlled Trial)
Randomized Controlled Trial
Controlled breathwork practices have emerged as potential tools for stress management and well-being. Here, we report a remote, randomized, controlled study (NCT05304000) of three different daily 5-min breathwork exercises compared with an equivalent period of mindfulness meditation over 1 month. The breathing conditions are (1) cyclic sighing, which emphasizes prolonged exhalations; (2) box breathing, which is equal duration of inhalations, breath retentions, and exhalations; and (3) cyclic hyperventilation with retention, with longer inhalations and shorter exhalations. The primary endpoints are improvement in mood and anxiety as well as reduced physiological arousal (respiratory rate, heart rate, and heart rate variability). Using a mixed-effects model, we show that breathwork, especially the exhale-focused cyclic sighing, produces greater improvement in mood (p < 0.05) and reduction in respiratory rate (p < 0.05) compared with mindfulness meditation. Daily 5-min cyclic sighing has promise as an effective stress management exercise.
Topics: Humans; Meditation; Affect; Anxiety; Respiration; Arousal
PubMed: 36630953
DOI: 10.1016/j.xcrm.2022.100895 -
JMIR MHealth and UHealth Jun 2019College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
College students experience high levels of stress. Mindfulness meditation delivered via a mobile app may be an appealing, efficacious way to reduce stress in college students.
OBJECTIVE
We aimed to test the initial efficacy and sustained effects of an 8-week mindfulness meditation mobile app-Calm-compared to a wait-list control on stress, mindfulness, and self-compassion in college students with elevated stress. We also explored the intervention's effect on health behaviors (ie, sleep disturbance, alcohol consumption [binge drinking], physical activity, and healthy eating [fruit and vegetable consumption]) and the feasibility and acceptability of the app.
METHODS
This study was a randomized, wait-list, control trial with assessments at baseline, postintervention (8 weeks), and at follow-up (12 weeks). Participants were eligible if they were current full-time undergraduate students and (1) at least 18 years of age, (2) scored ≥14 points on the Perceived Stress Scale, (3) owned a smartphone, (4) were willing to download the Calm app, (5) were willing to be randomized, and (7) were able to read and understand English. Participants were asked to meditate using Calm at least 10 minutes per day. A P value ≤.05 was considered statistically significant.
RESULTS
A total of 88 participants were included in the analysis. The mean age (SD) was 20.41 (2.31) years for the intervention group and 21.85 (6.3) years for the control group. There were significant differences in all outcomes (stress, mindfulness, and self-compassion) between the intervention and control groups after adjustment for covariates postintervention (all P<.04). These effects persisted at follow-up (all P<.03), except for the nonreacting subscale of mindfulness (P=.08). There was a significant interaction between group and time factors in perceived stress (P=.002), mindfulness (P<.001), and self-compassion (P<.001). Bonferroni posthoc tests showed significant within-group mean differences for perceived stress in the intervention group (P<.001), while there were no significant within-group mean differences in the control group (all P>.19). Similar results were found for mindfulness and self-compassion. Effect sizes ranged from moderate (0.59) to large (1.24) across all outcomes. A significant group×time interaction in models of sleep disturbance was found, but no significant effects were found for other health behaviors. The majority of students in the intervention group reported that Calm was helpful to reduce stress and stated they would use Calm in the future. The majority were satisfied using Calm and likely to recommend it to other college students. The intervention group participated in meditation for an average of 38 minutes/week during the intervention and 20 minutes/week during follow-up.
CONCLUSIONS
Calm is an effective modality to deliver mindfulness meditation in order to reduce stress and improve mindfulness and self-compassion in stressed college students. Our findings provide important information that can be applied to the design of future studies or mental health resources in university programs.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03891810; https://clinicaltrials.gov/ct2/show/NCT03891810.
Topics: Adolescent; Female; Humans; Male; Meditation; Mindfulness; Mobile Applications; Personal Satisfaction; Stress, Psychological; Students; Universities; Young Adult
PubMed: 31237569
DOI: 10.2196/14273 -
International Journal of Environmental... Nov 2019The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of... (Meta-Analysis)
Meta-Analysis
The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of this study is to review the scientific literature in order to analyze the effect produced by cognitive-behavioral programs and meditation strategies on stress, anxiety, and depression in students. A further aim is to identify the determinants of treatment success. The bibliographic search was carried out using Web of Science, specifically in the categories of "Education and Educational Research" and "Psychology", obtaining a sample of 122 articles published between 2007 and 2018. Studies were included which had a pre-experimental or quasi-experimental design and included pre-test and post-test phases. Following application of inclusion criteria, 34 articles were selected for inclusion in a meta-analysis of the random effects of each variable. This obtained an average effect size of -0.41 for stress, -0.37 for anxiety, and -0.30 for depression. Three moderating variables were analyzed, with significant correlations being found for the type of treatment relating to stress (Q = 11.01, df = 2, = 0.004, R = 0.294) and depression (Q = 6.14, df = 2, = 0.048; R = 0.436). The stage of education of the individuals was also found to impact upon anxiety intervention success (Q = 13.093 df = 2, = 0.0009, R = 0.196). Interventions mainly addressed the importance of meditation strategies, mindfulness programs, and cognitive-behavioral therapy to reduce stress, anxiety, and depression in students. This supports the need to increase research at an early age, considering the treatment of mental health as a key factor influencing academic performance and quality of life.
Topics: Adolescent; Anxiety; Child; Cognitive Behavioral Therapy; Depression; Female; Humans; Male; Meditation; Mental Health; Mindfulness; Quality of Life; Stress, Psychological; Students; Treatment Outcome; Young Adult
PubMed: 31717682
DOI: 10.3390/ijerph16224394 -
Frontiers in Bioscience (Scholar... Mar 2020Here, we review the neurophysiological and neuroimaging changes that mediation induces in structural and functional MRI. The available evidence from structural studies... (Review)
Review
Here, we review the neurophysiological and neuroimaging changes that mediation induces in structural and functional MRI. The available evidence from structural studies suggests that mediation impacts neuronal plasticity and the functional MRI suggest that there are changes in gray and white matter in subjects who meditate. FMRI studies show that meditation is associated with decreased activity of default mode network and activation of brain regions involved in cognitive and emotional control. Together, the available imaging techniques have revealed that rather than impacting specific brain regions, meditation causes structural and functional changes in large-scale brain networks.
Topics: Brain; Brain Mapping; Humans; Magnetic Resonance Imaging; Meditation; Neuroimaging
PubMed: 32114450
DOI: 10.2741/S542 -
Archives of Clinical Neuropsychology :... Oct 2021Theoretical models of mindfulness meditation conceptualize the cultivation of focused attention and regulation of emotional states, with the attitudinal foundations that... (Review)
Review
OBJECTIVE
Theoretical models of mindfulness meditation conceptualize the cultivation of focused attention and regulation of emotional states, with the attitudinal foundations that promote nonjudgment and acceptance, to facilitate cognitive and affective processing resulting in improved brain health. Within the scientific study of mindfulness meditation, outcomes assessing behavioral and neural correlates of attentional control and emotion regulation have been examined for their malleability as a function of engagement in mindfulness practices. This review synthesizes the results of our pilot trials examining the preliminary effects of mindfulness meditation on metrics of cognitive, affective, and brain health in older adults and in individuals with multiple sclerosis.
CONCLUSIONS
There is promising support for mindfulness meditation to enhance attentional control, reduce mind-wandering, and reduce emotion dysregulation. However, well-powered efficacy trials, with an objective assessment of mindfulness practice data are needed to further provide causal and comprehensive evidence supporting the efficacy of mindfulness meditation for brain health. Inclusion of independently derived and validated brain-based signatures of cognitive and affective functioning can additionally enable a parsimonious understanding of how mindfulness meditation can causally impact metrics of functional and structural integrity of the human brain.
Topics: Aged; Attention; Emotions; Humans; Meditation; Mindfulness; Neuropsychological Tests
PubMed: 34651648
DOI: 10.1093/arclin/acab053 -
Mindfulness meditation increases default mode, salience, and central executive network connectivity.Scientific Reports Aug 2022Recent research has begun to identify the neural mechanisms underlying the beneficial impact of mindfulness meditation training (MMT) on health and cognition. However,... (Clinical Trial)
Clinical Trial
Recent research has begun to identify the neural mechanisms underlying the beneficial impact of mindfulness meditation training (MMT) on health and cognition. However, little is known about the effects of MMT on the global interplay of large-scale networks (LSNs) in the brain. In the present study, healthy, meditation-naïve adults (N = 46) underwent resting state fMRI prior to and upon completing 31 days of MMT or an active control intervention. Independent component analysis, sliding time window, and seed-based correlation analyses were performed to assess training-related changes in functional connectivity (FC) within and between networks with relevance to mindfulness meditation. Across sliding time window analyses and seed-based correlation analyses, we found increased FC between nodes of the default mode network (DMN) and nodes of the salience network (SN) in participants of the MMT. Seed-based correlation analyses revealed further connectivity increases between the SN and key regions of the central executive network (CEN). These results indicate, that, among multiple LSNs, one month of mindfulness meditation effectively increases interconnectivity between networks of the triple network model (DMN, SN, CEN), hereby introducing a potential mechanistic concept underlying the beneficial impact of MMT.Clinical trial registration: This study is listed as a clinical trial on the ISRCTN registry with trial ID ISRCTN95197731 (date of first registration: 15/02/2022).
Topics: Adult; Brain; Brain Mapping; Humans; Magnetic Resonance Imaging; Meditation; Mindfulness; Nerve Net
PubMed: 35918449
DOI: 10.1038/s41598-022-17325-6 -
Journal of Affective Disorders Sep 2021Prenatal depression affects 20.7 percent of women worldwide, which was associated with preterm birth, low birth weight and Apgar score, as well as cognitive, emotional... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prenatal depression affects 20.7 percent of women worldwide, which was associated with preterm birth, low birth weight and Apgar score, as well as cognitive, emotional and behavioral development disorders. We conducted a systematic review and meta-analysis to retrieve the latest and best evidence about music, massage, yoga and exercise in the prevention and treatment of prenatal depression, and to preliminarily compare the four methods to explore the most effective means. We also compared different types of yoga and music, in order to find the most effective type of intervention.
METHODS
A comprehensive literature search was carried out through six databases on randomized controlled trials (RCTs). Effects were summarized by a random effects model using mean differences with 95% confidence intervals. Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.
RESULTS
This research found low to very low evidence that yoga, exercise, music and massage could reduce antenatal depression. Among them, music may be the most effective intervention, and integrated yoga other than simple yoga would improve prenatal depression. The effect of Chinese Medicine Five Element Music may be better than ordinary music.
CONCLUSION
It is important to support prenatal depression patients to make informed decisions about their behavior therapy.
Topics: Depression; Female; Humans; Infant, Newborn; Massage; Meditation; Music; Pregnancy; Yoga
PubMed: 34147972
DOI: 10.1016/j.jad.2021.05.122 -
General Hospital Psychiatry 2021The objective of this study was to 1) determine the effects of a meditation app on depression and anxiety in adults with sleep disturbance, and 2) explore the potential... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The objective of this study was to 1) determine the effects of a meditation app on depression and anxiety in adults with sleep disturbance, and 2) explore the potential mediating effects of fatigue, daytime sleepiness, and pre-sleep arousal on the relationship between use of the meditation app and changes in depression and anxiety.
METHODS
Participants were 239 adults with elevated insomnia symptoms (i.e., scores ≥ 10 on the Insomnia Severity Index) and limited or no previous experience with meditation. Depression, anxiety, fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, four weeks, and eight weeks. Repeated-measures ANCOVAs assessed intervention effects on depression and anxiety. Mediation models were estimated using the PROCESS macro.
RESULTS
Participants in the meditation group had more improvement in depression and anxiety symptoms during the intervention period than did those in the control group. Changes in somatic and cognitive pre-sleep arousal at mid-intervention fully mediated effects on depression and partially mediated effects on anxiety. There were no significant indirect effects of fatigue and daytime-sleepiness on changes in mental health.
CONCLUSIONS
A meditation app may improve depression and anxiety in adults with sleep disturbance, with effects being driven by improvements in pre-sleep arousal. Future studies should consider targeting pre-sleep arousal to improve mental health in this population.
Topics: Adult; Anxiety; Depression; Humans; Meditation; Mindfulness; Mobile Applications; Sleep
PubMed: 34537477
DOI: 10.1016/j.genhosppsych.2021.09.004 -
Alzheimer's & Dementia : the Journal of... Feb 2021Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks... (Review)
Review
INTRODUCTION
Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results.
METHODS
In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System.
RESULTS
Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols.
DISCUSSION
We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.
Topics: Aging; Cognitive Behavioral Therapy; Dementia; Exercise; Humans; Meditation; Music Therapy
PubMed: 33215876
DOI: 10.1002/alz.12188