Mindfulness training, exercise may not help subjective cognitive concerns

Older adults with subjective cognitive concerns who engaged in mindfulness-based stress reduction (MBSR) training, exercise, or a combination of the two did not improve cognitive function. Medex (mindfulness, education, exercise) clinical trials have shown.

Adults aged 65 years and older were randomly assigned to one of four groups. Get at least 300 minutes of exercise per week that combines aerobic, strength, and functional components. A combination of MBSR and exercise. His Eric Lenze, M.D., Ph.D., and colleagues at the Washington University School of Medicine in St. Louis, reported that a control group that received only health education showed significant differences in the primary outcomes of improved episodic memory or executive function at six months. I didn’t.of jam.

Neither intervention had a significant effect on episodic memory at 6 months.

• MBSR vs. No MBSR: Memory composite score of 0.44 vs. 0.48. Mean difference –0.04 points (95% CI –0.15 to 0.07, P.=0.50)
• Exercise vs. No Exercise: Scores of 0.49 vs. 0.42. Difference 0.07 points (95% CI –0.04 to 0.17, P.=0.23)

Similarly, for the 6-month running feature:

• 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 points (95% CI –0.03 to 0.18, P.=0.17)

There was no significant interaction between mindfulness training and exercise (P.=0.93 memory and P.=0.29 executive function) for 6 months.

No intervention effects were observed on memory for executive function at 18 months or on other secondary endpoints including MRI structural changes in bilateral hippocampal volume, bilateral dorsolateral prefrontal cortex (DLPFC) surface area and cortical thickness. did not.

said Ipsit Vahia, M.D., associate chief of geriatric psychiatry at McLean Hospital in Belmont, Massachusetts. I am involved in research.

The study “challenges commonly held assumptions about the universal benefits of lifestyle interventions and tailors interventions for older adults so that general health, mood, and cognition are taken into account.” It emphasizes the importance of things,” Vahia said. MedPage Today“This insight represents an important advance in clinical practice.”

“The study did not include people with symptoms such as depression or anxiety, both of whom have been shown to respond well to both mindfulness and exercise. , we know that cognition influences each other, but the exact nature of these interactions is not well understood,” added Vahia.

Lenze and co-authors identified a relatively homogeneous study population of predominantly Caucasian college-educated participants, which limits generalizability, and the hippocampus as a proxy for brain health and other potentially more sensitive brain health. and noted limitations to their study, including focusing on the structural features of DLPFC. ,end point.

“These invalid results differ from positive results in some randomized clinical trials. exercise and epidemiological data suggesting that exercise is associated with improvement cognition and brain health in older adults, and the limited literature supporting the beneficial role of the brain. mindfulness’” wrote the researcher.

They noted that one possible explanation for this could be the lack of robust negative controls, given that all interventions, including health education, benefited participants equally.

“For exercise interventions, physiological and performance changes suggest that participants benefited from exercise. Lifestyle interventions and independence for the study of the elderly, “Twenty-four months of exercise showed a beneficial effect on disability prevention, but no effect on cognitive performance,” Lenze and co-authors said.

A subgroup analysis of participants who showed the greatest improvement in several physiological and performance measures found that “even if the intervention resulted in beneficial changes in these putative mechanisms, it still did not lead to significant cognitive benefits.” It was shown that

Lenze and colleagues used a 2 × 2 factorial design to randomize 585 community-dwelling older adults with self-reported subjective cognitive problems (not dementia) in an 18-month trial. I made it artificial. The average age in this study was his 71.5 years and the average education level her 16.2 years. 72.5% of participants were female.

The study was conducted at two US sites from November 2015 to January 2019, with a final follow-up in March 2020. During the first 6 months, the participant had a median attendance of 90% in his MBSR classes and 83.3% in his exercise classes. Overall, 97.1% of his participants completed his 6-month assessment and 81.2% completed his 18-month assessment.