Background The primary focus of mindfulness‐based program (MBP) research to date has been on mental health. More recently, attention has turned to putative effects on cognition. An evidence synthesis is required to answer the key question of ‘Do MBPs confer cognitive benefit, and if so, for whom?’ A particularly crucial distinction is whether benefits differ according to individuals’ age. We undertook a systematic review and meta‐analysis of all relevant research across the adult lifespan. Method This review was conducted according to PRISMA guidelines, registered on Prospero (#CRD42018100904), and conducted searches of 7 databases. Included studies must have used a group‐based MBP, randomized participants to conditions, and used objective cognitive outcome measures. Two independent researchers assessed studies against criteria, extracted data and rated study quality. Meta‐analyses used robust variance estimation to assess overall effects. Result Forty‐six studies were included in the systematic review, and 38 contributed effect sizes for meta‐analysis (see figure). Across the studies included in the meta‐analysis, the cognitive domains most frequently assayed were executive function (66 outcomes) and attention (60 outcomes). All outcome measures were pooled for analysis. The studies of working‐age adults (18‐65 years old; k=28) included healthy, psychiatric and neurological samples (k=16 passively controlled studies; k=12 actively controlled studies). Studies of older adults (>65 years old; k=10) included healthy persons, and patients with subjective and objective cognitive impairment (k=7 passively controlled studies; k=3 actively controlled studies). When combining healthy and clinical studies of working‐age adults, meta‐analysis yielded a non‐significant pooled effect of MBP participation on cognitive performance compared to control conditions (g=0.28, p=.14; see table). A significant pooled effect was observed for the studies featuring older adults (g=0.27, p<.05; see table). Conclusion The current review assessed the effects of MBPs relative to control conditions on cognitive performance in adults across the lifespan, and found evidence of a significant positive effect for older adults only. No evidence of a benefit for younger populations was identified. As research in this fast‐developing field continues, it will be possible to examine whether effects vary according to healthy or clinical status, and to establish whether specific cognitive domains are differentially impacted.
Regular musical activity as a highly-stimulating lifestyle activity is proposed to be protective against age-related cognitive decline and Alzheimer's disease (AD). This study investigated associations between lifelong regular musical instrument playing, late-life cognitive abilities and brain morphology in older adults. We show that musical activity over the life course is associated with better global cognition, working memory, executive functions, language, and visuospatial abilities accounting for reserve proxies. Playing music is not significantly associated with gray matter volume in regions most affected by aging and AD. Selectively in the musically active participants, multi-domain cognitive abilities were enhanced with preserved gray matter volume in frontal and temporal regions. Our correlational findings suggest that playing a musical instrument may improve the recruitment of existing brain resources to facilitate late-life cognitive capacities. We propose that engaging in regular musical activity could serve as a low-threshold multimodal enrichment strategy that may promote cognitive resilience in advanced age.
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