Effect of an 18-Month Meditation Training on Regional Brain Volume and Perfusion in Older Adults

Abstract

ImportanceNo lifestyle-based randomized clinical trial directly targets psychoaffective risk factors of dementia. Meditation practices recently emerged as a promising mental training exercise to foster brain health and reduce dementia risk.ObjectiveTo investigate the effects of meditation training on brain integrity in older adults.Design, Setting, and ParticipantsAge-Well was a randomized, controlled superiority trial with blinded end point assessment. Community-dwelling cognitively unimpaired adults 65 years and older were enrolled between November 24, 2016, and March 5, 2018, in France. Participants were randomly assigned (1:1:1) to (1) an 18-month meditation-based training, (2) a structurally matched non-native language (English) training, or (3) no intervention arm. Analysis took place between December 2020 and October 2021.InterventionsMeditation and non-native language training included 2-hour weekly group sessions, practice of 20 minutes or longer daily at home, and 1-day intensive practices.Main Outcomes and MeasuresPrimary outcomes included volume and perfusion of anterior cingulate cortex (ACC) and insula. Main secondary outcomes included a global composite score capturing metacognitive, prosocial, and self-regulatory capacities and constituent subscores.ResultsAmong 137 participants (mean [SD] age, 69.4 [3.8] years; 83 [60.6%] female; 54 [39.4%] male) assigned to the meditation (n = 45), non-native language training (n = 46), or no intervention (n = 46) groups, all but 1 completed the trial. There were no differences in volume changes of ACC (0.01 [98.75% CI, −0.02 to 0.05]; P = .36) or insula (0.01 [98.75% CI, −0.02 to 0.03]; P = .58) between meditation and no intervention or non-native language training groups, respectively. Differences in perfusion changes did not reach statistical significance for meditation compared with no intervention in ACC (0.02 [98.75% CI, −0.01 to 0.05]; P = .06) or compared with non-native language training in insula (0.02 [98.75% CI, −0.01 to 0.05]; P = .09). Meditation was superior to non-native language training on 18-month changes in a global composite score capturing attention regulation, socioemotional, and self-knowledge capacities (Cohen d, 0.52 [95% CI, 0.19-0.85]; P = .002).Conclusions and RelevanceThe study findings confirm the feasibility of meditation and non-native language training in elderly individuals, with high adherence and very low attrition. Findings also show positive behavioral effects of meditation that were not reflected on volume, and not significantly on perfusion, of target brain areas.Trial RegistrationClinicalTrials.gov Identifier: NCT02977819

Exposure to negative socio-emotional events induces sustained alteration of resting-state brain networks in older adults

“…For the primary outcome of the Agewell RCT, an effect size of 0.75 per comparison was targeted, with 80% power and a two-sided type I error of 1.25% (Bonferroni correction for test multiplicity), resulting in a total of 126 participants needing to be included. The final number of participants in the Age-Well RCT (n = 137) was higher than the required minimum of 126 participants 70,71 . Sensitivity analyses then indicated that the final sample included in experiment 2 (n = 127) was reliable and sensitive enough to detect small-to medium-sized effects at a voxel level (α = 0.001, effect size of dz = 0.37), given a power of 1 − ß = 0.8 (ref.…”

“…Participants were recruited via advertising in media outlets, social media and flyers distributed at relevant local events and locations. Two participants were excluded for eligibility criteria and intervention allocation issues 71 . A total of 8 participants were excluded from the final data analysis due to a priori exclusion criteria, including abnormal brain morphology (n = 3), extreme head motion (n = 3) and presence of artifacts in brain images (n = 2).…”

“…The final sample for experiment 2 included N = 127 participants. Two participants were excluded for eligibility criteria and intervention allocation issues 71 . Eight participants were excluded from the final data analysis due to a priori exclusion criteria: abnormal brain morphology (n = 3), extreme head motion (n = 3) and presence of artifacts in brain images (n = 2).…”

The impact of dance movement interventions on psychological health in older adults without dementia: A systematic review and meta-analysis

“…As guiding principles, such intervention programs should 1. specifically aim to promote mental health and wellbeing in the elderly, 2. be easily accessible by implementation into onsite/online settings (Rugh et al, 2022) and 3. tailored to the specific needs of clinical/nonclinical older populations (Chao et al, 2021; Esmail et al, 2020). For example, the incorporation of dance/movement therapy, mindful movement practices and psychotherapeutic factors into targeted DMI programs for older people might promote mental capacities, such as creativity, positive thinking and mindfulness, that have far-reaching benefits for the brain, cognitive and mental health in older age (e.g., Chételat et al, 2022; Demnitz-King et al, 2022; Marchant et al, 2021; Whitfield et al, 2021). Mastering new skills including creative dance movements could improve self-efficacy in elders, which in turn may increase sense of mastery and autonomy as essential coping factors with regard to age-related conditions (Fancourt and Finn, 2019; Gerino et al, 2017).…”

“…As guiding principles, such intervention programs should 1. specifically aim to promote mental health and wellbeing in the elderly, 2. be easily accessible by implementation into onsite/online settings (Rugh et al, 2022) and 3. tailored to the specific needs of clinical/nonclinical older populations (Chao et al, 2021;Esmail et al, 2020). For example, the incorporation of and mindfulness, that have far-reaching benefits for the brain, cognitive and mental health in older age (e.g., Chételat et al, 2022;Demnitz-King et al, 2022;Marchant et al, 2021;Whitfield et al, 2021).…”