Mindfulness, Education, and Exercise for age-related cognitive decline: Study protocol, pilot study results, and description of the baseline sample

Abstract

Background/Aims Age-related cognitive decline is a pervasive problem in our aging population. To date, no pharmacological treatments to halt or reverse cognitive decline are available. Behavioral interventions, such as physical exercise and Mindfulness-Based Stress Reduction, may reduce or reverse cognitive decline, but rigorously designed randomized controlled trials are needed to test the efficacy of such interventions. Methods Here, we describe the design of the Mindfulness, Education, and Exercise study, an 18-month randomized controlled trial that will assess the effect of two interventions—mindfulness training plus moderate-to-vigorous intensity exercise or moderate-to-vigorous intensity exercise alone—compared with a health education control group on cognitive function in older adults. An extensive battery of biobehavioral assessments will be used to understand the mechanisms of cognitive remediation, by using structural and resting state functional magnetic resonance imaging, insulin sensitivity, inflammation, and metabolic and behavioral assessments. Results We provide the results from a preliminary study (n = 29) of non-randomized pilot participants who received both the exercise and Mindfulness-Based Stress Reduction interventions. We also provide details on the recruitment and baseline characteristics of the randomized controlled trial sample (n = 585). Conclusion When complete, the Mindfulness, Education, and Exercise study will inform the research community on the efficacy of these widely available interventions improve cognitive functioning in older adults.

Exploring Effects of Aerobic Exercise and Mindfulness Training on Cognitive Function in Older Adults at Risk of Dementia: A Feasibility, Proof-of-Concept Study

“…4 Future studies should consider a longer duration of the AT and more accessible forms of aerobic exercise (e.g., neighborhood walking), especially considering recent findings that light aerobic exercise increases brain volume. 26 To our knowledge, there is only 1 (ongoing) study exploring effects of MT and AT on cognitive function, 27 and thus, the literature does not offer many insights. A 2 × 2 RCT of cognitive training and aerobic activity found no differences between groups, but used a very active control condition, 11 while a small RCT suggested that combined aerobic and cognitive training could lead to larger effects than either intervention alone.…”

A pilot randomized sham controlled trial of bilateral iTBS for depression and executive function in older adults

“…Functional MRI data were processed following methods described by Raut et al 41 . Briefly, the preprocessing reduced slice and time dependent intensity artifacts and noise, standardized the whole brain intensity to mode value of 1000, corrected for within‐run head movement, and registered the data to a standardized space using an Atlas generated from 208 subjects from the MEDEX study 39 which used an identical protocol on the same scanner model. Multi‐echo data were analyzed by least squares fitting of the theoretical model defined in equation 1 in Poser et al 42 .…”

“…Functional MRI data were processed following methods described by Raut et al 41 Briefly, the preprocessing reduced slice and time dependent intensity artifacts and noise, standardized the whole brain intensity to mode value of 1000, corrected for within-run head movement, and registered the data to a standardized space using an Atlas generated from 208 subjects from the MEDEX study 39 which used an identical protocol on the same scanner model. Multi-echo data were analyzed by least squares fitting of the theoretical model defined in equation 1 in Poser et al 42 The fitted data then were converted to synthetic T2*-weighted images evaluated at TE = 30 ms. Nuisance regression was performed using white matter and ventricle segmentation generated from FreeSurfer acquisition, the mean video BOLD response averaged over all participants was subtracted from each subject time series.…”

Mobile survey engagement by older adults is high during multiple phases of the COVID-19 pandemic and is predicted by baseline and structural factors

“…Ninety-five community-dwelling older aged adults (67–87 years) were included in the StayWELL study. All had previously participated in the Mindfulness, Education, and Exercise (MEDEX) study ( 27 ) and were concurrently enrolled in an extension trial. The MEDEX study was a now-concluded 18-month randomized controlled trial to assess the effects of in-person interventions, which included three active treatments, i.e.…”