Mindfulness training, exercise of little benefit to patients with subjective cognitive concerns

Interventions that consist of mindfulness training, exercise, or both do not seem to produce any improvements in episodic memory or executive function at 6 months among older adults with subjective cognitive concerns, according to a study.

The study randomized 585 older adults (mean age 71.5 years, 72.5 percent women) with subjective cognitive concerns, except dementia, to undergo the following interventions: mindfulness-based stress reduction (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). These interventions lasted 18 months and comprised group-based classes and home practice.

Researchers examined the effect of the interventions in terms of the 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. These primary endpoints were measured at 6 months.

Secondary endpoints included hippocampal volume and dorsolateral prefrontal cortex thickness and surface area (measured on structural magnetic resonance imaging), functional cognitive capacity, and self-reported cognitive concerns at 18 months.

Of the patients, 568 (97.1 percent) completed 6 months in the trial and 475 (81.2 percent) completed 18 months. At 6 months, neither mindfulness training nor exercise yielded significant effects on episodic memory (MBSR vs no MBSR: mean difference, –0.04 points; p=0.50; exercise vs no exercise: difference, 0.07; p=0.23) and executive function (MBSR vs no MBSR: mean difference, 0.08 points; p=0.12; exercise vs no exercise: difference, 0.07; p=0.17).

Of note, there was no significant interaction between mindfulness training and exercise for the outcomes of memory (p=0.93) and executive function (p=0.29) at 6 months.

None of the secondary outcomes showed a significant improvement with the experimental interventions at 18 months.

The present data do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns.