{"doi":"10.1001/jama.2022.21680","title":"Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults","abstract":"<jats:sec><jats:title>Importance</jats:title><jats:p>Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from  November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020).</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Participants were randomized to undergo the following interventions: 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). Interventions lasted 18 months and consisted of group-based classes and home practice.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The 2 primary outcomes were 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; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, –0.04 points [95% CI, –0.15 to 0.07]; <jats:italic>P</jats:italic> = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, –0.04 to 0.17]; <jats:italic>P</jats:italic> = .23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 points [95% CI, –0.02 to 0.19]; <jats:italic>P</jats:italic> = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, –0.03 to 0.18]; <jats:italic>P</jats:italic> = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (<jats:italic>P</jats:italic> = .93 for memory and <jats:italic>P</jats:italic> = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT02665481\">NCT02665481</jats:ext-link></jats:p></jats:sec>","journal":"JAMA","year":2022,"id":594833,"datarank":0.7555428903620446,"base_score":5.0369526024136295,"endowment":5.0369526024136295,"self_citation_contribution":0.7555428903620446,"citation_network_contribution":0.0,"self_endowment_contribution":0.7555428903620446,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":153,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":919948,"name":"Michelle Voegtle","orcid":null,"position":1,"is_corresponding":false},{"id":12016,"name":"J. Philip Miller","orcid":"0000-0003-4568-6846","position":2,"is_corresponding":false},{"id":226074,"name":"Beau M. Ances","orcid":"0000-0003-3862-7397","position":3,"is_corresponding":false},{"id":357687,"name":"David A. Balota","orcid":null,"position":4,"is_corresponding":false},{"id":1480606,"name":"Deanna Barch","orcid":null,"position":5,"is_corresponding":false},{"id":336752,"name":"Colin A. Depp","orcid":"0000-0002-1841-6229","position":6,"is_corresponding":false},{"id":1522918,"name":"Breno Satler Diniz","orcid":null,"position":7,"is_corresponding":false},{"id":109306,"name":"Lisa T. Eyler","orcid":"0000-0002-7783-8798","position":8,"is_corresponding":false},{"id":461127,"name":"Erin R. Foster","orcid":"0000-0003-1625-2125","position":9,"is_corresponding":false},{"id":1522923,"name":"Torie R. Gettinger","orcid":null,"position":10,"is_corresponding":false},{"id":1082450,"name":"Denise Head","orcid":"0000-0002-7069-2634","position":11,"is_corresponding":false},{"id":285667,"name":"Tamara Hershey","orcid":"0000-0001-7549-0698","position":12,"is_corresponding":false},{"id":990963,"name":"Samuel Klein","orcid":"0000-0001-5786-7113","position":13,"is_corresponding":false},{"id":754880,"name":"Jeanne F. Nichols","orcid":"0000-0003-4612-1302","position":14,"is_corresponding":false},{"id":253970,"name":"Ginger E. Nicol","orcid":"0000-0001-5823-6129","position":15,"is_corresponding":false},{"id":759653,"name":"Tomoyuki Nishino","orcid":"0000-0001-7540-6476","position":16,"is_corresponding":false},{"id":240817,"name":"Bruce W. Patterson","orcid":"0000-0001-9261-0233","position":17,"is_corresponding":false},{"id":456781,"name":"Thomas L. Rodebaugh","orcid":"0000-0001-6814-7795","position":18,"is_corresponding":false},{"id":1522926,"name":"Julie Schweiger","orcid":null,"position":19,"is_corresponding":false},{"id":196937,"name":"Joshua S. Shimony","orcid":null,"position":20,"is_corresponding":false},{"id":640338,"name":"David R. Sinacore","orcid":"0000-0002-7242-3585","position":21,"is_corresponding":false},{"id":15947,"name":"Abraham Z. Snyder","orcid":"0000-0002-3379-9627","position":22,"is_corresponding":false},{"id":1522927,"name":"Susan Tate","orcid":null,"position":23,"is_corresponding":false},{"id":675103,"name":"Elizabeth W. Twamley","orcid":"0000-0002-8693-8782","position":24,"is_corresponding":false},{"id":302268,"name":"David Wing","orcid":"0000-0003-1883-9448","position":25,"is_corresponding":false},{"id":278785,"name":"Gregory F. Wu","orcid":"0000-0003-3588-0637","position":26,"is_corresponding":false},{"id":344451,"name":"Lei Yang","orcid":"0000-0003-2009-7316","position":27,"is_corresponding":false},{"id":1522928,"name":"Michael D. Yingling","orcid":null,"position":28,"is_corresponding":false},{"id":790828,"name":"Julie Loebach Wetherell","orcid":"0000-0002-7402-3331","position":29,"is_corresponding":false},{"id":253971,"name":"Eric J. Lenze","orcid":"0000-0002-0471-9368","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults","abstract":"<jats:sec><jats:title>Importance</jats:title><jats:p>Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults.</jats:p></jats:sec><jats:sec><jats:title>Design, Setting, and Participants</jats:title><jats:p>This 2 × 2 factorial randomized clinical trial was conducted at 2 US sites (Washington University in St Louis and University of California, San Diego). A total of 585 older adults (aged 65-84 y) with subjective cognitive concerns, but not dementia, were randomized (enrollment from  November 19, 2015, to January 23, 2019; final follow-up on March 16, 2020).</jats:p></jats:sec><jats:sec><jats:title>Interventions</jats:title><jats:p>Participants were randomized to undergo the following interventions: 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). Interventions lasted 18 months and consisted of group-based classes and home practice.</jats:p></jats:sec><jats:sec><jats:title>Main Outcomes and Measures</jats:title><jats:p>The 2 primary outcomes were 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; the primary end point was 6 months and the secondary end point was 18 months. There were 5 reported secondary outcomes: hippocampal volume and dorsolateral prefrontal cortex thickness and surface area from structural magnetic resonance imaging and functional cognitive capacity and self-reported cognitive concerns.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among 585 randomized participants (mean age, 71.5 years; 424 [72.5%] women), 568 (97.1%) completed 6 months in the trial and 475 (81.2%) completed 18 months. At 6 months, there was no significant effect of mindfulness training or exercise on episodic memory (MBSR vs no MBSR: 0.44 vs 0.48; mean difference, –0.04 points [95% CI, –0.15 to 0.07]; <jats:italic>P</jats:italic> = .50; exercise vs no exercise: 0.49 vs 0.42; difference, 0.07 [95% CI, –0.04 to 0.17]; <jats:italic>P</jats:italic> = .23) or executive function (MBSR vs no MBSR: 0.39 vs 0.31; mean difference, 0.08 points [95% CI, –0.02 to 0.19]; <jats:italic>P</jats:italic> = .12; exercise vs no exercise: 0.39 vs 0.32; difference, 0.07 [95% CI, –0.03 to 0.18]; <jats:italic>P</jats:italic> = .17) and there were no intervention effects at the secondary end point of 18 months. There was no significant interaction between mindfulness training and exercise (<jats:italic>P</jats:italic> = .93 for memory and <jats:italic>P</jats:italic> = .29 for executive function) at 6 months. Of the 5 prespecified secondary outcomes, none showed a significant improvement with either intervention compared with those not receiving the intervention.</jats:p></jats:sec><jats:sec><jats:title>Conclusions and Relevance</jats:title><jats:p>Among older adults with subjective cognitive concerns, mindfulness training, exercise, or both did not result in significant differences in improvement in episodic memory or executive function at 6 months. The findings do not support the use of these interventions for improving cognition in older adults with subjective cognitive concerns.</jats:p></jats:sec><jats:sec><jats:title>Trial Registration</jats:title><jats:p>ClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://clinicaltrials.gov/ct2/show/NCT02665481\">NCT02665481</jats:ext-link></jats:p></jats:sec>","is_dataset_classified":null,"base_score":5.0369526024136295,"endowment":5.0369526024136295,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"36511926","pmcid":"PMC9856438","openalex_id":"https://openalex.org/W4311249080","authors":[],"funders":[{"funder_name":"NICHD NIH HHS","grant_id":"P50 HD103525","title":null},{"funder_name":"NIMH NIH HHS","grant_id":"P50 MH122351","title":null},{"funder_name":"NCATS NIH HHS","grant_id":"UL1 TR002345","title":null},{"funder_name":"NIDDK NIH HHS","grant_id":"P30 DK056341","title":null},{"funder_name":"NCATS NIH HHS","grant_id":"UL1 TR000448","title":null}],"total_grants":5,"fwci":23.5605,"citation_percentile":0.998439,"influential_citations":0,"citation_trend":[{"year":2023,"count":29},{"year":2024,"count":46},{"year":2025,"count":51},{"year":2026,"count":27}],"oa_status":"green","license":null,"oa_locations":[{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9856438","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9856438","host_type":"repository"},{"url":"https://jamanetwork.com/journals/jama/articlepdf/2799406/jama_lenze_2022_oi_220128_1670262088.06091.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1001/jama.2022.21680","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/36511926","host_type":"repository"}],"fields_of_study":["Mindfulness and Compassion Interventions","Sleep and related disorders","Acupuncture Treatment Research Studies","Aged","Female","Humans","Male","Cognition","Executive Function","Exercise","Meditation","Mindfulness","Memory, Episodic","Exercise Therapy","Cognitive Aging","Healthy Lifestyle","Health Behavior","Stress, Psychological","Aged, 80 and over","Neuropsychological Tests","Cognitive Dysfunction","Magnetic Resonance Imaging"],"mesh_terms":["Cognitive Aging","Healthy Lifestyle","Aged","Aged, 80 and over","Cognition","Exercise Therapy","Female","Humans","Magnetic Resonance Imaging","Male","Neuropsychological Tests","Stress, Psychological","Health Behavior","Exercise","Meditation","Executive Function","Cognitive Dysfunction","Memory, Episodic","Mindfulness"],"keywords":["Medicine","Mindfulness","Randomized controlled trial","Episodic memory","Cognition","Physical therapy","Psychological intervention","Dementia","Effects of sleep deprivation on cognitive performance","Cognitive reserve","Cognitive training","Gerontology","Neuropsychology","Aerobic exercise","Meditation","Physical medicine and rehabilitation","Clinical psychology","Psychiatry","Cognitive impairment","Internal medicine","Disease"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Quality Education"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-27T15:41:50.261184Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}