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Published on: May 11, 2020
Effectiveness of mindfulness-based interventions on mental, cognitive outcomes and neuroplastic changes in older
Yihong Leow1, Nur Lidiya Binte Abdul Rashid2, Piyanee Klainin-Yobas3
1Emergency Medicine, Woodlands Health, Singapore, Singapore.
Aims:
To evaluate the effectiveness of mindfulness-based interventions (MBIs) on mental and cognitive outcomes including, anxiety, depression, attention, memory, global cognition and neuroplastic changes in older adults with mild cognitive impairment (MCI).
Design:
Systematic review and meta-analysis.
Data Source:
A three-step search strategy was conducted on eight electronic databases, grey literature and reference lists from inception to February 2022.
Review Methods:
Randomized controlled trials (RCTs) examining MBIs on older adults with MCI were screened and assessed for risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was conducted using RevMan using a random-effect model. Narrative synthesis was performed for studies where results could not be pooled statistically.
Results:
Ten RCTs were included in the review. Results suggested that right frontal parietal and left inferior temporal gyrus of the brain showed increased cortical thickness after receiving MBIs. There were significant interaction effects for global efficiency and significant interactions in the insular and gyrus regions. Functional connectivity between the posterior cingulate cortex, bilateral medial prefrontal cortex and left hippocampus were increased in participants undergoing MBIs. Nevertheless, meta-analysis showed non-significant pooled effects, favouring control groups on anxiety, depression, attention, memory and global cognition.
Conclusion:
This review suggested the potential effects of MBIs in improving cortical thickness and connectivity in regions associated with memory and attention. Nevertheless, the effects of MBIs compared to active control groups on depression, anxiety, attention, memory and global cognition are inconclusive due to the lack of studies and non-significant results.
Impact:
The review advocates for more rigorous studies with larger sample size and utilizing wait-list controls to evaluate the effects of MBIs. MBIs can be considered as an adjunct with other therapies to further enhance the effect on psychological and cognitive outcomes for older adults with MCI. No Patient or Public Contribution as this is a meta-analysis.
Insights
Mindfulness-based interventions show potential for improving brain structure and connectivity in older adults with mild cognitive impairment (MCI). However, effects on anxiety, depression, and cognition remain inconclusive, requiring further research.
Area of Science:
- Neuroscience
- Gerontology
- Psychiatry
Background:
- Mild cognitive impairment (MCI) affects older adults, impacting mental and cognitive functions.
- Mindfulness-based interventions (MBIs) are increasingly explored for their potential therapeutic benefits.
Approach:
- Systematic review and meta-analysis of ten randomized controlled trials (RCTs).
- Searched eight electronic databases, grey literature, and reference lists up to February 2022.
- Assessed risk of bias using the Cochrane Risk of Bias Tool and employed random-effect models for meta-analysis.
Key Points:
- MBIs demonstrated increased cortical thickness in the right frontal parietal and left inferior temporal gyrus.
- Enhanced functional connectivity was observed between the posterior cingulate cortex, medial prefrontal cortex, and hippocampus.
- Significant interaction effects were noted for global efficiency and in specific brain regions.
Conclusions:
- MBIs may positively influence neuroplasticity, specifically cortical thickness and functional connectivity in brain regions vital for memory and attention.
- Current evidence is inconclusive regarding the impact of MBIs on anxiety, depression, attention, memory, and global cognition compared to active controls.
- Further rigorous studies with larger sample sizes and appropriate control groups are recommended to clarify MBIs' efficacy in older adults with MCI.
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