Effectiveness of mindfulness-based interventions on inflammaging: a systematic review and meta-analysis

Mindfulness cultivates awareness, presence, and non-judgmental acceptance, enhancing overall well-being. Inflammaging, linking age and aged-related diseases, manifests through heightened levels of IL-6, TNF-α, and CRP, impacting aging indicators like TA, TL, PWV, and FMD. To assess how mindfulness-based interventions (MBIs) affect inflammaging, a search was conducted in PubMed, Web of Science, Cochrane Central Register, and ProQuest Dissertation & Theses Global up to March 2024. Criteria included English articles and dissertations with participants over 18. Selected studies were randomized controlled trials (RCTs) and pre-post trials evaluating biomarkers related to inflammaging. Standardized mean differences were calculated using Morris's d_ppc for RCTs and Cohen's d for uncontrolled pre-post trials. Eighty-nine studies were included. In RCTs, MBIs reduced levels of TNF-α (d_ppc = -0.40), IL-6 (d_ppc = -0.70), CRP (d_ppc = -0.48), and PWV (d_ppc = -0.30) while increasing FMD (d_ppc = 0.24), TL (d_ppc = 0.43) and TA (d_ppc = 0.84). Pre-post trials indicated MBIs reduced TNF-α (d_ppc = -0.17), IL-6 (d = -0.33) and CRP (d = -0.33). Moderator analyses highlighted that MBIs other than mainstream mindfulness practices were found to be more effective in reducing IL-6 and CRP, and MBIs were particularly effective in reducing TNF-α among those with diseases. The main analysis revealed moderate certainty evidence from RCTs and uncontrolled pre-post trials supporting a causal relationship between mindfulness practices and inflammaging-related responses. The findings suggest that exploring alternative types of MBIs beyond mainstream approaches may yield more sustained benefits in attenuating inflammaging.