The Age-Well randomized controlled trial of the Medit-Ageing European project: Effect of meditation or foreign language training on brain and mental health in older adults.
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ABSTRACT:
SUBMITTER: Poisnel G
PROVIDER: S-EPMC6296161 | biostudies-literature | 2018
REPOSITORIES: biostudies-literature
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The Age-Well randomized controlled trial of the Medit-Ageing European project: Effect of meditation or foreign language training on brain and mental health in older adults.
Poisnel Géraldine G Arenaza-Urquijo Eider E Collette Fabienne F Klimecki Olga M OM Marchant Natalie L NL Wirth Miranka M de La Sayette Vincent V Rauchs Géraldine G Salmon Eric E Vuilleumier Patrik P Frison Eric E Maillard Aline A Vivien Denis D Lutz Antoine A Chételat Gaël G
Alzheimer's & dementia (New York, N. Y.) 20181214
<h4>Introduction</h4>The Age-Well clinical trial is an ongoing monocentric, randomized, controlled trial aiming to assess an 18-month preventive meditation-based intervention directly targeting the attentional and emotional dimensions of aging to promote mental health and well-being in elderly people.<h4>Methods</h4>One hundred thirty-seven cognitively unimpaired older adults are randomized to either an 18-month meditation-based intervention, a structurally matched foreign language training, or ...[more]
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Project description:IntroductionThe Age-Well observational, cross-sectional study investigates the affective and cognitive mechanisms of meditation expertise with behavioral, neuroimaging, sleep, and biological measures sensitive to aging and Alzheimer's disease (AD).MethodsThirty cognitively unimpaired individuals aged 65 years or older with at least 10,000 hours of practice in mindfulness meditation (MM) and loving-kindness and compassion meditation (LKCM) are selected. The outcomes are the neuroimaging brain correlates of MM and LKCM and the assessments of long-term meditation practices on behavioral, neural, and biological measures as compared to nonmeditator older controls from the Age-Well randomized controlled trial.ResultsRecruitment and data collection began in late 2016 and will be completed by late 2019.DiscussionResults are expected to foster the understanding of the effects of meditation expertise on aging and of the mechanisms of action underlying the meditation intervention in the Age-Well randomized controlled trial. These finding will contribute to the design of meditation-based prevention randomized controlled trials for the aged population and to the exploration of the possible long-time developmental trajectory of meditation training.
| S-EPMC6300614 | biostudies-literature
Project description:ImportanceNonpharmacological interventions are a potential strategy to maintain or promote cognitive functioning in older adults.ObjectiveTo investigate the effects of 18 months' meditation training and 18 months' non-native language training on cognition in older adults.Design, setting, and participantsThis study was a secondary analysis of the Age-Well trial, an 18-month, observer-masked, randomized clinical trial with 3 parallel arms. Eligible participants were community-dwelling adults aged 65 years and older residing in Caen, France. Participants were enrolled from November 24, 2016, to March 5, 2018, and randomly assigned (1:1:1) to meditation training, non-native language (English) training, or no intervention arms. Final follow-up was completed on February 6, 2020. Data were analyzed between December 2021 and November 2022.InterventionsThe 18-month meditation and non-native language training interventions were structurally equivalent and included 2-hour weekly group sessions, daily home practice of 20 minutes or longer, and 1 day of more intensive home practice. The no intervention group was instructed not to change their habits and to continue living as usual.Main outcomes and measuresCognition (a prespecified secondary outcome of the Age-Well trial) was assessed preintervention and postintervention via the Preclinical Alzheimer Cognitive Composite 5 (PACC5), and composites assessing episodic memory, executive function, and attention.ResultsAmong 137 randomized participants, 2 were excluded for not meeting eligibility criteria, leaving 135 (mean [SD] age, 69.3 [3.8] years; 83 female [61%]) eligible for analysis. One participant among the remaining 135 did not complete the trial. In adjusted mixed effects models, no interaction effects were observed between visit and group for PACC5 (F2,131.39 = 2.58; P = .08), episodic memory (F2,131.60 = 2.34; P = .10), executive function (F2,131.26 = 0.89; P = .41), or attention (F2,131.20 = 0.34; P = .79). Results remained substantively unchanged across sensitivity and exploratory analyses.Conclusions and relevanceIn this secondary analysis of an 18-month randomized trial, meditation and non-native language training did not confer salutary cognitive effects. Although further analyses are needed to explore the effects of these interventions on other relevant outcomes related to aging and well-being, these findings did not support the use of these interventions for enhancing cognition in cognitively healthy older adults.Trial registrationClinicalTrials.gov Identifier: NCT02977819.
| S-EPMC10349342 | biostudies-literature
Project description:ObjectivesAs the world population is ageing, it is vital to understand how older adults can maintain and deepen their psychological well-being as they are confronted with the unique challenges of ageing in a complex world. Theoretical work has highlighted the promising role of intentional mental training such as meditation practice for enhancing human flourishing. However, meditation-based randomised controlled trials in older adults are lacking. We aimed to investigate the effects of meditation training on psychological well-being in older adults.MethodsThis study presents a secondary analysis of the Age-Well trial (ClinicalTrials.gov: NCT02977819), which randomised 137 healthy older adults (age range: 65 to 84 years) to an 18-month meditation training, an active comparator (English language training), or a passive control. Well-being was measured at baseline, mid-intervention, and 18-month post-randomisation using the Psychological Well-being Scale (PWBS), the World Health Organisation's Quality of Life (QoL) Assessment psychological subscale, and composite scores reflecting the meditation-based well-being dimensions of awareness, connection, insight, and a global score comprising the average of these meditation-based dimensions.ResultsThe 18-month meditation training was superior to English training on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and the subscales of awareness, connection, insight, and superior to no-intervention only on changes in the global score (0.54 [95% CI: 0.26, 0.82], p = 0.0002) and awareness. Between-group differences in psychological QoL in favour of meditation did not remain significant after adjusting for multiple comparisons. There were no between-group differences in PWBS total score. Within the meditation group, psychological QoL, awareness, insight, and the global score increased significantly from baseline to 18-month post-randomisation.ConclusionThe longest randomised meditation training conducted to date enhanced a global composite score reflecting the meditation-based well-being dimensions of awareness, connection, and insight in older adults. Future research is needed to delineate the cognitive, affective, and behavioural factors that predict responsiveness to meditation and thus help refine the development of tailored meditation training.
| S-EPMC10691714 | biostudies-literature
Project description:ImportanceNo lifestyle-based randomized clinical trial directly targets psychoaffective risk factors of dementia. Meditation practices recently emerged as a promising mental training exercise to foster brain health and reduce dementia risk.ObjectiveTo investigate the effects of meditation training on brain integrity in older adults.Design, setting, and participantsAge-Well was a randomized, controlled superiority trial with blinded end point assessment. Community-dwelling cognitively unimpaired adults 65 years and older were enrolled between November 24, 2016, and March 5, 2018, in France. Participants were randomly assigned (1:1:1) to (1) an 18-month meditation-based training, (2) a structurally matched non-native language (English) training, or (3) no intervention arm. Analysis took place between December 2020 and October 2021.InterventionsMeditation and non-native language training included 2-hour weekly group sessions, practice of 20 minutes or longer daily at home, and 1-day intensive practices.Main outcomes and measuresPrimary outcomes included volume and perfusion of anterior cingulate cortex (ACC) and insula. Main secondary outcomes included a global composite score capturing metacognitive, prosocial, and self-regulatory capacities and constituent subscores.ResultsAmong 137 participants (mean [SD] age, 69.4 [3.8] years; 83 [60.6%] female; 54 [39.4%] male) assigned to the meditation (n = 45), non-native language training (n = 46), or no intervention (n = 46) groups, all but 1 completed the trial. There were no differences in volume changes of ACC (0.01 [98.75% CI, -0.02 to 0.05]; P = .36) or insula (0.01 [98.75% CI, -0.02 to 0.03]; P = .58) between meditation and no intervention or non-native language training groups, respectively. Differences in perfusion changes did not reach statistical significance for meditation compared with no intervention in ACC (0.02 [98.75% CI, -0.01 to 0.05]; P = .06) or compared with non-native language training in insula (0.02 [98.75% CI, -0.01 to 0.05]; P = .09). Meditation was superior to non-native language training on 18-month changes in a global composite score capturing attention regulation, socioemotional, and self-knowledge capacities (Cohen d, 0.52 [95% CI, 0.19-0.85]; P = .002).Conclusions and relevanceThe study findings confirm the feasibility of meditation and non-native language training in elderly individuals, with high adherence and very low attrition. Findings also show positive behavioral effects of meditation that were not reflected on volume, and not significantly on perfusion, of target brain areas.Trial registrationClinicalTrials.gov Identifier: NCT02977819.
| S-EPMC9552046 | biostudies-literature
Project description:The purpose of the present study was to identify health and well-being typologies among a sample of older European adults. Further, we examined various demographic, social, and health behaviour characteristics that were used to discriminate between such groups. The participants were 1,381 community-dwelling adults aged 65 years and above (M age = 73.65; SD = 7.77) from six European Union (EU) countries who completed self-reported questionnaires. Hierarchical cluster analysis was initially conducted followed by a k means analysis to confirm cluster membership. Four clusters were identified and validated: 'good health and moderate functioning' (38.40%), 'moderate health and functioning' (30.84%), 'obese and depressed' (20.24%) and 'low health and functioning' (10.51%). The groups could be discriminated based on age, gender, nationality, years of education, social isolation and health behaviours (alcohol consumption and walking behaviour). The results of the study demonstrate heterogeneity with regard to the relationships between the variables examined. The information can be used in targeting older Europeans for health promotion interventions.
| S-EPMC5547292 | biostudies-other
Project description:Context • The benefits of a mindfulness meditation (MM) intervention are most often evidenced by improvements in self-rated stress and mental health. Given the physiological complexity of the psychological stress system, it is likely that some people benefit significantly, whereas others do not. Clinicians and researchers could benefit from further exploration to determine which baseline factors can predict clinically significant improvements from MM. Objectives • The study intended to determine (1) whether the baseline measures for participants who significantly benefitted from MM training were different from the baseline measures of participants who did not, and (2) whether a classification analysis using a decision-tree, machine-learning approach could be useful in predicting which individuals would be most likely to improve. Design • The research team performed a secondary analysis of a previously completed randomized, controlled clinical trial. Setting • The study occurred at the Oregon Health & Science University (Portland, OR, USA) and in participants' homes. Participants • Participants were 134 stressed, generally healthy adults from the metropolitan area of Portland, Oregon, who were 50 to 85 y old. Intervention • Participants were randomly assigned either to a 6-wk MM intervention group or to a waitlist control group, who received the same MM intervention after the waitlist period. Outcome Measures • Outcome measures were assessed at baseline and at 2-mo follow-up intervals. A responder was defined as someone who demonstrated a moderate, clinically significant improvement on the mental health component (MHC) of the short-form health-related quality of life (SF-36) (ie, a change ?4). The MHC had demonstrated the greatest effect size in the primary analysis of the previously mentioned randomized, controlled clinical trial. Potential predictors were demographic information and baseline measures related to stress and affect. Univariate statistical analyses were performed to compare the values of predictors in the responder and nonresponder groups. In addition, predictors were chosen for a classification analysis using a decision tree approach. Results • Of the 134 original participants, 121 completed the MM intervention. As defined previously, 61 were responders and 60 were nonresponders. Analyses of the baseline measures demonstrated significant differences between the 2 groups in several measures: (1) the positive and negative affect schedule negative subscale (PANAS-neg), (2) the SF-36-MHC, and (3) the SF-36 energy/fatigue, with clinically worse scores being associated with greater likelihood of being a responder. Disappointingly, the decision-tree analyses were unable to achieve a classification rate of better than 65%. Conclusions • The differences in predictor variables between responders and nonresponders to an MM intervention suggested that those with worse mental health at baseline were more likely to improve. Decision-tree analysis was unable to usefully predict who would respond to the intervention.
| S-EPMC5802968 | biostudies-literature
Project description:In recent years, foreign language learning (FLL) has been proposed as a possible cognitive intervention for older adults. However, the brain network and cognitive functions underlying FLL has remained largely unconfirmed in older adults. In particular, older and younger adults have markedly different cognitive profile-while older adults tend to exhibit decline in most cognitive domains, their semantic memory usually remains intact. As such, older adults may engage the semantic functions to a larger extent than the other cognitive functions traditionally considered the most important (e.g., working memory capacity and phonological awareness). Using anatomical measurements and a cognitive test battery, the present study examined this hypothesis in twenty cognitively normal older adults (58-69 years old), who participated in a two-month Italian learning programme. Results showed that the immediate learning success and long-term retention of Italian vocabularies were most consistently predicted by the anatomical measures of the left pars orbitalis and left caudal middle frontal cortex, which are implicated in semantic and episodic memory functions. Convergent evidence was also found based on the pattern of cognitive associations. Our results are consistent with a prominent role of semantic and episodic memory functions in vocabulary learning in older learners.
| S-EPMC8942782 | biostudies-literature
Project description:(1) The effects of intensive mental training based on meditation on the functional and structural organization of the human brain have been addressed by several neuroscientific studies. However, how large-scale connectivity patterns are affected by long-term practice of the main forms of meditation, Focused Attention (FA) and Open Monitoring (OM), as well as by aging, has not yet been elucidated. (2) Using functional Magnetic Resonance Imaging (fMRI) and multivariate pattern analysis, we investigated the impact of meditation expertise and age on functional connectivity patterns in large-scale brain networks during different meditation styles in long-term meditators. (3) The results show that fMRI connectivity patterns in multiple key brain networks can differentially predict the meditation expertise and age of long-term meditators. Expertise-predictive patterns are differently affected by FA and OM, while age-predictive patterns are not influenced by the meditation form. The FA meditation connectivity pattern modulated by expertise included nodes and connections implicated in focusing, sustaining and monitoring attention, while OM patterns included nodes associated with cognitive control and emotion regulation. (4) The study highlights a long-term effect of meditation practice on multivariate patterns of functional brain connectivity and suggests that meditation expertise is associated with specific neuroplastic changes in connectivity patterns within and between multiple brain networks.
| S-EPMC8393942 | biostudies-literature
Project description:Objective: A comprehensive, integrated support programme for new international students of medicine has been developed, implemented and evaluated at the Charité. The objectives of the programme were improved social integration, orientation on the study program and Charité campus, as well as qualification in medical specialist language. Project outline: The "Charité Orientation Module for International Students" (ChOIS) was designed by a working group with a variety of expertise in the field of international students. The programme has three stages: Recruitment (specific invitation on matriculation); Orientation week before semester start; and Parallel events during the first semester. ChoOIS was piloted in the Winter Semester 2015/16 and, following evaluation, continued in a modified form in the Summer Semester 2016. Key features were: Welcome and social integration by faculty welcome-events and student group activities; Orientation on the study program, on teaching infrastructures at the Charité and on student life in Berlin by senior medical students; and Training in language for medical communication and bedside teaching by professional lecturers. Results: Results of evaluations conducted after the orientation weeks, at the end of the semester and retrospectively in the 3rd semester produced high approval ratings of the individual features of the ChOIS-programme and of the programme as a whole by participating students. Discussion: A comprehensive, integrated support programme for new international students of medicine has been developed and implemented. The ChOIS-programme can serve as a practice model to guide other medical faculties. In future, a programme that goes beyond the start of the course and includes more involvement by senior students would be desirable.
| S-EPMC6326404 | biostudies-other
Project description:In adults, music and speech share many neurocognitive functions, but how do they interact in a developing brain? We compared the effects of music and foreign language training on auditory neurocognition in Chinese children aged 8-11 years. We delivered group-based training programs in music and foreign language using a randomized controlled trial. A passive control group was also included. Before and after these year-long extracurricular programs, auditory event-related potentials were recorded (n = 123 and 85 before and after the program, respectively). Through these recordings, we probed early auditory predictive brain processes. To our surprise, the language program facilitated the children's early auditory predictive brain processes significantly more than did the music program. This facilitation was most evident in pitch encoding when the experimental paradigm was musically relevant. When these processes were probed by a paradigm more focused on basic sound features, we found early predictive pitch encoding to be facilitated by music training. Thus, a foreign language program is able to foster auditory and music neurocognition, at least in tonal language speakers, in a manner comparable to that by a music program. Our results support the tight coupling of musical and linguistic brain functions also in the developing brain.
| S-EPMC8634570 | biostudies-literature