The vast majority of older adults will suffer declines in cognitive functions such as memory and cognitive control (or executive function), interfering with their ability to participate and engage in meaningful activities. Importantly, the recent observation that the brain retains plasticity late into life suggests that timely and personalized interventions might remediate age-related cognitive decline. Two promising interventions are Mindfulness-Based Stress Reduction and Exercise, each of which appears to act in multi-modal ways to make plastic changes in CNS function to improve memory and cognitive control in older adults. Our research team has conducted several studies of these interventions, supporting their benefits and pathways to improved cognitive functioning. We propose a 2x2 factorial design RCT to definitively test MBSR and exercise for remediation of age-related cognitive decline. We will randomize 580 healthy community-living adults aged 65+ to one of four conditions: MBSR alone, exercise alone, MBSR+exercise, or health education (a control condition). Participants will receive protocolized interventions for a six-month acute period, followed by a 12-month maintenance period. We will examine (1) cognitive improvements using a well-validated and sensitive neuropsychological battery focusing on memory and cognitive control;(2) mechanistic changes such as reduced cortisol and improved insulin sensitivity (3) neuroimaging markers of plasticity: structural and functional connectivity changes indicating plastic CNS changes underlying the cognitive improvements (4) individual variability that predicts response to the interventions. Our main goal is to carry out a high-quality clinical trial, such that data and biosamples will become a resource for the scientific community. Then, we can not only improve the lives of older adults in the near-term by matching individuals to readily available interventions that most benefit them, we can also understand the mechanisms of neuroplastic changes with interventions to rescue cognitive decline with aging, leading to a more active and vital senior community.

Public Health Relevance

The world is graying, and the vast majority of older adults will have declines in cognitive function, interfering with function, quality of life, and engagement in valued activities. We will test two promising interventions - Mindfulness Based Stress Reduction (MBSR) and Exercise - for their ability to remediate age-related cognitive decline. MBSR and exercise are both inexpensive, well-tolerated, safe, and highly scalable interventions;therefore i our project can demonstrate how effective they are, for whom, and by what mechanisms, in the near term older adults could receive lifestyle strategies that would benefit their brain and cognitive functioning, staving off disability and dependence on others and maintaining engagement in life's most valued activities.

National Institute of Health (NIH)
Research Project (R01)
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Special Emphasis Panel (ZAG1)
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Wagster, Molly V
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Washington University
Schools of Medicine
Saint Louis
United States
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