Mindfulness Training for Mitigating Age-Related Cognitive Decline in the Elderly

缓解老年人与年龄相关的认知衰退的正念训练

• 批准号: 9925768
• 负责人: Ruchika Shaurya Prakash
• 金额: $ 36.2万
• 依托单位: OHIO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-15 至 2022-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9925768
• 关键词: Adherence; Affective; Age; Age-associated memory impairment; Architecture; Area; Attention; Behavioral; Brain; Characteristics; Cognition; Control Groups; Data; Decision Making; Education; Educational Intervention; Elderly; Future; Goals; Impaired cognition; Individual; Intervention; Laboratories; Lateral; Life Style; Link; Maintenance; Matched Group; Measures; Mediating; Medical; Mind; Mindfulness Training; Nerve Degeneration; Neuronal Plasticity; Outcome; Performance; Placebo Control Effect; Population; Prefrontal Cortex; Psychological Transfer; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Rehabilitation therapy; Research; Research Design; Resources; Rest; Role; Single-Blind Study; Testing; Time; Training; Training Programs; Well in self; Work; active control; active lifestyle; age related; aging brain; attentional control; base; cognitive benefits; cognitive enhancement; cognitive function; cognitive performance; cognitive process; cognitive rehabilitation; cognitive task; cognitive training; computerized; cost effective; design; distraction; effective therapy; efficacy testing; emotion regulation; executive function; follow-up; human old age (65+); improved; indexing; intervention cost; lifestyle intervention; mindfulness; mindfulness meditation; mindfulness-based stress reduction; neural correlate; novel; post intervention; programs; randomized controlled design; recruit; relating to nervous system; satisfaction; skills; tool; treatment duration; treatment effect

The overarching goal of this project is to rigorously test the efficacy of mindfulness training as a cognitive rehabilitation tool to mitigate age-related cognitive decline. Although the last decade has seen an increase in the number of cognitive training studies in the elderly, the majority of studies focus on computerized task-specific cognitive training, resulting in enhanced performance on the task being trained, but weak transfer to other tasks in the same domain and no transfer to other domains. The proposed study, employing mindfulness training as a cognitive rehabilitation tool, is novel in its reconceptualization of traditional cognitive training approaches into a training program that first and foremost promotes concentrative attention, thereby targeting attentional control, and secondly, does so in a framework that cultivates acceptance and non-reactivity, thus prioritizing older adults' increased socioemotional drive for emotional well-being and satisfaction. Our main hypothesis is that eight weeks of training in practices of mindfulness meditation, designed to increase concentrative attention and reduce the wandering tendencies of the mind, will increase performance on tasks of attentional control in the elderly, partially via mindfulness-induced neuronal plasticity in the intrinsic functional architecture of the brain. Using a single-blind, randomized controlled design, 120 older adults ages 65-85 will be assigned to either a mindfulness-based stress reduction (MBSR) group or an active lifestyle education control group matched for therapist contact time, engagement with the material, format of the intervention, a combination of experiential and didactic components, and perceived cognitive benefits. Assessments of dependent variables will be completed at pre-training, post-training, and then at a 12-month follow-up session. In Aim 1, we will investigate the short- and long-term impact of MBSR training on behavioral and neural correlates of attentional control (Aim 1.a and 1.b), and then examine the mediating role of mind-wandering and default-mode network connectivity in yielding attentional control benefits (Aim 1.c). Aim 2 investigates the efficacy of MBSR for far-transfer to abilities contributing to quality of life: broad laboratory- based and everyday measures of cognition (Aim 2.a), and emotion regulation strategies (Aim 2.b). The proposed work will establish the causal link between engagement in mindfulness practices and improved attentional control as well as identify reduced mind-wandering and default-mode network integrity as potential mechanisms of action through which mindfulness training exerts its effect on attentional control. Not only will the current study design offer an easily disseminable and cost effective treatment for cognitive decline in older adults, it will also provide a theoretical mechanism on which to base future cognitive rehabilitation designs, advancing the field of rehabilitation as a whole.

该项目的总体目标是严格测试正念训练作为认知康复工具缓解与年龄相关的认知衰退的功效。尽管近十年来针对老年人的认知训练研究数量有所增加，但大多数研究都集中在计算机化的特定任务认知训练上，导致训练任务的表现增强，但对同一领域其他任务的迁移较弱，并且没有迁移到其他领域。拟议的研究采用正念训练作为认知康复工具，其新颖之处在于将传统认知训练方法重新概念化为训练计划，该计划首先促进集中注意力，从而瞄准注意力控制，其次，在培养接受性和非反应性的框架内进行，从而优先考虑老年人增强的社会情感驱动力，以实现情感健康和满意度。我们的主要假设是，八周的正念冥想练习训练，旨在提高集中注意力并减少思维游移倾向，将提高老年人注意力控制任务的表现，部分是通过正念诱导的大脑内在功能结构中的神经元可塑性。采用单盲、随机对照设计，120 名 65-85 岁的老年人将被分配到基于正念的减压 (MBSR) 组或积极的生活方式教育对照组，这些组与治疗师接触时间、对材料的参与度、干预形式、体验和教学成分的组合以及感知的认知益处相匹配。因变量的评估将在培训前、培训后以及 12 个月的后续会议中完成。在目标 1 中，我们将研究 MBSR 训练对注意力控制的行为和神经相关性的短期和长期影响（目标 1.a 和 1.b），然后研究走神和默认模式网络连接在产生注意力控制益处中的中介作用（目标 1.c）。目标 2 研究了 MBSR 对于远距离迁移到有助于生活质量的能力的功效：广泛的基于实验室和日常的认知测量（目标 2.a）和情绪调节策略（目标 2.b）。拟议的工作将建立参与正念练习和改善注意力控制之间的因果关系，并确定减少走神和默认模式网络完整性作为正念训练对注意力控制发挥作用的潜在行动机制。当前的研究设计不仅将为老年人认知衰退提供一种易于传播且具有成本效益的治疗方法，还将提供未来认知康复设计的理论机制，从而推动整个康复领域的发展。