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

该项目的首要目标是严格测试正念训练作为一种认知康复工具的功效，以减轻与年龄相关的认知衰退。尽管近十年来，老年人认知训练研究的数量有所增加，但大多数研究都集中在计算机化的特定任务认知训练上，导致在被训练任务上的表现增强，但对同一领域其他任务的迁移能力较弱，没有向其他领域的迁移。该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的认知训练方法重新概念化为一种训练计划，首先是促进集中注意力，从而针对注意力控制，其次，在培养接受性和非反应性的框架中进行，从而优先考虑老年人增加的社会情感驱动，以获得情感健康和满意度。我们的主要假设是，八周的正念冥想训练，旨在提高注意力集中，减少走神的倾向，将提高老年人在注意力控制任务上的表现，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名年龄在65-85岁之间的老年人将被分配到基于正念的减压（MBSR）组或积极生活方式教育对照组，这些组在治疗师接触时间、对材料的参与程度、干预形式、体验和教学成分的结合以及感知到的认知益处方面相匹配。因变量的评估将在培训前、培训后以及12个月的随访期间完成。在目标1中，我们将研究正念减压训练对注意控制行为和神经相关的短期和长期影响（目标1）。A和1。b)，然后检验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（目的1.c）。目标2调查正念减压对远距离迁移能力的功效，有助于提高生活质量：广泛的实验室基础和日常认知测量（目标2）。a)和情绪调节策略（目的2.b）。本研究将建立正念练习与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是正念训练对注意力控制产生影响的潜在机制。目前的研究设计不仅为老年人认知能力下降提供了一种易于推广和成本有效的治疗方法，而且还将为未来的认知康复设计提供理论机制，从而推动整个康复领域的发展。

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.