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

这个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有效性，以缓解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，结果是提高了被训练任务的成绩，但较弱地转移到同一领域的其他任务上，没有转移到其他领域。这项拟议的研究将正念训练作为一种认知康复工具，其新颖之处在于将传统的认知训练方法重新构思为一个训练计划，首先促进集中注意力，从而瞄准注意力控制，其次，在培养接受性和无反应性的框架下这样做，从而优先考虑老年人对情绪健康和满足感的更高的社会情感驱动力。我们的主要假设是，为期八周的正念冥想练习将提高老年人在注意力控制任务中的表现，这部分是通过正念诱导大脑内在功能架构中的神经元可塑性来实现的。正念冥想的目的是增加注意力集中，减少大脑的走神倾向。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压力减轻(MBSR)组或积极生活方式教育控制组，两组在治疗师接触时间、与材料的参与度、干预的形式、经验和教学成分的组合以及感知的认知益处方面匹配。对因变量的评估将在培训前、培训后，然后在为期12个月的后续会议上完成。在目标1中，我们将调查MBSR训练对注意控制的行为和神经相关的短期和长期影响(目标1.a和1.b)，然后考察走神和默认模式网络连接在产生注意控制益处(目标1.c)中的中介作用。目的2研究MBSR对远距离迁移到对生活质量有贡献的能力的有效性：广泛的基于实验室和日常的认知测量(目标2.a)，以及情绪调节策略(目标2.b)。这项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联系，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发挥作用的潜在行动机制。目前的研究设计不仅将为老年人认知能力下降提供一种易于传播和成本效益高的治疗方法，还将为未来的认知康复设计提供一个理论机制，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.