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

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的有效性，以减轻与年龄相关的认知衰退。虽然在过去的十年中，老年人的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特定任务的认知训练上，从而提高了训练任务的性能，但在同一领域的其他任务中的转移较弱，并且没有转移到其他领域。拟议的研究采用正念训练作为认知康复工具，将传统的认知训练方法重新概念化为训练计划，首先促进集中注意力，从而针对注意力控制，其次，在培养接受和非反应性的框架中这样做，从而优先考虑老年人增加的社会情感驱动力，以获得情感健康和满意度。我们的主要假设是，为期八周的正念冥想练习训练旨在增加注意力集中并减少思维的漂移倾向，将部分通过正念诱导的神经元可塑性来提高老年人注意力控制任务的表现。大脑内在功能架构。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正念减压（MBSR）组或积极生活方式教育对照组，这些对照组与治疗师接触时间，材料参与，干预形式，经验和教学成分的组合以及感知的认知益处相匹配。将在培训前、培训后和12个月随访时完成因变量评估。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调查MBSR对远距离转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，并将减少的走神和默认模式网络完整性确定为潜在的行动机制，正念训练通过这些机制对注意力控制产生影响。目前的研究设计不仅为老年人的认知衰退提供了一种易于传播和具有成本效益的治疗方法，还将为未来的认知康复设计提供一种理论机制，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.