Mindfulness-Based Stress Reduction, Health Education and Exercise

MBSR teaches mindfulness, or the focusing of attention and awareness, through various meditation techniques. Mindfulness meditation practices appear to produce neurocircuitry changes that are the reverse of those seen in age-related cognitive decline. It is widely available, acceptable to older people, and carries minimal risk of side effects or adverse events. Exercise - specifically, intense, multi-component exercise - also appears to affect brain structure and function and improve cognitive performance.

The investigators will randomize 580 non-demented healthy adults aged 65 to 84 to one of four conditions: MBSR alone, exercise alone, MBSR + exercise, or a health education discussion group control condition.

The study will consist of a 6-month acute intervention phase with weekly visits followed by a 12-month maintenance phase with weekly or monthly visits and other prompts to maintain intervention behaviors.

Assessments include cognitive tests, biomarkers, neuroimaging assessments, functional assessments to examine real-world benefits of the interventions, and other behavioral assessments to characterize participants and pave the way for further exploratory analyses.

Inclusion criteria

• Community-living men and women age 65 to 84.
• Self-reported cognitive complaints that are a normal part of aging.
• No current meditation practice nor prior training in it.
• Sedentary.

Exclusion criteria

• Known diagnosis of dementia, mild cognitive impairment, other clinical neurodegenerative illness (e.g., Parkinson's disease, cerebrovascular disease), psychotic disorder, or any unstable psychiatric condition.
• Medical conditions that suggest shortened lifespan, such as metastatic cancer; or would prohibit safe participation in the interventions, including cardiovascular disease or musculoskeletal conditions; or would interfere with the assessments, such as taking medications for diabetes or ferromagnetic metal/bridgework that would interfere with MRI signal.
• IQ <70 as estimated by the Wechsler Test of Adult Reading
• Sensory impairment (language, hearing, or visual) that would prevent participation.
• Alcohol abuse within 6 months.
• Current illicit drug use.
• Concurrent cognitive training, such as brain-training software, or other interventions expected to affect neuroplasticity.
• Medications that interfere with measurements, including cancer chemotherapy, glucocorticoids, and interferon.
• Inability to cooperate with protocol.