Mindfulness-Based Stress Reduction, Health Education and Exercise

NCT ID: NCT02665481

Last Updated: 2022-09-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

585 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-04-30

Study Completion Date

2021-05-31

Brief Summary

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The purpose of this research is to examine the effects of four interventions on age-related cognitive decline in healthy older adults. The investigators will examine the effects of Mindfulness Based Stress Reduction (MBSR) psychotherapy, multi-component intensity-based aerobic exercise, and their combination, compared to a discussion group.

Detailed Description

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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.

Conditions

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Age-related Cognitive Decline

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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MBSR

Mindfulness-Based Stress Reduction consists of a brief introductory meeting, eight weekly 2.5-hour classes, and a retreat, followed by monthly booster sessions for approximately 15 months. Content includes instruction in mindfulness meditation practices, gentle mindful movement, and exercises to enhance mindfulness in everyday life.

Group Type EXPERIMENTAL

MBSR

Intervention Type BEHAVIORAL

Exercise

The exercise protocol is optimal for improving aerobic fitness and insulin sensitivity in older adults, as well as improving strength and balance and reducing indices of frailty.It consists of classes twice weekly for 6 months, building up to 1.5 hr, under the direct supervision of trained exercise instructors, followed by once weekly classes for 12 months.

Group Type EXPERIMENTAL

Exercise

Intervention Type BEHAVIORAL

MBSR + Exercise

This condition will receive both MBSR and exercise as described above. Participants in this condition will come in once weekly to receive MBSR and twice weekly to receive exercise classes, with at-home exercise the other two days as well as daily, at-home mindfulness practice. After the initial classes participants will also attend additional weekly or monthly sessions until completion of the study.

Note that at each site a pilot group is undergoing MBSR + Exercise (not randomized, separate from the RCT).

Group Type EXPERIMENTAL

MBSR

Intervention Type BEHAVIORAL

Exercise

Intervention Type BEHAVIORAL

Health Education

Health Education is a group-based intervention that increases health-related knowledge and action. Health Education improves chronic disease management.Health Education consists of ten weekly 2.5-hour classes, followed by monthly classes for approximately 15 months.

Group Type ACTIVE_COMPARATOR

Health Education

Intervention Type BEHAVIORAL

Interventions

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MBSR

Intervention Type BEHAVIORAL

Exercise

Intervention Type BEHAVIORAL

Health Education

Intervention Type BEHAVIORAL

Other Intervention Names

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Mindfulness-Based Stress Reduction Multi-component intensity-based exercise

Eligibility Criteria

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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.
Minimum Eligible Age

65 Years

Maximum Eligible Age

84 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of California, San Diego

OTHER

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

National Center for Complementary and Integrative Health (NCCIH)

NIH

Sponsor Role collaborator

The Brain Research Foundation

OTHER

Sponsor Role collaborator

Washington University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eric J Lenze, MD

Role: PRINCIPAL_INVESTIGATOR

Washington University School of Medicine

Locations

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University of California San Diego

San Diego, California, United States

Site Status

Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Lenze EJ, Voegtle M, Miller JP, Ances BM, Balota DA, Barch D, Depp CA, Diniz BS, Eyler LT, Foster ER, Gettinger TR, Head D, Hershey T, Klein S, Nichols JF, Nicol GE, Nishino T, Patterson BW, Rodebaugh TL, Schweiger J, Shimony JS, Sinacore DR, Snyder AZ, Tate S, Twamley EW, Wing D, Wu GF, Yang L, Yingling MD, Wetherell JL. Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial. JAMA. 2022 Dec 13;328(22):2218-2229. doi: 10.1001/jama.2022.21680.

Reference Type DERIVED
PMID: 36511926 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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http://healthymind.wustl.edu/medex

Visit the Healthy Mind Lab for more information about the MEDEX study and our other areas of research. STL: http://healthymind.wustl.edu/medex UCSD: http://www.medexstudy.com/

Other Identifiers

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1R01AG049369-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

201410093

Identifier Type: -

Identifier Source: org_study_id

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