The end of the year makes me think about my hopes for the new year and my propensity to make decisions with very limited success in maintaining the potential for self-improvement.
Every new year reminds me that I am getting older. Aging is an unavoidable part of life, but we continue to explore ways to avoid the age-related losses of strength, beauty, thinking, and memory.
In search of the Fountain of Youth, many promising clues ultimately lead to a dead end. But to address the sense of memory loss that comes with aging, I was intrigued by a trial that focused on two fundamental components of wellness: exercise and mindfulness.
The study was published in JAMA (Journal of the American Medical Association) and was called the MEDEX trial.
This design is called a 2 x 2 factorial randomized trial, in which participants are randomly assigned to a mindfulness intervention, an exercise intervention, both, or neither.
In this way, we were able to test multiple ideas while using shared control groups.
Participants were community-dwelling adults aged 65 to 84 years. They must be relatively sedentary at the start of the study and must not engage in mindfulness (meditation) practices. They had to report memory or concentration problems. However, thinking skills had to be intact based on standard dementia screening tests. In other words, they were your average elderly worried about not being as smart as they used to be.
The intervention itself was quite intense. The exercise group received 90-minute instructor-led sessions twice weekly for his first six months of the study and once weekly thereafter. Participants were also encouraged to exercise at home for a total of 300 minutes of exercise per week.
The mindfulness program was characterized by eight weekly classes of 2.5 hours each and half-day retreats teaching the tenets of mindfulness and meditation, followed by monthly reviews. The participant was instructed to meditate for 60 minutes a day in addition to his classes.
For 144 people who were randomized to both meditation and exercise, this trial was a significant commitment. As such, one might think that adherence to the intervention would be low, but that does not appear to be the case.
The attendance rate for the mindfulness class was over 90% and the attendance rate for the exercise class was over 80%. Also, the diary-based reports on home efforts were very good.
Control groups were not left to their own devices. Recognizing that the community aspects of exercise and mindfulness classes may provide benefits independent of the actual exercise or mindfulness, the control group met on a similar schedule to discuss health education. I was. However, there was no mention of exercise or mindfulness practiced in the control group setting.
The primary outcomes were changes in memory and executive function scores from a battery of neuropsychological tests.
Memory scores improved over time in all three groups: mindfulness, exercise, and health education. Cognitive composite (thinking) scores improved similarly in all three groups. There was also no added effect of mindfulness combined with exercise.
The researchers also used MRI (magnetic resonance imaging) to measure brain anatomy and found no substantial differences in results between groups.
Those who were randomly exercised had shorter sleep latencies, better aerobic fitness, and better muscle strength. So something was happening.
The researchers tried to separate the people in the exercise group who experienced the greatest physical changes. Even in that select group, the intervention had no significant effect.
They think that the improved scores in the control group may reflect the fact that the participants learned how to take the test better over time. This is fairly common in the neuropsychiatric literature.
This is not the result I wanted. I wish I knew that exercise and meditation can make a huge difference as I get older. When making aspirations, it’s a good idea to have data to back up your ideas.
