Mindfulness Interventions Linked to
Cognitive Benefit

Nancy A. Melville

March 31, 2020

Mindfulness-based interventions can have a beneficial effect on cognition, albeit only in certain cognitive domains, new research suggests.

A meta-analysis of 78 randomized controlled trials with almost 6000 participants showed mindfulness-based interventions improved attention, memory, and processing speed.

"As research shows that human minds wander on average 47% of waking hours, and greater inattention predicts more unhappiness, mindfulness-based interventions can help us better manage our moods and ways of cognitively processing our experiences," study investigator Nur Hani Zainal, MS, told Medscape Medical News.

"On top of effectively reducing common depressive and anxiety symptoms, mindfulness-based interventions can enhance our ability to concentrate for prolonged time periods despite distractions in our environment," added Zainal, Department of Psychology,  Pennsylvania State University in University Park.

The findings were scheduled to be presented this month at the Anxiety and Depression Association of America (ADAA) Conference 2020. However, that conference was canceled in the wake of the coronavirus pandemic.

Practice Makes Perfect

The investigators identified 78 randomized controlled trials conducted between 1989 and 2019 that evaluated the effects of mindfulness interventions on unique cognitive domains and cognitive abilities.

The studies, which included a total of 5918 participants, largely relied on cognitive testing conducted pre- and postmindfulness treatment.

The researchers predicted that participants who underwent mindfulness-based interventions "would experience more positive changes over time for multiple aspects of cognitive functioning in the brain" compared with their wait-listed counterparts or those who received no treatment, or experienced another nonmindfulness intervention.

Results showed that mindfulness-based interventions had significant effects in 9 of the 17 cognitive domains evaluated, with Hedges g effect sizes ranging from 0.24 to 1.33.

The mindfulness group vs the control group was "more accurate and sometimes quicker on tasks measuring some aspects of cognitive functioning," said Zainal.

"Also, people who learned and made it a habit to practice mindfulness skills via mindfulness-based interventions, compared to controls, were more likely to report that their ability to sustain focus on tasks amid distractions noticeably became better over time," she added.

Among participants with heightened clinical symptoms, those receiving mindfulness interventions showed more benefits in measures of verbal fluency, episodic memory, and subjective attention than the control group.

Conversely, healthy participants showed greater improvements in executive attention compared with those with elevated clinical symptoms. Effects of the interventions on working memory accuracy were similar among those with and without clinical symptoms.

Improved Focus

Additional factors associated with improvements from the mindfulness-based interventions included participation in longer in-person and home-based sessions, which predicted improved processing speed and episodic memory.

Those findings are notable considering that intervention deliveries can range from intensive meditation retreats requiring 10 hours or more per day of training to clinically focused individual or group-based treatments instructing participants to meditate for about 45 minutes daily.

By definition, mindfulness involves paying attention to experiences in the here-and-now in receptive, nonjudgmental, and flexible ways continually, Zainal explained.

"The findings overall lend weight to theories that mindfulness-based interventions cultivate improvement in observational skills as well as nonjudgmental acceptance of external and internal events," she said.

In addition, "the cognitive benefits can extend to both healthy young adults to help them to become less absent-minded, more attentive, and effective at accomplishing tasks."

In enhancing the ability to monitor and alter environmental inputs, the interventions can furthermore help those with anxiety and illness, Zainal said.

The benefits can also assist middle- and older- aged patients recovering from breast cancer and stroke, as well as those struggling with depression and anxiety by enhancing their inhibitory control and processing speed abilities, she added.

Lessons for COVID-19 Pandemic

Commenting on the findings for Medscape Medical News, Darren L. Dunning, PhD, MRC Cognition and Brain Sciences Unit at the University of Cambridge, United Kingdom, said the study "certainly adds to the existing evidence base for mindfulness-based interventions, particularly from a mechanistic point of view."   

Dunning found similar results in children and adolescents, with results showing greater benefits in older individuals, in a separate recent review of mindfulness interventions.

"I would suggest that the main utility of mindfulness-based interventions is probably in improving mental health and well-being, but if there are also some improvements in cognitive skills then that's a bonus," he told Medscape Medical News.

In terms of clinical practice, Dunning said it's not uncommon to encounter some skepticism among both younger and older patients regarding the effects of mindfulness interventions.

"I think a little skepticism is healthy. My strategy is not to overcomplicate things, but rather to try and distill mindfulness down to its basics," he said.

"I tell my participants that mindfulness is purposefully paying attention to the present, and treating intrusive thoughts with an attitude of acceptance and curiosity. It's essentially focusing on 'now' and being kind to yourself."

Mindfulness strategies can be particularly beneficial at a time when all generations are grappling with lockdowns, isolation, and social distancing, Dunning noted.

"I think structuring our day is essential, so incorporating a regular, short mindfulness session into each day could help with this," he said.

Dunning said in adding mindfulness into his regimen while being confined, he tries to take his single walk of the day "in a more mindful way."

"At the moment, it's much quieter than normal, so outside I find it easier to pay attention to the sounds around me. We can also try to eat in a more mindful way, take our time at dinner, and savor each bite," he said.

"Mindfulness is particularly useful as a preventive tool for mental ill health and relapse prevention. So if anyone is really struggling then I would urge them to seek help from a professional," Dunning noted.

Dunning added that he "highly" recommends resources like Mark Williams' Mindfulness Meditations on YouTube, and the Headspace App.

Zainal and Dunning have disclosed no relevant financial relationships.

Anxiety and Depression Association of America (ADAA) Conference 2020: Session 219B, abstract 4. Originally scheduled to have been presented
March 20, 2020.

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