Impact of mindfulness training on in-the-moment attentional control and emotion dysregulation in older adults: secondary analysis of a pilot, placebo-controlled randomized controlled trial.

Mindfulness-based interventions show increasing promise for improving attention and emotion regulation- processes that critically support healthy aging. Given their complex, multi-faceted nature, identifying specific aspects of attention and emotion regulation that are modifiable with training in older adults, particularly compared with active control groups, is an ongoing challenge. We performed pre-registered, secondary analyses of a pilot randomized controlled trial comparing the effects of a four-week mindfulness-based attention training (MBAT) group and a lifestyle education (LifeEd) active control group on attention and emotion dysregulation in older adults. Differential training outcomes were assessed for: (a) in-the-moment effects of mind-wandering on sustained attention, measured by performance decrements preceding self-reported mind-wandering, and (b) self-reported emotion dysregulation. Baseline working memory (WM) performance was tested as a moderator of training effects. There were no significant between-group differences for change in in-the-moment effects of mind-wandering on attention or emotion dysregulation. However, baseline WM moderated training effects, such that older adults with higher WM showed greater reductions in emotion dysregulation following mindfulness training. This has potential implications for identifying aging cohorts that may benefit most from this type of training.

Effects of 4-week mindfulness training versus adaptive cognitive training on processing speed and working memory in multiple sclerosis.

OBJECTIVE: The aim of this preregistered, secondary analysis of a pilot randomized controlled trial (NCT02717429) was to compare the impact of 4-week mindfulness-based training and adaptive cognitive training, with a waitlist control condition, on processing speed and working memory in people with multiple sclerosis (PwMS). METHOD: Sixty-one PwMS were randomized to mindfulness-based training (MBT), adaptive computerized cognitive training (aCT), or a waitlist (WL) control group and completed the Brief Repeatable Battery of Neuropsychological Tests at pre- and posttraining. Training-related changes on the Symbol Digit Modalities Test (SDMT) and the Paced Auditory Serial Addition Test (PASAT) were the primary outcomes of interest. Baseline cognitive status was examined as a moderator of treatment gains. Practice time, change in aCT game difficulty, and rate of change in state awareness across MBT were assessed as correlates of cognitive gains. FINDINGS: Compared with aCT and WL, mindfulness training significantly improved processing speed (ηp² = .14). Baseline cognitive status did not moderate change in processing speed (ηp² = .005) or working memory (ηp² = .014). Practice time and change in game difficulty were not significantly correlated with cognitive gains (all ps > .49). In the MBT group, rate of change in awareness was significantly associated with improvement in working memory (ρ = .52, p = .04). CONCLUSIONS: In PwMS, 4 weeks of mindfulness meditation training improved processing speed above and beyond aCT and WL. More rapid change in awareness during mindfulness training may be associated with greater gains in working memory. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mindfulness and Attention: Current State-of-Affairs and Future Considerations.

This review examines longitudinal studies of changes in components of attention following mindfulness training. A total of 57 retreat studies, non-randomized trials, and randomized controlled trials were identified. Employing the classical taxonomy proposed by Posner and Petersen (1990), outcome measures were broadly categorized based on whether they involved maintenance of an aroused state (alerting), selective prioritization of attention to target items (orienting), or assessed conflict monitoring (executive attention). Although many non-randomized and retreat studies provide promising evidence of gains in both alerting and conflict monitoring following mindfulness training, evidence from randomized controlled trials, especially those involving active control comparison groups, is more mixed. This review calls attention to the urgent need in our field of contemplative sciences to adopt the methodological rigor necessary for establishing mindfulness meditation as an effective cognitive rehabilitation tool. Although studies including wait-listed control comparisons were fruitful in providing initial feasibility data and pre-post effect sizes, there is a pressing need to employ standards that have been heavily advocated for in the broader cognitive and physical training literatures. Critically, inclusion of active comparison groups and explicit attention to the reduction of demand characteristics are needed to disentangle the effects of placebo from treatment. Further, detailed protocols for mindfulness and control groups and examination of theoretically guided outcome variables with established metrics for reliability and validity are key ingredients in the systematic study of mindfulness meditation. Adoption of such methodological rigor will allow for causal claims supporting mindfulness training as an efficacious treatment modality for cognitive rehabilitation and enhancement.

Shared neural recruitment across working memory and motor control tasks as a function of task difficulty and age.

Past research suggests that working memory (WM) and motor control may engage similar cognitive and neural mechanisms in older adults, particularly when task difficulty increases. However, much of this evidence arises from comparisons across behavioral and imaging studies that test only one of the foregoing functional domains. The current study used fMRI within the same group of older adults to investigate whether WM and motor control recruit common mechanisms, and whether recruitment increased with task demand and age. A conjunction analysis across WM and motor tasks revealed engagement of several frontoparietal regions as a function of increasing task demand. A separate conjunction analysis which included age as a predictor showed comparable regions exhibit increased recruitment with both increasing task demand and age. Results suggest that the recruitment of common frontoparietal regions across WM and motor tasks in response to task difficulty is maintained across the older adult lifespan.

The Effects of Useful Field of View Training on Brain Activity and Connectivity.

OBJECTIVES: Useful Field of View training (UFOVt) is an adaptive computerized cognitive intervention that improves visual attention and transfers to maintained health and everyday functioning in older adults. Although its efficacy is well established, the neural mechanisms underlying this intervention are unknown. This pilot study used functional MRI (fMRI) to explore neural changes following UFOVt. METHOD: Task-driven and resting-state fMRI were used to examine changes in brain activity and connectivity in healthy older adults randomized to 10 hr of UFOVt (n = 13), 10 hr of cognitively stimulating activities (CSA; n = 11), or a no-contact control (NC; n = 10). RESULTS: UFOVt resulted in reduced task-driven activity in the majority of regions of interest (ROIs) associated with task performance, CSA resulted in reduced activity in one ROI, and there were no changes within the NC group. Relative to NC, UFOVt reduced activity in ROIs involved in effortful information processing. There were no other significant between-group task-based differences. Resting-state functional connectivity between ROIs involved in executive function and visual attention was strengthened following UFOVt compared with CSA and NC. DISCUSSION: UFOVt enhances connections needed for visual attention. Together with prior work, this study provides evidence that improvement of the brain's visual attention efficiency is one mechanism underlying UFOVt.

Connectome-based models predict attentional control in aging adults.

There are well-characterized age-related differences in behavioral and neural responses to tasks of attentional control. However, there is also increasing recognition of individual variability in the process of neurocognitive aging. Using connectome-based predictive modeling, a method for predicting individual-level behaviors from whole-brain functional connectivity, a sustained attention connectome-based prediction model (saCPM) has been derived in young adults. The saCPM consists of two large-scale functional networks: a high-attention network whose strength predicts better attention and a low-attention network whose strength predicts worse attention. Here we examined the generalizability of the saCPM for predicting inhibitory control in an aging sample. Forty-two healthy young adults (n = 21, ages 18-30) and older adults (n = 21, ages 60-80) performed a modified Stroop task, on which older adults exhibited poorer performance, indexed by higher reaction time cost between incongruent and congruent trials. The saCPM generalized to predict reaction time cost across age groups, but did not account for age-related differences in performance. Exploratory analyses were conducted to characterize the effects of age on functional connectivity and behavior. We identified subnetworks of the saCPM that exhibited age-related differences in strength. The strength of two low-attention subnetworks, consisting of frontoparietal, medial frontal, default mode, and motor nodes that were more strongly connected in older adults, mediated the effect of age group on performance. These results support the saCPM's ability to capture attention-related patterns reflected in each individual's functional connectivity signature across both task context and age. However, older and younger adults exhibit functional connectivity differences within components of the saCPM networks, and it is these connections that better account for age-related deficits in attentional control.

Memory-guided force control in healthy younger and older adults.

Successful performance of a memory-guided motor task requires participants to store and then recall an accurate representation of the motor goal. Further, participants must monitor motor output to make adjustments in the absence of visual feedback. The goal of this study was to examine memory-guided grip force in healthy younger and older adults and compare it to performance on behavioral tasks of working memory. Previous work demonstrates that healthy adults decrease force output as a function of time when visual feedback is not available. We hypothesized that older adults would decrease force output at a faster rate than younger adults, due to age-related deficits in working memory. Two groups of participants, younger adults (YA: N = 32, mean age 21.5 years) and older adults (OA: N = 33, mean age 69.3 years), completed four 20-s trials of isometric force with their index finger and thumb, equal to 25% of their maximum voluntary contraction. In the full-vision condition, visual feedback was available for the duration of the trial. In the no vision condition, visual feedback was removed for the last 12 s of each trial. Participants were asked to maintain constant force output in the absence of visual feedback. Participants also completed tasks of word recall and recognition and visuospatial working memory. Counter to our predictions, when visual feedback was removed, younger adults decreased force at a faster rate compared to older adults and the rate of decay was not associated with behavioral performance on tests of working memory.

Deficits in inhibitory force control in young adults with ADHD.

Poor inhibitory control is a well-established cognitive correlate of adults with ADHD. However, the simple reaction time (RT) task used in a majority of studies records performance errors only via the presence or absence of a single key press. This all-or-nothing response makes it impossible to capture subtle differences in underlying processes that shape performance. Subsequently, all-or-nothing tasks may underestimate the prevalence of executive function deficits in ADHD. The current study measured inhibitory control using a standard Go/No-Go RT task and a more sensitive continuous grip force task among adults with (N=51, 22 female) and without (N=51, 29 female) ADHD. Compared to adults without ADHD, adults with ADHD made more failed inhibits in the classic Go/No-Go paradigm and produced greater and more variable force during motor inhibition. The amount of force produced on failed inhibits was a stronger predictor of ADHD-related symptoms than the number of commissions in the standard RT task. Adults with ADHD did not differ from those without ADHD on the mean force and variability of force produced in Go trials. These findings suggest that the use of a precise and continuous motor task, such as the force task used here, provides additional information about the nature of inhibitory motor control in adults with ADHD.