AUTHORS: Chételat G, Lutz A, Klimecki O, Frison E, Asselineau J, Schlosser M, Arenaza-Urquijo E, Mézenge F, Kuhn E, Moulinet I, Touron E, Dautricourt S, André C, Palix C, Ourry V, Felisatti F, Gonneaud J, Landeau B, Rauchs G, Chocat A, Quillard A, Ferrand Devouge E, Vuilleumier P, de La Sayette V, Vivien D, Collette F, Poisnel G, Marchant NL

JAMA Neurology, 79(11): 1165-74, November 2022


IMPORTANCE No lifestyle-based randomized clinical trial directly targets psychoaffective risk
factors of dementia. Meditation practices recently emerged as a promising mental training
exercise to foster brain health and reduce dementia risk.

OBJECTIVE To investigate the effects of meditation training on brain integrity in older adults.

DESIGN, SETTING, AND PARTICIPANTS Age-Well was a randomized, controlled superiority trial
with blinded end point assessment. Community-dwelling cognitively unimpaired adults
65 years and older were enrolled between November 24, 2016, and March 5, 2018, in France.
Participants were randomly assigned (1:1:1) to (1) an 18-month meditation-based training,
(2) a structurally matched non-native language (English) training, or (3) no intervention arm.
Analysis took place between December 2020 and October 2021.

INTERVENTIONS Meditation and non-native language training included 2-hour weekly group
sessions, practice of 20 minutes or longer daily at home, and 1-day intensive practices.
MAIN OUTCOMES AND MEASURES Primary outcomes included volume and perfusion of
anterior cingulate cortex (ACC) and insula. Main secondary outcomes included a global
composite score capturingmetacognitive, prosocial, and self-regulatory capacities and
constituent subscores.
RESULTS Among 137 participants (mean [SD] age, 69.4 [3.8] years; 83 [60.6%] female;
54 [39.4%] male) assigned to the meditation (n = 45), non-native language training (n = 46),
or no intervention (n = 46) groups, all but 1 completed the trial. There were no differences in
volume changes of ACC (0.01 [98.75%CI, −0.02 to 0.05]; P = .36) or insula (0.01 [98.75%CI,
−0.02 to 0.03]; P = .58) between meditation and no intervention or non-native language
training groups, respectively. Differences in perfusion changes did not reach statistical
significance for meditation compared with no intervention in ACC (0.02 [98.75%CI, −0.01
to 0.05]; P = .06) or compared with non-native language training in insula (0.02 [98.75%CI,
−0.01 to 0.05]; P = .09). Meditation was superior to non-native language training on
18-month changes in a global composite score capturing attention regulation,
socioemotional, and self-knowledge capacities (Cohen d, 0.52 [95%CI, 0.19-0.85]; P = .002).
CONCLUSIONS AND RELEVANCE The study findings confirm the feasibility of meditation and
non-native language training in elderly individuals, with high adherence and very low
attrition. Findings also show positive behavioral effects of meditation that were not reflected
on volume, and not significantly on perfusion, of target brain areas.

TRIAL REGISTRATION Identifier: NCT02977819


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