Periodic Reporting for period 5 - MEDIT-AGEING (Investigating the impact of meditation training on mental health and wellbeing in the ageing population) Reporting period: 2021-07-01 to 2022-03-31 Summary of the context and overall objectives of the project Medit-Ageing investigated the effectiveness of different non-pharmacological interventions on ageing, especially on mental health and well-being of older adults. We conducted 2 clinical trials involving patients with subjective cognitive decline (SCD) in the SCD-Well trial and cognitively intact older adults and expert meditators in the Age-Well trial.SCD-Well assessed the effect of short-term interventions on behavioural measures mainly. This trial was conducted in four centres in four different countries (UK, Germany, Spain and France). Recruitment, enrolment, and data acquisition were performed for 147 patients recruited from memory clinics and presenting some level of SCD. They were randomised to either the meditation or health education condition. The intervention lasted for eight weeks, and the effects were measured just after the intervention and 6 months later. The primary outcome paper reported that the mindfulness was not superior to a health education intervention in reducing subclinical anxiety symptoms in older adults with SCD. A sustained reduction in anxiety symptoms was observed in both groups, which suggests that subclinical anxiety symptoms in older adults with SCD are modifiable.Age-Well assessed the effects of 18-month interventions in cognitively intact older adults, and of long-term meditation in expert meditators, on both behavioural and biological measures. These measures included blood sample analyses, sleep and neuroimaging data. The analyses were split into two parts, the first one measuring changes before and after intervention, i.e. between baseline and 18-month follow-up, in the cognitively intact older adults and the second one comparing data of expert meditators to those of cognitively intact older adults. Recruitment, enrolment, and data acquisition were performed for 136 participants in Caen, France. The primary outcome paper from Age-Well trial confirms the feasibility of meditation and foreign language training in elderly, with high adherence and very low attrition, and shows positive behavioural effects of meditation that were not reflected on volume, and not significantly on perfusion, of target brain areas. Future analyses on secondary outcomes will determine the measures most sensitive to meditation training, and the factors associated with responsiveness to the intervention. Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far The project delivered and validated short interventions to seniors reporting SCD, across four European countries, and long interventions to healthy seniors. Significant self-report improvements were found on a global score reflecting attention regulation, socio-emotional capacities and self-knowledge capacities in the long but not the short interventions when comparing the meditation intervention to the active control. Age-Well confirms the feasibility of meditation and language training in elderly, paving the way for future studies on similar interventions in ageing populations. To further understand how lifestyle could influence older adults’ cognitive and brain health, a battery of questionnaires was proposed and has been harmonised in the four different countries of the project. Notably, the harmonisation of one of these questionnaires assessing lifetime experiences (LEQ) is now available for sharing with the scientific community in the four languages.For a better understanding of the role and malleability of emotional processes in healthy ageing, we have developed an innovative task to measure brain activations during and after emotionally challenging events - the Socio-affective Video Task Rest. We also developed behavioural assessment batteries in four languages. More than 50 measures were selected, acquired, translated and compiled into a manual for use as a project resource. Dissemination and PublicationThe communication team has created and managed two websites, the main project website in English and an additional French language website. The Medit-Ageing European Network of research, clinical and professional stakeholders was established in June 2016 and at the end of the funding period, it holds 898 validated and consented names. A multi-country media contacts database (newspapers, magazines, freelancers, online, radio & TV) was created and holds a curated list of 2003 contacts from across the globe. Over the course of the project, there has been significant international media coverage including articles in local and national press, radio, TV highlights and online media outlets.22 papers have been published or about to be submitted in high-rank peer reviewed journals:• 5 reviews: on the SCD population (Jessen et al., Lancet Neurol, 2020), on the impact of meditation on ageing (Chételat et al., Alz Res Ther, 2018; Klimecki et al., Psychology, 2019), on the effects of mindfulness-based programs on cognitive performance in adults (Whitfield et al., Neuropsycho Rev, 2021) and the impact of language learning on ageing (Ware et al., Front Aging Neurosci, 2021)• A theoretical model on the meditation interventions (Lutz and Chételat et al. Ageing Res Rev 2021) (IF 10.9)• 3 protocol papers on SCD-Well (Marchant et al., Alz Dement, 2018), Age-Well (Poisnel et al., Alz Dement, 2018) and the expert mediators observational study (Lutz et al., Alz Dement, 2018)• 2 primary outcome articles of SCD-Well and Age-Well clinical trials (Marchant et al., Psychother Psychosom, 2021; Chételat, Lutz et al., JAMA Neurol, 2022) (IF: 18,3)• Analyses on baseline data led to the publication of 11 articles, amongst which 7 have been accepted in high-rank peer-reviewed journals (JAMA Neurology – IF: 18.3 Neurology - IF: 9.9; Neuroimage – IF: 7.4; Alzheimer's research and Therapy – IF 6.4 and Front Aging Neurosci – IF 4.5) and 5 are about to be submitted or under review in high-rank peer-reviewed journals. Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far) As life expectancy increases, the number of people affected by age-related conditions increases too. This can include mental health problems such as Alzheimer’s Disease, memory loss and dementia.Research is needed to identify the determinants of health into later life. Our findings will contribute to important discussions around safeguarding quality of life for more of the population, informing healthcare providers and policy makers on interventions to help reduce the cost/care burden on health services caused by age-associated diseases.MEDIT-AGEING is expected to result in:- Improved therapeutic management of older adults affected by mental conditions and disorders. - Maintenance of cognitive abilities of older people. - Establishment of preventive strategies favouring the mental dimension of healthy ageing. - Reduction of the negative impact of mental disorders on comorbidities. - MEDIT-AGEING improving innovation capacity and integration of new knowledge MEDIT-AGING is the first project to comprehensively study the short and long-term cognitive, emotional, and biological correlates and the efficacy of meditation within one multidisciplinary consortium. Novel mechanisms will be identified in a model condition (meditation experts) and in association with AD-risk factors in cognitively intact older adults. Our aim is to contribute to better-designed international prevention programs, sustainable policies on long-term care, and guidelines on promoting mental wellbeing of the ageing population. Understanding the determinants of wellbeing in ageing will also contribute to the development of age-friendly services and settings.
