Can meditation delay the onset of Alzheimer's disease?

• Meditation could reduce the risk of developing a neurodegenerative disease, according to our partner

  The Conversation

  .

• This is all the more interesting as, in parallel with the increase in lifespan, more and more people are affected by Alzheimer's disease or other neurodegenerative diseases.

• This analysis was conducted by

  Gaël Chételat

  and

  Antoine Lutz

  , both directors of neuroscience research at the National Institute for Health and Medical Research (Inserm).

Meditation is a growing practice, to which many health benefits, both physical and mental, are attributed.

More and more studies suggest that it could improve well-being and mental health in aging, and in particular reduce the risk of developing a neurodegenerative disease: an asset that could prove crucial as the hope of life is increasing, which goes hand in hand with an aging population.

Today in France, out of 67 million inhabitants, 19.6% are over 65 and this figure is constantly rising.

Life expectancy is 78.4 years for men and 84.8 years for women;

in 2060, it should be 86 and 91.1 years respectively – a gain of more than 6 years expected.

However, the health of seniors raises specific questions.

In parallel with the increase in lifespan, an ever greater number of people are affected by Alzheimer's disease or other neurodegenerative diseases leading to dementia.

Nearly 15% of adults over 60 suffer from pathologies associated with aging.

Preserving the good mental health of this public is therefore a real challenge and any preventive strategy should be considered.

However, the real effects of meditation have never really been scientifically studied in this light.

This is the objective of our latest published study, conducted as part of the

project (Silver Health Study programme) – a first, the results and perspectives of which we present here.

​Why meditation?

A whole series of risk factors for neurodegenerative diseases have been identified: smoking, pollution, poor diet, physical inactivity, etc.

The techniques to counter them are numerous: practice physical activity and cognitive training, have a good diet (preferably Mediterranean), follow a cardiovascular health education program… Several studies evaluate these practices.

But other risk factors, some of which are amplified during aging, remain largely underestimated by research: depression, stress, anxiety, sleep problems (which affect one out of two people over 60), feelings of loneliness and social exclusion, etc.

And there are no scientifically substantiated preventive intervention programs directly targeting these psycho(-socio)-affective risk factors.

It is this deficiency that we wanted to fill by studying the effects of meditation as part of the European project H2020 Silver Health Study.

The practice of meditation is distinguished precisely by the fact of directly targeting these psycho(-socio)-affective factors, in addition to being an excellent cognitive training.

For example, it has been shown to be effective in reducing stress, depression, anxiety, etc. This subject of study being recent, there are not yet solid data, in the context of randomized control trials, on the possible impacts of meditation on cognition and the brain in aging.

The most practiced and researched meditation techniques are age-old mindfulness techniques.

It is a form of mental training, embodied in a stable and relaxed body posture.

She seeks to cultivate a new way of relating to emotions, thoughts and sensations, which is more open, welcoming and benevolent.

So it's not just about relaxation or forcing yourself “not to think about anything”.

The religious aspect and the beliefs associated with Buddhism are absent.

There are now different programs developed over eight weeks, standardized and accessible to all.

They help, with simple exercises, (observation, feeling of breathing…), to get in touch with one's mind in order to become aware of spontaneous affective reactions or erroneous perceptions which can amplify stress or ruminations.

This allows you to be more present in what you do, to be more consciously present in what you experience, to be less scattered.

These programs have been studied in detail for nearly 40 years and used daily in hundreds of hospitals around the world.

Meta-analyses summarizing these results have demonstrated a positive effect on cognition, stress regulation and clinical conditions such as depression or anxiety.

This pledge of seriousness, which gives the guarantee of a rigorous practice (MBSR), allowed its diffusion.

​An unparalleled research program

As part of the European research project H2020, involving eleven research teams in six countries, we have set up an 18-month meditation program.

Our goal: to study the impact on multiple factors associated with aging and Alzheimer's disease via clinical trials (here,

, the first results of which we recently published in the journal

).

A suitable infrastructure, where the necessary imaging tools have been mobilized, has been set up at the Cycéron centre.

Our protocol has several strengths, rarely met, namely a large cohort, a long study time and a very varied range of measures:

• We followed a panel of 137 participants over 65, divided into three groups: one receiving meditation training (45 people), one following a cognitive activity (here, learning a foreign language; 46 people ) and a control group (no specific activity; 46 people).

• In this type of study, the observation times are usually shorter than in our study (2 to 6 months) and the attrition rate (i.e. the proportion of participants who leave the study) is about 15%.

  Here, in eighteen months, and despite the constraints (coming every week for a 2-hour session with a teacher + an individual daily practice, assisted by a tablet, of 20 minutes or more), we have not had of abandonment.

  This suggested a strong involvement of the participants and a positive feeling.

• Our originality was also based on the diversity of the measurements carried out, before and after the test: search for lesions (presence of amyloid deposits linked to Alzheimer's, etc.), analysis of functional connectivity at the cerebral level, measurements of the volume of cerebral structures, blood markers (presence of stress markers, etc.), sleep, well-being scale, etc.

  This allowed us to accurately assess the potential effects of meditation on a broad spectrum of complementary measures of interest.

Mixed results

Previous work had identified which brain regions should be tracked primarily.

These were the anterior cingulate cortex (which integrates affective processes – emotional feeling, heartbeat – and cognitive functions, such as reward anticipation, decision-making or cognitive control, etc.) and the insula or insular cortex (involved in emotions, interoception, dependence, consciousness…).

We thought that their volume and functioning were likely to have been influenced by meditation, as observed in long-time expert subjects.

In reality, we did not measure any significant change in volume, either for the anterior cingulate cortex or for the insula.

There was therefore no detectable effect on brain structure in these two regions.

By measuring blood flow, or the amount of blood that arrives in these brain regions per unit of time (reflecting functioning), we also did not see a significant effect of meditation… A positive trend was however observed, indicating that, possibly, a longer follow-up or a larger number of participants could have made it possible to reach the significance level.

On the other hand, concerning the impact of meditation on behavior, the effects are significant: the ability to regulate emotions and attention reported by the participants were better preserved in the meditation group compared to the other two.

A positive effect was also found on the overall score combining measures of socio-emotional skills, self-knowledge and regulation of attention – measures that are known to be correlated with the well-being of the elderly.

This benefit emerges not only from our questionnaires but also from a qualitative study conducted on the basis of interviews at the end of the study.

Work that is just beginning

There is still a lot of data to analyze to understand the effects of meditation, not only on the volume and functioning of the rest of the brain, as on all the other measures taken (sleep, blood biomarkers, etc.).

In addition, we were fortunate to be able to carry out an additional follow-up three years after the end of the intervention: this additional data will allow us to assess the effects of meditation in the longer term.

OUR “ALZHEIMER” FILE

Finally, we are developing an application for phones or tablets offering the same meditation program.

Openly proposing this application will make it possible to reach even more people and will be a new opportunity to collect additional data.

It is, in any case, an exploratory study of a new kind.

And our results, although still preliminary, are promising.

And the data being collected will fuel a lot of other work: this is just the beginning.

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