Mindfulness Enhances Cognitive Functioning: A Meta-Analysis of 111 Randomized Controlled Trials

Author: Nur Hani Zainal Ph.D1, Michelle G Newman Ph.D2
Affiliation: <sup>1</sup> Harvard Medical School, 108 Longwood Ave, Boston, MA 02115. <sup>2</sup> The Pennsylvania State University, 371 Moore Building, University Park, PA 16802.
Conference/Journal: Health Psychol Rev
Date published: 2023 Aug 14
Other: Special Notes: doi: 10.1080/17437199.2023.2248222. , Word Count: 260

Background In theory, habitually exercising mindfulness skills can improve cognitive functioning abilities. However, no comprehensive quantitative reviews of the efficacy of MBIs on global and unique cognitive subdomains exist to date. Method: This meta-analysis examined the effects of MBIs on global cognition and 15 cognitive subdomains. Inclusion criteria: meditation naïve participants; participants randomly assigned to MBIs or no-treatment, waitlist, or active control; outcome measures included at least one behavioral cognitive assessment or subjective cognitive functioning measure; teaching mindfulness skills was the primary treatment focus. Exclusion criteria: inadequate data to calculate effect sizes; MBIs included only one session; control condition that contained any MBI form. Robust variance estimation and moderator analyses controlling for presence of reported treatment fidelity were conducted. Results: One-hundred-and-eleven RCTs (n = 9,538) met eligibility criteria. MBIs had small-to-moderate significant effects on global cognition, executive attention, WM accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (vs. waitlist/no-treatment, average g = 0.257-0.643; vs. active controls, average g = 0.192-0.394). MBIs did not impact executive functioning (EF) latency indices, verbal fluency, processing speed, episodic memory, and cognitive error. Treatment effects were stronger for those with elevated psychiatric symptoms compared to healthy controls, and medical samples, studies with complete-case (vs. intention-to-treat) analysis, face-to-face (vs. self-guided) delivery, and use of non-standard mindfulness-based stress reduction or mindfulness-based cognitive therapy (vs. standard MBI). Conclusion: MBIs consistently yielded small-to-moderate yet practically meaningful effect sizes on global cognition and six cognitive subdomains that captured accuracy vs. latency-based indices of EF and sustained accuracy.

Keywords: cognitive functioning; executive function; meta-analysis; mindfulness-based interventions; randomized controlled trials.

PMID: 37578065 DOI: 10.1080/17437199.2023.2248222