Mindfulness may be a window into brain health in early Alzheimer’s risk

A new study published in the journal Mindfulness has found that older adults with early signs of cognitive impairment show reduced levels of dispositional mindfulness, and that this decline may be linked to changes in brain connectivity. Specifically, the researchers identified weaker functional connections in the ventromedial prefrontal cortex—a brain region involved in emotional regulation—as a predictor of lower mindfulness in individuals with mild cognitive impairment.

The study was conducted to better understand how mindfulness traits change in the early stages of cognitive decline, before a diagnosis of dementia is made. The researchers focused on two groups: individuals with subjective cognitive decline, who report memory issues despite normal test performance, and those with mild cognitive impairment, who show measurable deficits but still maintain independence in daily life. Both groups are at increased risk of developing Alzheimer’s disease, and identifying early behavioral or neurological changes could aid in prevention and intervention efforts.

Mindfulness, often cultivated through practices like meditation, is also considered a stable personality trait. People naturally vary in their ability to remain present and aware of their thoughts and feelings. This capacity, known as dispositional mindfulness, has been linked to improved attention, emotional regulation, and brain health in prior studies involving healthy individuals. However, little research has explored how this trait may change in people experiencing early cognitive decline, or how it relates to brain function and structure.

To investigate these questions, the research team recruited 79 older adults—48 with subjective cognitive decline and 31 with mild cognitive impairment—from the Czech Brain Aging Study. All participants underwent cognitive assessments, brain imaging, and a behavioral test of mindfulness called the Breath Counting Task. In this task, participants were instructed to count their breaths in cycles of nine over an 18-minute period, with accuracy measured through physiological data. Unlike questionnaires, this task offers a direct behavioral measure of mindfulness.

The researchers also conducted advanced brain imaging, including structural and functional magnetic resonance imaging. They focused on specific brain regions previously linked to mindfulness and cognitive decline: the hippocampus (important for memory), the posterior cingulate cortex (involved in mind-wandering), the rostral anterior cingulate cortex (linked to self-awareness), and the ventromedial prefrontal cortex (associated with emotional appraisal and decision-making). Connectivity between brain regions was examined using resting-state functional imaging, while brain structure was assessed through volumetric and diffusion-weighted scans.

The results showed that participants with mild cognitive impairment had significantly lower mindfulness scores on the Breath Counting Task than those with subjective cognitive decline. This group difference remained statistically significant even after adjusting for age and other factors. Interestingly, differences in cognitive performance on traditional memory and attention tests did not predict mindfulness scores in either group. This suggests that the ability to maintain mindful attention may reflect distinct mental processes not captured by standard cognitive tests.

One of the most important findings was that greater functional connectivity in the ventromedial prefrontal cortex predicted higher mindfulness scores in individuals with mild cognitive impairment. This relationship was not found in those with subjective cognitive decline, indicating a possible compensatory mechanism in more impaired individuals. In other words, people in the early stages of measurable cognitive loss may need to rely more heavily on this brain region to sustain mindful awareness.

No significant associations were found between mindfulness scores and brain structure in any of the examined regions, including the hippocampus and posterior cingulate cortex. This was somewhat surprising given prior research linking mindfulness training to changes in gray matter volume in these areas. The authors suggest that structural brain differences may be less sensitive to subtle variations in dispositional mindfulness, or that longer-term meditation practice may be required to influence brain anatomy.

The study’s findings underscore the potential of mindfulness as both a behavioral marker and a modifiable factor in cognitive aging. Because mindfulness has been linked to reduced stress and improved emotional coping, higher levels of dispositional mindfulness may help buffer against the effects of cognitive decline. Moreover, the fact that individuals with mild impairment showed lower mindfulness but still maintained the ability to engage in the breath-counting task suggests that mindfulness interventions could be feasible and beneficial for this population.

One of the strengths of the study is its use of a behavioral measure of mindfulness rather than relying solely on self-reported questionnaires, which can be biased or less reliable in older adults. The Breath Counting Task provides a quantifiable index of attentional stability, which may be especially relevant in assessing early cognitive changes. Additionally, the integration of multiple brain imaging methods allowed the researchers to examine both functional and structural correlates of mindfulness.

However, the study was cross-sectional, meaning it cannot determine whether lower mindfulness causes cognitive decline, results from it, or simply reflects parallel changes. Longitudinal studies are needed to understand how mindfulness and brain function co-evolve over time in aging individuals. Another limitation was the lack of biomarker data to confirm whether participants with mild impairment were on a trajectory toward Alzheimer’s disease. Including such data in future research could help clarify whether the observed changes are specific to this condition.

The study, “Present Mind in the Ageing Brain: Neural Associations of Dispositional Mindfulness in Cognitive Decline,” was authored by Rastislav Šumec, Pavel Filip, Martin Vyhnálek, Stanislav Katina, Dusana Dorjee, Jakub Hort, and Kateřina Sheardová.