Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials

ABSTRACT

Background

Currently no comprehensive meta-analysis of MBI efficacy on global and unique cognitive subdomains exist.

Method

Examined the effects of MBIs on global cognition and 15 cognitive subdomains. Inclusion criteria: meditation naïve participants; randomized controlled trial; outcome included one objective or subjective cognitive functioning measure; primary focus was teaching mindfulness skills. Exclusion criteria: inadequate data; one-session ; control condition contained any MBI component. Robust variance estimation and moderator analyses controlling for presence of 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, working memory accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (vs. waitlist/no-treatment, g = 0.257–0.643; vs. active controls, 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 vs. healthy controls, and medical samples, studies with complete-case (vs. intention-to-treat) analysis, face-to-face (vs. self-guided) delivery, and non-standard (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:

• Mindfulness-based interventions
• cognitive functioning
• randomised controlled trials
• meta-analysis
• executive function

Acknowledgments

This research was supported in part by National Institute of Mental Health R01 MH115128. The current study also received funding from the Pennsylvania State University RGSO Dissertation award, Penn State Susan Welch/Nagle Family Graduate Fellowship, the National University of Singapore (NUS) Development Grant, and the Association for Behavioral and Cognitive Therapies (ABCT) Leonard Krasner Student Dissertation Award. We also sincerely thank Drs. Nicole Anderson, Micela Balconi, Peter Malinowski, Michael Mrazek, Martin Prätzlich, Benjamin Schöne, Rob H.J. van der Lubbe, and Kathleen Walsh for providing descriptive data of the means and standard deviations of scores on all cognitive test(s) administered in their study at all time-points upon request. We also thank Dr. Mike Cheung at the National University of Singapore for offering statistical consultation to refine our Method section. We also wish to express gratitude to our 16 undergraduate research assistants – Ana Clever, Alexa Belnick, Armani Moore, Emma Win, Emily Forcht, Isabella Gonzalez, Jamie Gensbauer, Kathryn Miller, Madeline Lamonica, Madison Yeoman, Natalie Gottret, Natalie Suzette, Noor Lamba, Serena Chen, Shannon McGovern, and Vivian Nguyen – who served as reliability coders on the team and who regularly attended meta-analysis meetings to resolve any observed discrepancies between ratings.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Due to space constraints, readers should refer to the definitions of italicized cognitive functioning constructs throughout the manuscript in Table 1 of the main manuscript and Table S1 in the online supplemental materials (OSM).

2 We calculated the pre-follow-up effect size only for global cognition because there were insufficient studies to synthesize effect sizes based on the 1 global cognition and 15 cognitive subdomains examined herein.

3 A similar pattern of results was attained when the analysis was carried out with and without the 6 outliers.

4 Due to space constraints, we only reported in text statistically significant results for all moderator analyses.