Ruchika Shaurya Prakash

Objectives: The current study examined the efficacy of mindfulness-based stress reduction (MBSR), compared with an active control lifestyle education program (LifeEd), in improving fluid and driving-related cognition in older adults. Dose–response associations between mindfulness practice and treatment gains were also examined. Method: One hundred fifty participants were randomized to one of two groups. Outcomes were assessed at pre-intervention, post-intervention, and 6- and 12-month follow-ups. Results: There were no significant group-by-time interaction effects or dose–response associations ( p > 0.05). Both groups improved on tasks of fluid and driving-related cognition at post-intervention and/or follow-up ( p < 0.05). Conclusions: Older adults in both groups showed improvements in cognition across the 12-month period, with no evidence of a differential advantage for MBSR. Structured, cognitively engaging interventions may support cognition in later life through multiple pathways, although practice effects cannot be ruled out in this study. Pre-registration: See ClinicalTrials.gov (NCT03626532) and Open Science Framework pre-registration: https://osf.io/3jmru/overview?view_only=09f091be1d0d4c4da7a99c3fcb6e2b4a

Background: In the United States, the prevalence of Alzheimer disease (AD) is projected to double over the next 30 years, with associated familial and societal costs estimated at US $1 trillion annually if current trends continue. Although pharmacological treatments of AD are showing promise, the adoption of healthy lifestyle behaviors, particularly during the preclinical phase of AD, may reduce dementia rates by up to 45%. Subjective cognitive decline (SCD), defined as persistent self-perceived declines in cognitive functioning compared with previously normal cognitive abilities, has been identified as a potential preclinical stage of AD. Objective: This randomized controlled trial aims to evaluate the feasibility and acceptability of an internet-based, asynchronous mindfulness-based stress reduction program compared with an active control group (an internet-based lifestyle education program). Secondary objectives include examining preliminary effects of each intervention on SCD, plasma-based biomarkers of amyloid and tau pathology, and everyday mind-wandering. Methods: Sixty adults aged 50 years and older will be screened for SCD in the absence of objective cognitive impairment, based on the Uniform Data Set Neuropsychological Battery (version 3.0) from the National Alzheimer’s Coordinating Center. Eligible and consenting participants will complete behavioral and imaging-based tasks of sustained attention and mind-wandering, as well as blood draws at baseline and after the 8-week intervention. After baseline assessments, participants will be randomized to either an internet-based, asynchronous mindfulness-based stress reduction program or the internet-based lifestyle education program. Both programs have been adapted from our manualized in-person programs and refined through focus group interviews with the target population. Results: The study was funded in April 2024. Phase 1 focused on iterative development of the 2 programs based on focus group feedback. Recruitment for the randomized controlled trial (internet-based mind-body training trial) began in June 2025 and is ongoing. Recruitment is expected to conclude in September 2026, with data collection ending in December 2026. Conclusions: Behavioral, lifestyle-based interventions that emphasize experiential practices show promise as preventative strategies to prevent decline in cognitive and brain health. Yet, there remain significant barriers to engaging with in-person programs, including limited accessibility, time and schedule constraints, and travel logistics. The internet-based mind-body training trial will evaluate the feasibility and acceptability of 2 fully online, mind-body training programs for adults at risk for AD. Future Stage II and Stage III studies will be necessary to establish the efficacy of these programs for improving AD biomarkers and cognitive outcomes and their broader dissemination to adults noticing subtle changes in cognitive functioning.

Objectives: Older adults exhibit age-related declines in processes of attentional control, demonstrating an emergent need to identify mind-body interventions that support healthy cognitive aging. Mindfulness training is a promising intervention for improving attentional control processes, but relatively few methodologically rigorous studies have examined whether these effects extend to older adults. Methods: This pre-registered Stage II randomized controlled trial (RCT) of older adults (N = 150), aged 65–85 years, examined the effects of eight weeks of Mindfulness-Based Stress Reduction (MBSR) versus an active control training program on immediate and long-term metrics of attentional control. Results: Compared with the active control, MBSR did not differentially improve most metrics of sustained attention or mind-wandering, although a small effect was observed for self-reported task-unrelated thoughts. Improvements were observed in Go/No-Go (GNG) dL over time. Additionally, Groups differed on the GNG reaction time coefficient of variability and the Conners Continuous Performance Test d′ and reaction time variability. Discussion: Our findings suggest that mindfulness training compared to an active control may not differentially enhance attentional control among older adults.

The properties of functional brain networks are an important determinant of cognitive function in aging and dementia. Despite this, few studies have comprehensively examined demographic and biopsychosocial predictors of functional brain networks, and none have attempted to do so across the adult lifespan while accounting for collinearity among these predictors. The current study used data from 525 individuals between the ages of 35 and 100 years from the Human Connectome Project 2.0 Lifespan Release, which includes task-based functional neuroimaging, physical and emotional health, and demographic information. Two functional brain network properties previously identified as moderators of cognitive decline, entropy and modularity, were used as outcome metrics in four elastic net regression models that identified and ranked predictors of these metrics as well as their age-interaction terms. We identified biological sex, sleep duration, instrumental support, visual acuity, education, social isolation, diastolic blood pressure, and vigorous physical activity as the strongest and most consistent predictors of entropy and modularity beyond age. Importantly, these predictors differed from ranked correlational results, suggesting many predictors share large amounts of overlapping statistical variance. Additionally, we found that biological sex exhibited a significant moderation effect such that males demonstrated greater age-related decreases to network resilience with increasing age compared to females. In the current study, we ranked biopsychosocial health determinants of network properties in an adult lifespan sample. Given previous research implicating modularity and entropy as possible measures of cognitive reserve, these results may inform our understanding of resilience to cognitive decline in aging.

BACKGROUND In the United States, the prevalence of Alzheimer’s disease (AD) is projected to double over the next 30 years, with associated familial and societal costs estimated at $1 trillion dollars annually if current trends continue. Although pharmacological treatments of AD are showing promise, the adoption of healthy lifestyle behaviors, particularly during the preclinical phase of AD, may reduce dementia rates by up to 45%. Subjective cognitive decline (SCD)—defined as persistent self-perceived declines in cognitive functioning compared with previously normal cognitive abilities—has been identified as a potential preclinical stage of AD. OBJECTIVE This randomized controlled trial aims to evaluate the feasibility and acceptability of a internet-based, asynchronous mindfulness-based stress reduction program (iMBSR) compared with an active control group, internet-based Lifestyle Education (iLifeEd). Secondary objectives include examining preliminary effects of each intervention on subjective cognitive decline, plasma-based biomarkers of amyloid and tau pathology, and everyday mind-wandering. METHODS Sixty adults aged 50 and older will be screened for subjective cognitive decline in the absence of objective cognitive impairment, based on the Uniform Data Set neuropsychological battery version 3.0 (UDS3-NB) from the National Alzheimer’s Coordinating Center. Eligible and consenting participants will complete behavioral and imaging-based tasks of sustained attention and mind-wandering, as well as blood draws at baseline and after the eight-week intervention. After baseline assessments, participants will be randomized to either iMBSR or the iLifeEd program. Both programs have been adapted from our manualized in-person programs and refined through focus groups interviews with the target population. RESULTS The study was funded in April 2024. Phase I focused on iterative development of the two programs based on focus group feedback. Recruitment for the randomized controlled trial (iMBT) began in July 2025 and is ongoing. Recruitment is expected to conclude in December 2025, with data collection ending in March 2026. CONCLUSIONS Behavioral, lifestyle-based interventions that emphasize experiential practices show promise as preventative strategies to prevent decline in cognitive and brain health. Yet, there remain significant barriers to engaging with in-person programs, including, limited accessibility, time and schedule constraints, and travel logistics. The iMBT trial will evaluate the feasibility and acceptability of two fully online, mind-body training programs for adults at-risk for AD. Future Stage II and Stage III studies will be necessary to establish the efficacy of these programs for improving AD biomarkers and cognitive outcomes, and their broader dissemination to adults noticing subtle changes in cognitive functioning. CLINICALTRIAL Clinicaltrials.gov (#NCT07019402). Registered June 13, 2025 https://clinicaltrials.gov/study/NCT07019402

Multiple sclerosis is associated with impairments in working memory functioning. Lifestyle physical activity interventions show promise in improving cognitive functioning; however, the evidence is limited. We examined the efficacy of a lifestyle physical activity intervention, involving step tracking and psychoeducational materials, on improving step counts, working memory functioning, and network strength in a whole-brain network of working memory. Participants (n = 75) were randomly assigned to a group tracking steps with a pedometer (step-track), or a group tracking water intake with a smart water bottle (water-track), for 6 months. At baseline, mid, and postintervention, we assessed weekly physical activity (GT3X+ accelerometer), weekly water intake (H20 Pal Smart Bottle), and working memory functioning. Additionally, the combined network strength of a validated working memory connectome was calculated. We ran random intercept linear mixed models to examine differences between the groups, over time. A significant Group × Time interaction effect with steps and water intake indicated that the step-track group increased their steps, and the water-track group increased their water intake, in comparison to each other, from baseline to postintervention (p < .05). Both groups improved in behavioral working memory over time (p < .05). No significant differences were found on the network strength. Our 6-month randomized controlled trial involving physical activity tracking showed increased step count in the intervention group. Behavioral working memory improved in both groups, potentially due to practice effects. Future studies should include both active and passive control groups to discern practice effects from intervention impact. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mind–body interventions involve practices that intentionally combine mental and physical fitness, showing promise for improving psychological and cognitive health in older adults. Limited research exists on adherence to these interventions and the demographic and psychosocial factors that may predict variability in compliance. In the current study, we identified key correlates—demographic, psychosocial, and cognitive—of adherence to two mind–body interventions. Baseline and intervention data were analyzed together from a randomized controlled trial of older adults who participated in two four-week mind–body interventions and completed practice logs (n = 60). Adherence was defined as the average weekly self-reported minutes of homework practice during the intervention. Baseline correlates included education, sex assigned at birth, working memory score, emotion dysregulation, positive and negative affect, trait mindfulness, and depression. Partial least squares regression was used to identify latent components. A significant one-component solution from the final model explained 23.08% of the variance in practice minutes. Greater adherence was associated with mild depressive symptoms, difficulties with emotion regulation, and lower working memory scores. These findings suggest that participants with mild emotional and cognitive difficulties may be more likely to adhere to mind–body interventions. These results emphasize the target population likely to engage in mind–body interventions and may be valuable for designing tailored interventions and developing strategies to maximize adherence. This study was registered on ClinicalTrials.gov (#NCT03432754) on February 14, 2018.

Among the cerebrospinal fluid (CSF)-based measures of Alzheimer's disease (AD) pathology, the ratiometric measure of p-tau/Aβ42 shows the best diagnostic accuracy. However, few studies have linked the p-tau/Aβ42 ratio to cognition directly. The goal of this study was to examine whether a CSF-based p-tau/Aβ42 ratio predicts changes in global cognitive functioning, episodic memory, and executive functioning over a 2-year period in cognitively unimpaired (CU) older adults, in individuals with mild cognitive impairment (MCI), and in those with AD. This study involves secondary analysis of data from 1,215 older adults available in the Alzheimer's Disease Neuroimaging Initiative. Neuropsychological composite variables, collected at baseline, 6-month, 12-month, and 24-month follow-ups, of global cognition, episodic memory, and executive functioning, were included. Generalized least square linear models were constructed to examine the effect of CSF p-tau/Aβ42, diagnostic group, and change over time on cognitive scores. CSF p-tau/Aβ42 ratio predicted cognitive decline, both on global cognition and episodic memory, in individuals with MCI and AD, but not in CU older adults. The p-tau/Aβ42 ratio, in contrast, predicted decline in executive functioning for all three diagnostic groups. Our study, which included individuals with CU, MCI, and AD, provides evidence of differential cognitive consequences of accumulated AD pathology across diagnostic groups, particularly in the domains of global cognition and episodic memory. Additionally, AD pathology was associated with worsening executive functioning across all three diagnostic groups, suggesting that declines in executive functioning may occur well before declines in other cognitive domains. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

INTRODUCTION: Alzheimer's disease (AD) is characterized by the presence of two proteinopathies, amyloid and tau, which have a cascading effect on the functional and structural organization of the brain. METHODS: In this study, we used a supervised machine learning technique to build a model of functional connections that predicts cerebrospinal fluid (CSF) p‐tau/Aβ ₄₂ (the PATH‐fc model). Resting‐state functional magnetic resonance imaging (fMRI) data from 289 older adults in the Alzheimer's Disease Neuroimaging Initiative (ADNI) were utilized for this model. RESULTS: We successfully derived the PATH‐fc model to predict the ratio of p‐tau/Aβ ₄₂ as well as cognitive functioning in older adults across the spectrum of healthy and pathological aging. However, the in‐sample fit magnitude was low, indicating a need for further model development. DISCUSSION: Our pathology‐based model of functional connectivity included representation from multiple canonical networks of the brain with intra‐network connectivity associated with low pathology and inter‐network connectivity associated with higher levels of pathology. Highlights: Whole‐brain functional connectivity model (PATH‐fc) is linked to AD pathophysiology. The PATH‐fc model predicts performance in multiple domains of cognitive functioning. The PATH‐fc model is a distributed model including representation from all canonical networks.