An 18-month meditation training selectively improves psychological well-being in older adults

Abstract

Objectives: As the world population is ageing, it is vital to understand how older adults can maintain and deepen their psychological well-being as they are confronted with the unique challenges of ageing in a complex and vulnerable world. Theoretical work has highlighted the promising role of intentional mental training such as meditation practice for enhancing human flourishing. However, meditation-based randomised controlled trials in older adults are lacking. We aimed to investigate the effects of meditation training on psychological well-being in older adults.Methods: The Age-Well trial (ClinicalTrials.gov: NCT02977819) randomised 137 healthy older adults to an 18-month meditation training (9-month mindfulness followed by 9-month compassion and loving-kindness training), a structurally matched active comparator (English language training), or a passive control. Well-being was measured at baseline, mid-intervention, and 18-month post-randomisation using the Psychological Well-being Scale (PWBS), the World Health Organisation’s Quality of Life (QoL) Assessment psychological subscale, and composite scores reflecting meditation-based well-being dimensions of awareness, connection, insight, and a global score comprising the average of these three meditation-based dimensions. Mixed effects models assessed between- and within-group differences in change over 18 months.Results: Meditation training was superior to English training on changes in the global score and the subscales of awareness, connection, insight, and superior to no-intervention only on changes in the global score and awareness. Between-group differences in psychological QoL in favour of meditation did not remain significant after adjusting for multiple comparisons. There were no between-group differences in PWBS total score. Within the meditation group, psychological QoL, awareness, insight, and the global score increased significantly from baseline to 18-month post-randomisation. Exploratory moderator analyses suggested that greater levels of well-being at baseline predicted smaller improvements for most well-being outcomes.Conclusion: The longest randomised meditation training conducted to date enhanced a global composite score reflecting the meditation-based well-being dimensions of awareness, connection, and insight in older adults. Future research is needed to delineate the cognitive, affective, and behavioural factors that predict responsiveness to meditation and thus help refine the development and efficacy of tailored meditation-based interventions.