Effects of mindfulness-based interventions on cognitive outcomes in adults with neurological disorders: a systematic review and meta-analysis of randomized controlled trials
Hui Yan, Yue Zhong, Qiang Ji, Fengya Zhu, Shao Yin, Ying Liu
BMC Nursing October 6, 2026 DOI: 10.1186/s12912-026-05359-4 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review and meta-analysis Randomized Peer reviewed |
|---|---|
| Sample size | 479 |
| Population | Adults with neurological disorders |
| Interventions | Mindfulness-based interventions mindfulness-based stress reduction (MBSR) and other structured MBIs |
| Measures | NIHSS |
| Topics | Meditation |
| Key findings | Mindfulness-based interventions were associated with higher cognitive scores on average (Hedges g = 0.82, 95% CI 0.12 to 1.52), but heterogeneity was substantial (I² = 90%) and the prediction interval crossed the null, so the authors describe the evidence as low certainty. Depression did not differ significantly between groups (g = −0.19), and no subgroup factor significantly modified effects. |
Abstract
To evaluate the effectiveness of mindfulness-based interventions (MBIs), including but not limited to mindfulness-based cognitive therapy (MBCT), mindfulness-based stress reduction (MBSR), and other structured MBIs, in improving cognitive and psychological outcomes in adults with neurological disorders. We searched six databases through April 25, 2025. Eight randomized controlled trials were included, and 479 participants contributed to the primary cognitive meta-analysis. Random-effects models were prespecified because of expected clinical and methodological heterogeneity; between-study variance was estimated using restricted maximum likelihood, with Hartung-Knapp confidence intervals. Exploratory subgroup analyses examined disease type, intervention model, and treatment duration. Risk of bias was assessed using the Cochrane RoB 2 tool. Across eight trials, mindfulness-based interventions were associated with higher cognitive scores on average (Hedges g = 0.82, 95% CI 0.12 to 1.52; p = 0.027), but heterogeneity was substantial (I² = 90.0%) and the prediction interval crossed the null (− 1.17 to 2.82). Tests for subgroup differences were not significant for disease type ( p = 0.098), intervention model ( p = 0.154), or treatment duration ( p = 0.954). Depression did not differ significantly between groups (7 trials; 443 participants; g = − 0.19, 95% CI − 1.08 to 0.71). Mindfulness levels showed a small positive pooled estimate (2 trials; 118 participants; g = 0.17, 95% CI 0.04 to 0.30). NIHSS was reported by one eligible trial involving 80 participants and was therefore not meta-analyzed (MD = − 2.89, 95% CI − 3.60 to − 2.18). Low-certainty evidence suggests that MBIs may be associated with higher cognitive scores in adults with neurological disorders. However, substantial heterogeneity and a prediction interval crossing the null limit confidence in this finding. No subgroup factor showed significant effect modification, and evidence for secondary outcomes remained limited. Further well-designed trials are needed before MBIs can be recommended specifically for cognitive improvement. Not applicable.
Comparable studies
Other systematic reviews and meta-analyses on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations | 2014 | Meta-analysis | n = 3,515 |
| Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects | 2009 | Systematic review and meta-analysis | |
| The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators | 2012 | Meta-analysis | n = 163 |
| Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission | 2016 | Meta-analysis of individual patient data from randomized controlled trials | n = 1,258 |
| Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials | 2011 | Systematic review |