Mindfulness-Based Stress Reduction, Health Education and Exercise

MBSR teaches mindfulness, or the focusing of attention and awareness, through various
meditation techniques. Mindfulness meditation practices appear to produce neurocircuitry
changes that are the reverse of those seen in age-related cognitive decline. It is widely
available, acceptable to older people, and carries minimal risk of side effects or adverse
events. Exercise - specifically, intense, multi-component exercise - also appears to affect
brain structure and function and improve cognitive performance.

The investigators will randomize 580 non-demented healthy adults aged 65 to 84 to one of four
conditions: MBSR alone, exercise alone, MBSR + exercise, or a health education discussion
group control condition.

The study will consist of a 6-month acute intervention phase with weekly visits followed by a
12-month maintenance phase with weekly or monthly visits and other prompts to maintain
intervention behaviors.

Assessments include cognitive tests, biomarkers, neuroimaging assessments, functional
assessments to examine real-world benefits of the interventions, and other behavioral
assessments to characterize participants and pave the way for further exploratory analyses.

Inclusion Criteria:

- Community-living men and women age 65 to 84.

- Self-reported cognitive complaints that are a normal part of aging.

- No current meditation practice nor prior training in it.

- Sedentary.

Exclusion Criteria:

- Known diagnosis of dementia, mild cognitive impairment, other clinical
neurodegenerative illness (e.g., Parkinson's disease, cerebrovascular disease),
psychotic disorder, or any unstable psychiatric condition.

- Medical conditions that suggest shortened lifespan, such as metastatic cancer; or
would prohibit safe participation in the interventions, including cardiovascular
disease or musculoskeletal conditions; or would interfere with the assessments, such
as taking medications for diabetes or ferromagnetic metal/bridgework that would
interfere with MRI signal.

- IQ <70 as estimated by the Wechsler Test of Adult Reading

- Sensory impairment (language, hearing, or visual) that would prevent participation.

- Alcohol abuse within 6 months.

- Current illicit drug use.

- Concurrent cognitive training, such as brain-training software, or other interventions
expected to affect neuroplasticity.

- Medications that interfere with measurements, including cancer chemotherapy,
glucocorticoids, and interferon.

- Inability to cooperate with protocol.