, Volume 8, Issue 3, pp 627–638 | Cite as

Meditation in Stressed Older Adults: Improvements in Self-Rated Mental Health Not Paralleled by Improvements in Cognitive Function or Physiological Measures

  • Barry S. Oken
  • Helané Wahbeh
  • Elena Goodrich
  • Daniel Klee
  • Tabatha Memmott
  • Meghan Miller
  • Rongwei Fu


To determine if mindfulness meditation (MM) in older adults improves cognition and, secondarily, if MM improves mental health and physiology, 134 at least mildly stressed 50–85-year olds were randomized to a 6-week MM intervention or a waitlist control. Outcome measures were assessed at baseline and 2 months later at visit 2. The primary outcome measure was an executive function/attentional measure (flanker task). Other outcome measures included additional cognitive assessments, salivary cortisol, respiratory rate, heart rate variability, Positive and Negative Affect Schedule (PANAS), Center for Epidemiologic Studies Depression (CESD), Perceived Stress Scale (PSS), Neuroticism-Extraversion-Openness (NEO) personality traits, and SF-36 health-related quality of life. One hundred twenty-eight participants completed the study though visit 2 assessments. There was no significant change in the primary or other cognitive outcome measures. Even after statistical adjustment for multiple outcomes, self-rated measures related to negative affect and stress were all significantly improved in the MM intervention compared to waitlist group (PANAS-negative, CESD, PSS, and SF-36 health-related quality of life Vitality and Mental Health Component). The SF-36 Mental Health Component score improved more than the minimum clinically important difference. There were also significant changes in personality traits such as Neuroticism. Changes in positive affect were not observed. There were no group differences in salivary cortisol or heart rate variability. These moderate-sized improvements in self-rated measures were not paralleled by improvements in cognitive function or physiological measures. Potential explanations for this discrepancy in stress-related outcomes are discussed to help improve future studies.


Meditation Stress Cognition Mental health Aging Adherence 



Roger Ellingson is acknowledged for engineering support. Jeff Proulx helped edit the paper. Preliminary results were presented at the International Conference on Integrative Medicine and Health 2016 annual meeting.

Compliance with Ethical Standards

Conflict of Interest

There were no conflicts of interest by any authors. This study was funded in part by Oregon Health & Science University and by grants from National Institutes of Health (AT005121 and UL1TR000128).

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Abbott, R. A., Whear, R., Rodgers, L. R., Bethel, A., Thompson Coon, J., Kuyken, W.,…Dickens, C. (2014). Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials. Journal of Psychosomatic Research, 76(5), 341–351. doi:  10.1016/j.jpsychores.2014.02.012
  2. Astin, J. A. (1997). Stress reduction through mindfulness meditation. Effects on psychological symptomatology, sense of control, and spiritual experiences. Psychotherapy and Psychosomatics, 66(2), 97–106. doi: 10.1159/000289116.PubMedCrossRefGoogle Scholar
  3. Baer, R. A., Smith, G. T., & Allen, K. B. (2004). Assessment of mindfulness by self-report: the Kentucky Inventory of mindfulness skills. Assessment, 11(3), 191–206.PubMedCrossRefGoogle Scholar
  4. Baer, R. A., Smith, G. T., Hopkins, J., Krietmeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45. doi: 10.1177/1073191105283504.PubMedCrossRefGoogle Scholar
  5. Barlow, D. H., Ellard, K. K., Sauer-Zavala, S., Bullis, J. R., & Carl, J. R. (2014). The origins of neuroticism. Perspectives on Psychological Science, 9(5), 481–496. doi: 10.1177/1745691614544528.PubMedCrossRefGoogle Scholar
  6. Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society. Series B (Methodological), 57(289–300).Google Scholar
  7. Benton, A. L., & Hamsher, K. D. S. (1989). Multilingual aphasia examination. Iowa City: AJA Associates.Google Scholar
  8. Brookmeyer, R., Gray, S., & Kawas, C. (1998). Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. American Journal of Public Health, 88(9), 1337–1342.PubMedPubMedCentralCrossRefGoogle Scholar
  9. Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848.PubMedCrossRefGoogle Scholar
  10. Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatric Research, 28(2), 192–213. doi: 10.1016/0165-1781(89)90047-4.CrossRefGoogle Scholar
  11. Caspi, A., Hariri, A. R., Holmes, A., Uher, R., & Moffitt, T. E. (2010). Genetic sensitivity to the environment: the case of the serotonin transporter gene and its implications for studying complex diseases and traits. The American Journal of Psychiatry, 167(5), 509–527. doi: 10.1176/appi.ajp.2010.09101452.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Cherkin, D., Deyo, R. A., & Berg, A. O. (1991). Evaluation of a physician intervention to improve primary care for low-back pain: II. Impact on patients. Spine, 16, 1173–1178.PubMedCrossRefGoogle Scholar
  13. Chiesa, A., & Serretti, A. (2010). A systematic review of neurobiological and clinical features of mindfulness meditations. Psychological Medicine, 40, 1239–1252. doi: 10.1017/S0033291709991747.PubMedCrossRefGoogle Scholar
  14. Chiesa, A., Calati, R., & Serretti, A. (2011). Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings. Clinical Psychology Review, 31(3), 449–464. doi: 10.1016/j.cpr.2010.11.003.PubMedCrossRefGoogle Scholar
  15. Cohen, S., Karmarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.PubMedCrossRefGoogle Scholar
  16. Costa, P. T., & McCrae, R. R. (2010). NEO inventories: professional manual. Lutz: Psychological Assessment Resources, Inc.Google Scholar
  17. Coteur, G., Feagan, B., Keininger, D. L., & Kosinski, M. (2009). Evaluation of the meaningfulness of health-related quality of life improvements as assessed by the SF-36 and the EQ-5D VAS in patients with active Crohn’s disease. Alimentary Pharmacology and Therapeutics, 29(9), 1032–1041. doi: 10.1111/j.1365-2036.2009.03966.x.PubMedCrossRefGoogle Scholar
  18. Davidson, R. J., & McEwen, B. S. (2012). Social influences on neuroplasticity: stress and interventions to promote well-being. Nature Neuroscience, 15(5), 689–695. doi: 10.1038/nn.3093.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Daviglus, M.L., Bell, C.C., Berrettini, W., Bowen, P.E., Connolly, E.S., Cox, N.J.,…Trevisan, M. (2010). NIH state-of-the-science conference statement: preventing Alzheimer’s disease and cognitive decline. NIH Consensus State of the Science Statements, 27(4), 1–30.Google Scholar
  20. DeRubeis, R. J., Siegle, G. J., & Hollon, S. D. (2008). Cognitive therapy versus medication for depression: treatment outcomes and neural mechanisms. Nature Reviews Neuroscience, 9(10), 788–796. doi: 10.1038/nrn2345.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Devilly, G. J., & Borkovec, T. D. (2000). Psychometric properties of the credibility/expectancy questionnaire. Journal of Behavioral Therapy and Experimental Psychiatry, 31, 73–86. doi: 10.1016/S0005-7916(00)00012-4.CrossRefGoogle Scholar
  22. Esch, T., Stefano, G. B., Fricchione, G. L., & Benson, H. (2002). The role of stress in neurodegenerative diseases and mental disorders. Neuroendocrinology Letters, 23(3), 199–208.PubMedGoogle Scholar
  23. Evans, G. W., & Schamberg, M. A. (2009). Childhood poverty, chronic stress, and adult working memory. Proceedings of the National Academy of Sciences, 106, 6545–6549. doi: 10.1073/pnas.0811910106.CrossRefGoogle Scholar
  24. Gard, T., Holzel, B. K., & Lazar, S. W. (2014). The potential effects of meditation on age-related cognitive decline: a systematic review. The Annals of the New York Academy of Sciences, 1307, 89–103. doi: 10.1111/nyas.12348.PubMedCrossRefGoogle Scholar
  25. Golden, C. J. (2002). Stroop color and word test manual. Wood Dale: Stoelting Co.Google Scholar
  26. Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R.,…Haythornthwaite, J. A. (2014a). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine. doi:  10.1001/jamainternmed.2013.13018
  27. Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R.,…Haythornthwaite, J. A. (2014b). Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368. doi:  10.1001/jamainternmed.2013.13018
  28. Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004). Mindfulness-based stress reduction and health benefits: a meta-analysis. Journal of Psychosomatic Research, 57(1), 35–43. doi: 10.1016/S0022-3999(03)00573-7.PubMedCrossRefGoogle Scholar
  29. Hasenkamp, W., Wilson-Mendenhall, C. D., Duncan, E., & Barsalou, L. W. (2012). Mind wandering and attention during focused meditation: a fine-grained temporal analysis of fluctuating cognitive states. NeuroImage, 59(1), 750–760. doi: 10.1016/j.neuroimage.2011.07.008.PubMedCrossRefGoogle Scholar
  30. Hrobjartsson, A., & Gotzsche, P. C. (2001). Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. The New England Journal of Medicine, 344(21), 1594–1620. doi: 10.1056/NEJM200105243442106.PubMedCrossRefGoogle Scholar
  31. Hruschka, D. J., Kohrt, B. A., & Worthman, C. M. (2005). Estimating between- and within-individual variation in cortisol levels using multilevel models. Psychoneuroendocrinology, 30(7), 698–714. doi: 10.1016/j.psyneuen.2005.03.002.PubMedCrossRefGoogle Scholar
  32. Hurd, M. D., Martorell, P., Delavande, A., Mullen, K. J., & Langa, K. M. (2013). Monetary costs of dementia in the United States. The New England Journal of Medicine, 368(14), 1326–1334. doi: 10.1056/NEJMsa1204629.PubMedPubMedCentralCrossRefGoogle Scholar
  33. Institute of Medicine (U.S.). Committee on the public health dimensions of cognitive aging, Blazer, Dan G., Yaffe, Kristine, & Liverman, Catharyn T. (2015). Cognitive aging: progress in understanding and opportunities for action. National Academies Press.Google Scholar
  34. Jacobs, T. L., Epel, E. S., Lin, J., Blackburn, E. H., Wolkowitz, O. M., Bridwell, D. A.,…Saron, C. D. (2011). Intensive meditation training, immune cell telomerase activity, and psychological mediators. Psychoneuroendocrinology, 36(5), 664–681. doi:  10.1016/j.psyneuen.2010.09.010
  35. Jha, A. P., Krompinger, J., & Baime, M. J. (2007). Mindfulness training modifies subsystems of attention. Cognitive, Affective, & Behavioral Neuroscience, 7(2), 109–119. doi: 10.3758/CABN.7.2.109.CrossRefGoogle Scholar
  36. Jha, A. P., Stanley, E. A., Kiyonaga, A., Wong, L., & Gelfand, L. (2010). Examining the protective effects of mindfulness training on working memory capacity and affective experience. Emotion, 10(1), 54–64. doi: 10.1037/a0018438.PubMedCrossRefGoogle Scholar
  37. Juster, R. P., McEwen, B. S., & Lupien, S. J. (2009). Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience & Biobehavioral Reviews. doi: 10.1016/neubiorev.2009.10.002.Google Scholar
  38. Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4(1), 33–47. doi: 10.1016/0163-8343(82)90026-3.PubMedCrossRefGoogle Scholar
  39. Kabat-Zinn, J., Massion, A. O., Kristeller, J., Peterson, L. G., Fletcher, K. E., Pbert, L.,…Santorelli, S. F. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry, 149(7), 936–943.Google Scholar
  40. Kaul, P., Passafiume, J., Sargent, C. R., & O’Hara, B. F. (2010). Meditation acutely improves psychomotor vigilance, and may decrease sleep need. Behavioral and Brain Functions, 6, 47. doi: 10.1186/1744-9081-6-47.PubMedPubMedCentralGoogle Scholar
  41. Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V.,…Hofmann, S. G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. Clinical Psychology Review, 33(6), 763–771. doi:  10.1016/j.cpr.2013.05.005
  42. Kirsch, I. (2010). The emperor’s new drugs: exploding the antidepressant myth. New York: Basic Books.Google Scholar
  43. Knopman, D. S., Roberts, R. O., Geda, Y. E., Pankratz, V. S., Christianson, T. J., Petersen, R. C., & Rocca, W. A. (2010). Validation of the telephone interview for cognitive status-modified in subjects with normal cognition, mild cognitive impairment, or dementia. Neuroepidemiology, 34(1), 34–42. doi: 10.1159/000255464.PubMedCrossRefGoogle Scholar
  44. Kraemer, H. C., Giese-Davis, J., Yutsis, M., O’Hara, R., Neri, E., Gallagher-Thompson, D.,…Spiegel, D. (2006). Design decisions to optimize reliability of daytime cortisol slopes in an older population. The American Journal of Geriatric Psychiatry, 14(4), 325–333. doi:  10.1097/01.JGP.0000201816.26786.5b
  45. Kremen, W. S., Lachman, M. E., Pruessner, J. C., Sliwinski, M., & Wilson, R. S. (2012). Mechanisms of age-related cognitive change and targets for intervention: social interactions and stress. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 67(7), 760–765. doi: 10.1093/gerona/gls125.CrossRefGoogle Scholar
  46. Lahey, B. B. (2009). Public health significance of neuroticism. The American Psychologist, 64(4), 241–256. doi: 10.1037/a0015309.PubMedPubMedCentralCrossRefGoogle Scholar
  47. Lupien, S. J., Nair, N. P. V., Briere, S., Maheu, F., Tu, M. T., Lemay, M.,…Meaney, M. J. (1999). Increased cortisol levels and impaired cognition in human aging: implication for depression and dementia later in life. Reviews in the Neurosciences, 10(2), 117–139. doi:  10.1515/REVNEURO.1999.10.2.117
  48. Lupien, S. J., McEwen, B. S., Gunnar, M. R., & Heim, C. (2009). Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nature Reviews Neuroscience, 10(6), 434–445. doi: 10.1038/nrn2639.PubMedCrossRefGoogle Scholar
  49. McEwen, B. S. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338(3), 171–179. doi: 10.1056/NEJM199801153380307.PubMedCrossRefGoogle Scholar
  50. Mobus, G.E., & Kalton, M.C. (2015). Principles of systems science. New York: Springer.Google Scholar
  51. Moore, A., Gruber, T., Derose, J., & Malinowski, P. (2012). Regular, brief mindfulness meditation practice improves electrophysiological markers of attentional control. Frontiers in Human Neuroscience, 6, 18. doi: 10.3389/fnhum.2012.00018.PubMedPubMedCentralCrossRefGoogle Scholar
  52. Morris, J., Heyman, A., Mohs, R., & Hughes, M. (1989). The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) part 1. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology, 39, 1159–1165. doi: 10.1212/WNL.39.9.1159.PubMedCrossRefGoogle Scholar
  53. Moynihan, J. A., Chapman, B. P., Klorman, R., Krasner, M. S., Duberstein, P. R., Brown, K. W., & Talbot, N. L. (2013). Mindfulness-based stress reduction for older adults: effects on executive function, frontal alpha asymmetry and immune function. Neuropsychobiology, 68(1), 34–43. doi: 10.1159/000350949.PubMedCrossRefGoogle Scholar
  54. Mukherjee, S., Yadav, R., Yung, I., Zajdel, D., & Oken, B. S. (2011). Sensitivity to mental effort and test-retest reliability of heart rate variability measures in healthy seniors. Clinical Neurophysiology, 122, 2059–2066. doi: 10.1016/j.clinph.2011.02.032.PubMedPubMedCentralGoogle Scholar
  55. Neuendorf, R., Wahbeh, H., Chaime, I., Yu, J., Hutshison, K., & Oken, B. S. (2015a). The effects of mind-body interventions on sleep quality: a systematic review. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2015/902708.PubMedPubMedCentralGoogle Scholar
  56. Neuendorf, R., Wahbeh, H., Chamine, I., Yu, J., Hutchison, K., & Oken, B. S. (2015b). The effects of mind-body interventions on sleep quality: a systematic review. Evidence-based Complementary and Alternative Medicine, 2015, 902708. doi: 10.1155/2015/902708.PubMedPubMedCentralCrossRefGoogle Scholar
  57. NPR, Foundation, Robert Wood Johnson, & Health, Harvard School of Public. (2014). The Burden of Stress in America.
  58. Oken, B. S. (2008). Placebo effects: clinical aspects and neurobiology. Brain, 131, 2812–2823. doi: 10.1093/brain/awn116.PubMedPubMedCentralCrossRefGoogle Scholar
  59. Oken, B.S., Kishiyama, S., Zajdel, D, Bourdette, D., Carlsen, J., Haas, M.,…Mass, M. (2004). Randomized controlled trial of yoga and exercise in multiple sclerosis. Neurology, 62(11), 2058–2064. doi:  10.1212/01.WNL.0000129534.88602.5C
  60. Oken, B.S., Zajdel, D., Kishiyama, S., Flegal, K., Dehen, C., Haas, M.,…Leyva, J. (2006). Randomized controlled 6-month trial of yoga in healthy seniors. Alternative Therapies in Health and Medicine, 12(1), 40–47.Google Scholar
  61. Oken, B. S., Flegal, K., Zajdel, D., Kishiyama, S., Haas, M., & Peters, D. (2008). Expectancy effect: impact of pill administration on cognitive performance in healthy seniors. Journal of Clinical and Experimental Neuropsychology, 30, 7–17. doi: 10.1080/13803390701775428.PubMedCrossRefGoogle Scholar
  62. Oken, B. S., Fonareva, I., Haas, M., Wahbeh, H., Lane, J. B., Zajdel, D. P., & Amen, A. M. (2010). Pilot controlled trial of mindfulness meditation and education for dementia caregivers. Journal of Alternative and Complementary Medicine, 16, 1031–1038.PubMedPubMedCentralCrossRefGoogle Scholar
  63. Oken, B. S., Fonareva, I., & Wahbeh, H. (2011). Stress-related cognitive dysfunction in dementia caregivers. Journal of Geriatric Psychiatry and Neurology, 24, 192–199. doi: 10.1177/0891988711422524.CrossRefGoogle Scholar
  64. Oken, B. S., Chamine, I., & Wakeland, W. (2015). A systems approach to stress, stressors, and resilience in humans. Behavioural Neuroscience, 282, 144–154. doi: 10.1155/2015/902708.Google Scholar
  65. Ospina, M.B., Bond, K., Karkhaneh, M., et al. (2007). Meditation practices for health: state of the research (AHRQ). Evidence Report/Technology Assessment (Full Report), Number 155, Publication No. 07-E010., 1-263.Google Scholar
  66. Ottaviani, C., Shahabi, L., Tarvainen, M., Cook, I., Abrams, M., & Shapiro, D. (2014). Cognitive, behavioral, and autonomic correlates of mind wandering and perseverative cognition in major depression. Frontiers in Neuroscience, 8, 433. doi: 10.3389/fnins.2014.00433.PubMedGoogle Scholar
  67. Ottaviani, C., Thayer, J. F., Verkuil, B., Lonigro, A., Medea, B., Couyoumdjian, A., & Brosschot, J. F. (2016). Physiological concomitants of perseverative cognition: a systematic review and meta-analysis. Psychological Bulletin, 142(3), 231–259. doi: 10.1037/bul0000036.PubMedCrossRefGoogle Scholar
  68. Ownby, R. L., Crocco, E., Acevedo, A., John, V., & Loewenstein, D. (2006). Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Archives of General Psychiatry, 63(5), 530–538. doi: 10.1001/archpsyc.63.5.530.PubMedPubMedCentralCrossRefGoogle Scholar
  69. Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B.,…Wallace, R. B. (2007). Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology, 29(1-2), 125–132. doi:  10.1159/000109998
  70. Plassman, B. L., Langa, K. M., Fisher, G. G., Heeringa, S. G., Weir, D. R., Ofstedal, M. B.,…Wallace, R. B. (2008). Prevalence of cognitive impairment without dementia in the United States. Annals of Internal Medicine, 148(6), 427–434. doi:  10.7326/0003-4819-148-6-200803180-00005
  71. Pocock, S. J., & Simon, R. (1975). Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics, 31, 103–115. doi: 10.2307/2529712.PubMedCrossRefGoogle Scholar
  72. Radloff, L. (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi: 10.1177/014662167700100306.CrossRefGoogle Scholar
  73. Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. In J. Weinman, S. Wright, & M. Johnston (Eds.), Measures in health psychology: a user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor: Nfer-Nelson.Google Scholar
  74. Seeman, T. E., McEwen, B. S., Rowe, J. W., & Singer, B. H. (2001). Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proceedings of the National Academy of Sciences, 98, 4770–4775. doi: 10.1073/pnas.081072698.CrossRefGoogle Scholar
  75. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford.Google Scholar
  76. Segerstrom, S. C., Boggero, I. A., Smith, G. T., & Sephton, S. E. (2014). Variability and reliability of diurnal cortisol in younger and older adults: implications for design decisions. Psychoneuroendocrinology, 49, 299–309. doi: 10.1016/j.psyneuen.2014.07.022.PubMedPubMedCentralCrossRefGoogle Scholar
  77. Semple, R. J. (2010). Does mindfulness meditation enhance attention? A randomized controlled trial. Mindfulness, 1, 121–130. doi: 10.1007/s12671-010-0017-2.CrossRefGoogle Scholar
  78. Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual Review of Clinical Psychology, 4, 1–32. doi: 10.1146/annurev.clinpsy.3.022806.091415.PubMedCrossRefGoogle Scholar
  79. Stawski, R. S., Sliwinski, M. J., & Smyth, J. M. (2006). Stress-related cognitive interference predicts cognitive function in old age. Psychology and Aging, 21, 535–544. doi: 10.1037/0882-7974.21.3.535.PubMedPubMedCentralCrossRefGoogle Scholar
  80. Tang, Y. Y., Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q.,…Posner, M. I. (2007). Short-term meditation training improves attention and self-regulation. Proceedings of the National Academy of Sciences of the United States of America, 104(43), 17152–17156. doi:  10.1073/pnas.0707678104
  81. Task Force of the European Society of Cardiology, NASPE. (1996). Heart rate variability—standards of measurement, physiological interpretation, and clinical use. Circulation, 93, 1043–1065.CrossRefGoogle Scholar
  82. Thayer, J. F., Friedman, B. H., & Borkovec, T. D. (1996). Autonomic characteristics of generalized anxiety disorder and worry. Biological Psychiatry, 39(4), 255–266. doi: 10.1016/0006-3223(95)00136-0.PubMedCrossRefGoogle Scholar
  83. Wahbeh, H., & Oken, B. (2013). Salivary cortisol lower in posttraumatic stress disorder. Journal of Traumatic Stress, 26, 1–8. doi: 10.1002/jts.21798.CrossRefGoogle Scholar
  84. Wahbeh, H., Kishiyama, S., Zajdel, D., & Oken, B. (2008). Salivary cortisol awakening response in mild Alzheimer’s disease, caregivers, and non-caregivers. Alzheimer’s Disease & Related Disorders, 22, 181–183. doi: 10.1097/WAD.0b013e31815a9dff.CrossRefGoogle Scholar
  85. Wahbeh, H., Zwickey, H., & Oken, B. (2011). One method for objective adherence measurement in mind-body medicine. The Journal of Alternative and Complementary Medicine, 17, 1–3. doi: 10.1089/acm.2010.0316.CrossRefGoogle Scholar
  86. Wahbeh, H., Lane, J. B., Goodrich, E., Miller, M., & Oken, B. S. (2014a). One-on-one mindfulness meditation trainings in a research setting. Mindfulness, 5, 88–99. doi: 10.1007/s12671-012-0155-9.PubMedCrossRefGoogle Scholar
  87. Wahbeh, H., Svalina, M. N., & Oken, B. S. (2014b). Group, one-on-one, or internet?: preferences for mindfulness meditation delivery format and their predictors. Open Medicine Journal, 1, 66–74.PubMedPubMedCentralCrossRefGoogle Scholar
  88. Wahbeh, H., Goodrich, E., Goy, E., & Oken, B. S. (2016). Mechanistic pathways of mindfulness meditation in combat veterans with posttraumatic stress disorder. Journal of Clinical Psychology, 72, 365–383.PubMedPubMedCentralCrossRefGoogle Scholar
  89. Walach, H. (2001). The efficacy paradox in randomized controlled trials of CAM and elsewhere: beware of the placebo trap. Journal of Alternative and Complementary Medicine, 7, 213–218.CrossRefGoogle Scholar
  90. Ware, J. E. (1993). SF-36 health survey: manual interpretation guide. Boston: The Health Institute.Google Scholar
  91. Ware, J. E. (2000). SF-36 health survey update. Spine, 25(24), 3130–3139.PubMedCrossRefGoogle Scholar
  92. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. doi: 10.1037/0022-3514.54.6.1063.PubMedCrossRefGoogle Scholar
  93. Wechsler, D. (2008). Wechsler Adult Intelligence Scale (4th ed.). San Antonio: Pearson.Google Scholar
  94. White, L., Small, B. J., Petrovitch, H., Ross, G. W., Masaki, K., Abbott, R. D.,…Markesbery, W. (2005). Recent clinical-pathologic research on the causes of dementia in late life: update from the Honolulu-Asia Aging Study. Journal of Geriatric Psychiatry and Neurology, 18(4), 224–227. doi:  10.1177/0891988705281872
  95. Wilson, R. S., Evans, D. A., Bienias, J. L., Mendes De Leon, C. F., Schneider, J. A., & Bennett, D. A. (2003). Proneness to psychological distress is associated with risk of Alzheimer’s disease. Neurology, 61(11), 1479–1485. doi: 10.1212/01.WNL.0000096167.56734.59.PubMedCrossRefGoogle Scholar
  96. Wilson, R. S., Arnold, S. E., Schneider, J. A., Li, Y., & Bennett, D. A. (2007). Chronic distress, age-related neuropathology, and late-life dementia. Psychosomatic Medicine, 69(1), 47–53. doi: 10.1097/01.psy.0000250264.25017.21.PubMedCrossRefGoogle Scholar
  97. Wilson, R. S., Begeny, C. T., Boyle, P. A., Schneider, J. A., & Bennett, D. A. (2011). Vulnerability to stress, anxiety, and development of dementia in old age. The American Journal of Geriatric Psychiatry, 19(4), 327–334. doi: 10.1097/JGP.0b013e31820119da.PubMedPubMedCentralCrossRefGoogle Scholar
  98. Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: evidence of brief mental training. Consciousness and Cognition, 19(2), 597–605. doi: 10.1016/j.concog.2010.03.014.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Barry S. Oken
    • 1
  • Helané Wahbeh
    • 2
  • Elena Goodrich
    • 2
  • Daniel Klee
    • 2
  • Tabatha Memmott
    • 2
  • Meghan Miller
    • 2
    • 3
  • Rongwei Fu
    • 4
  1. 1.Departments of Neurology, Behavioral Neuroscience, and Biomedical EngineeringOregon Health & Science UniversityPortlandUSA
  2. 2.Department of NeurologyOregon Health & Science UniversityPortlandUSA
  3. 3.University of North CarolinaChapel HillUSA
  4. 4.School of Public HealthOregon Health & Science UniversityPortlandUSA

Personalised recommendations