Internet-delivered mindfulness training to reduce cognitive variability in adults with subjective cognitive decline - PROJECT SUMMARY Rising prevalence rates of Alzheimer’s disease (AD), paired with limited treatment options to alter the disease course, have prompted substantial scientific investigation into delineating and prolonging preclinical stages of AD. Presence of subjective cognitive decline (SCD) is the earliest detectable preclinical stage of AD, reflected by self-reported cognitive decline in the absence of objective cognitive impairment on standardized neuropsychological testing. People with SCD are at elevated risk of developing AD, report more variable cognitive functioning in daily life not yet detectable on lab-based neuropsychological testing, and exhibit less stable brain dynamics that mirror changes commonly observed in AD—making them ideal candidates for prevention-based behavioral interventions. Thus, there is an urgent need to identify promising preventative interventions to mitigate cognitive and neural risks associated with the development of AD for adults with SCD. Mindfulness training is one such intervention shown to improve multiple aspects of functioning relevant to AD, including cognitive functioning, brain structural integrity, and brain functional integrity. Building upon this prior work, the current proposal will leverage my sponsor’s ongoing pilot feasibility trial—the Internet-based Mind- Body Training study (iMBT; 1R61AG081982-01)—to investigate whether mindfulness training reduces everyday cognitive variability and enhances intrinsic brain dynamics among adults with SCD. Here, I will investigate whether an internet-delivered Mindfulness-Based Stress Reduction (iMBSR) program compared to a Lifestyle Education (iLE) program reduces cognitive variability in daily life, as indexed by two ecological momentary assessment cognitive tests. I will also examine the preliminary effects of iMBSR versus iLE programs on dynamic, whole-brain states—measured using resting-state dynamic functional connectivity and k-means clustering analysis. By using innovative methodologies, findings from this proposal will enable us to delineate cognitive variability in everyday contexts and neural dynamics among individuals with SCD. Critically, the proposed research will yield novel insights into the utility of mindfulness training for promoting cognitive and neural stability in adults at-risk for AD.
