Please cite this article in press as: Larouche E, et al. Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer’s disease: An interdisciplinary perspective. Behav Brain Res (2014), http://dx.doi.org/10.1016/j.bbr.2014.05.058 ARTICLE IN PRESS G Model BBR-8949; No. of Pages 14 Behavioural Brain Research xxx (2014) xxx–xxx Contents lists available at ScienceDirect Behavioural Brain Research jou rn al hom epage: www.elsevier.com/locate/bbr Research report Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer’s disease: An interdisciplinary perspective Eddy Larouche a,b , Carol Hudon a,b , Sonia Goulet a,b,∗ a École de psychologie, Université Laval, 2325, rue des Bibliothèques, Québec, QC, Canada G1V 0A6 b Centre de recherche de l’Institut universitaire en santé mentale de Québec (CRIUSMQ), 2601, de la Canardière (F-2400), Québec, QC, Canada G1J 2G3 h i g h l i g h t s • Hippocampal damage is central in MCI/AD and could be prevented or delayed by MBI. • MBI reduce MCI/AD adverse factors (stress, depression, metabolic syndrome). • Multiple pathways could explain MBI’s effects on modifiable adverse factors. • Effects seem based on neuro- endocrine, immune, and transmission regulation. • MBI show great potential to prevent the neurodegenerative cascade leading to AD. a r t i c l e i n f o Article history: Received 4 February 2014 Received in revised form 20 May 2014 Accepted 26 May 2014 Available online xxx Keywords: Mild cognitive impairment Alzheimer’s disease Mindfulness-based intervention Stress Depression Metabolic syndrome a b s t r a c t The present article is based on the premise that the risk of developing Alzheimer’s disease (AD) from its prodromal phase (mild cognitive impairment; MCI) is higher when adverse factors (e.g., stress, depres- sion, and metabolic syndrome) are present and accumulate. Such factors augment the likelihood of hippocampal damage central in MCI/AD aetiology, as well as compensatory mechanisms failure triggering a switch toward neurodegeneration. Because of the devastating consequences of AD, there is a need for early interventions that can delay, perhaps prevent, the transition from MCI to AD. We hypothesize that mindfulness-based interventions (MBI) show promise with regard to this goal. The present review dis- cusses the associations between modifiable adverse factors and MCI/AD decline, MBI’s impacts on adverse factors, and the mechanisms that could underlie the benefits of MBI. A schematic model is proposed to illustrate the course of neurodegeneration specific to MCI/AD, as well as the possible preventive mech- anisms of MBI. Whereas regulation of glucocorticosteroids, inflammation, and serotonin could mediate MBI’s effects on stress and depression, resolution of the metabolic syndrome might happen through a reduction of inflammation and white matter hyperintensities, and normalization of insulin and oxida- tion. The literature reviewed in this paper suggests that the main reach of MBI over MCI/AD development involves the management of stress, depressive symptoms, and inflammation. Future research must focus on achieving deeper understanding of MBI’s mechanisms of action in the context of MCI and AD. This necessitates bridging the gap between neuroscientific subfields and a cross-domain integration between basic and clinical knowledge. © 2014 Elsevier B.V. All rights reserved. 1. Introduction Alzheimer’s disease (AD) is a neurodegenerative disorder that affected about 35,560,000 people worldwide in 2010; this ∗ Corresponding author at: Université Laval, École de psychologie, CRIUSMQ, 2601 de la Canardière (F-2400), Québec, QC, Canada G1J 2G3. Tel.: +1 418 663 5000x6805. E-mail address: sonia.goulet@psy.ulaval.ca (S. Goulet). prevalence is expected to increase to 115,380,000 by 2050 given population aging in several countries [1]. AD is preceded by a prodromal phase that can be identified in individuals with mild cognitive impairment (MCI) [2]. MCI generally encompasses a wide range of cognitive deficits affecting episodic memory [3], semantic memory [4], executive functioning and attention [5], language [6], and visuospatial skills [7]. The loss of episodic memory character- izes a subset of people with MCI most at risk to develop AD [2]. In fact, memory impairment is the most significant cognitive predictor of dementia in people with MCI [8]. In those individuals, memory http://dx.doi.org/10.1016/j.bbr.2014.05.058 0166-4328/© 2014 Elsevier B.V. All rights reserved.