Zainal · Health psychology review 2024 · meta-analysis of randomized controlled trials · n=9,538 participants (111 studies)

Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials.

Level 1 - systematic review of randomized trials

Meta-analysis of randomized controlled trials

PubMed 37578065 · doi:10.1080/17437199.2023.2248222 · record verified 2026-08-26

What was done

Authors conducted a meta-analysis of 111 randomized controlled trials comprising 9,538 meditation-naive participants to assess the effect of mindfulness-based interventions (MBIs) on global cognition and 15 cognitive subdomains. Included studies required at least one objective or subjective cognitive outcome and a primary focus on teaching mindfulness skills, excluding single-session interventions and controls with MBI components. Meta-analytic pooling used robust variance estimation and moderator analyses controlling for treatment fidelity.

What was found

MBIs produced small-to-moderate improvements in global cognition, executive attention, working memory accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (g = 0.257 to 0.643 versus waitlist/no-treatment; g = 0.192 to 0.394 versus active controls). MBIs did not impact executive functioning latency indices, verbal fluency, processing speed, episodic memory, or cognitive error. Treatment effects were stronger for individuals with elevated psychiatric symptoms versus healthy controls and medical samples, studies with complete-case versus intention-to-treat analysis, face-to-face versus self-guided delivery, and non-standard versus standard MBIs.

Why it matters

This review demonstrates that mindfulness interventions selectively improve accuracy and attention-based cognitive domains rather than processing speed or memory. It highlights that face-to-face delivery and psychiatric populations show the largest cognitive gains.

Limits

Effects were significantly larger in studies using complete-case analysis rather than intention-to-treat, indicating potential bias from study attrition. The abstract does not report exact numerical values for non-significant outcomes, long-term follow-up effects, or intervention duration.