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Spirituality and the Aging BrainAuthor(s): Andrew B. Newberg

Source: Generations: Journal of the American Society on Aging , Vol. 35, No. 2,
Neuroscience of the Aging Brain: Perspectives on Brain Health and Lifestyle (Summer
2011), pp. 83-91
Published by: American Society on Aging

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GE N E R ATIONS – Journal of the American Society on Aging

By Andrew B. Newberg

Spirituality
and the Aging Brain
Evidence suggests that meditation, prayer, and other related
religious and spiritual practices may have significant effects
on the aging brain—positive effects that may help improve
memory and cognition, mood, and overall mental health.

I n the past thirty years, scientists have ex- available in the literature. The neuroimaging
plored the neurobiological and clinical effects techniques used in these studies include posi-
of meditation, prayer, and related spiritual tron emission tomography (PET) (Herzog et al.,
practices and experiences. Initial studies 1990−1991; Lou et al., 1999); single photon
measured changes in autonomic activity, such emission computed tomography (SPECT)
as heart rate and blood pressure, and electroen- (Newberg et al., 2001; Newberg et al., 2003); and
cephalographic changes associated with such functional magnetic resonance imaging (fMRI)
practices. Studies have also
looked at changes in hormonal
and immunological function. Functional neuroimaging has opened a new window
Still other studies have exam- into the investigation of meditative states.
ined the clinical effects of
meditation and prayer upon physical and (Lazar et al., 2000; Brefczynski-Lewis et al.,
psychological disorders, including hypertension, 2007; Beauregard and Paquette, 2006).
cancer, depression, and anxiety. Each of these techniques provides different
This article reviews the existing knowledge advantages and disadvantages in the study of
on the neurophysiological and clinical findings meditation. Though fMRI has improved
associated with religious and spiritual practices resolution over SPECT and the ability of
and experiences, and explores the potential health immediate anatomic correlation, it is some-
effects of these practices with regard to aging. times difficult to use for studying meditation
because of machine noise. There is also the
Neuroimaging: A Window into problem of requiring the subject to lie down—
Meditative States an atypical posture for many forms of medita-
Functional neuroimaging has opened a new tion. The environment should allow subjects to
window into the investigation of meditative have a strong meditative experience by enabling
states by exploring the neurological correlates of them to use the postures or actions that are part
these experiences, and a growing number of of their meditation practice. Accommodating
imaging studies of meditative practices are now subjects’ meditation postures is also a problem

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GE NER ATIO NS – Journal of the American Society on Aging
when using PET imaging (which also provides
better resolution than SPECT).
The process of SPECT imaging, however,
allows for an injection of a radioactive tracer
during a particular meditation or prayer prac-
tice, which can then capture the pattern of
cerebral blood flow (as it correlates with activ-
ity). The problem with SPECT, though, is that
only one or two states can be studied in a day.
Functional MRI can measure multiple time
points during the same scanning session and can
capture changes in cerebral blood flow during
different meditation practices, or throughout a
particular practice. However, fMRI can only
evaluate cerebral blood flow, while PET and
SPECT can evaluate neurotransmitter systems
such as serotonin and dopamine.
Though each of these functional brain
imaging techniques offers important advan-
tages and disadvantages for studying medita-
tion, prayer, or other spiritual phenomena, the
best approach may depend on a number of
individual factors.
Types of Spiritual Practices
There are many specific approaches to medita-
tion and prayer, but they can be divided into two
basic categories. The first category is one in
which a person attempts to clear all thought
from their sphere of attention, and includes
practices such as Theravada—a form of medita-
tion in which individuals attempt to reach a
subjective state characterized by a sense of no
space, no time, and no thought. This state is
cognitively experienced as fully integrated and
unified: there is no sense of a self and other.
The second category is one in which the
subject focuses attention on a particular object,
image, phrase, or word, and includes practices
such as Transcendental Meditation and various
forms of Tibetan Buddhism. This form of
meditation is designed to lead to a subjective
experience of absorption with the object of
focus. Mindfulness meditation (Kabat-Zinn,
1991) is a practice in which attention is focused
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Pages 83–91
on whatever thoughts or feelings enter the mind,
and the goal is to be more aware of one’s inner
mental processes.
There is also guided meditation, in which the
meditation experience is guided by a leader who
verbally directs the practitioner, either in person
or on tape. Other meditators merely practice the
meditation of their own volition. There are likely
important differences between volitional (per-
formed solely by the practitioner) and guided
(performed with the assistance of a teacher or
recording that instructs the practitioner) medita-
tion practices, which should also be reflected in
specific differences in cerebral activation.
Phenomenological analysis suggests that the
end result of many meditation or prayer prac-
tices is similar, although this result might be
described differently depending upon the culture
and individual. Such spiritual experiences—even
mystical experiences—seem to have certain
similar features (and certain distinctions). It
seems reasonable that while the initial neuro-
physiological activation that occurs during any
given practice may differ, there may eventually
be a convergence of experiences and neurophysi-
ological correlates. However, the brain structures
and functions described will likely apply to other
types of meditation practices although the
specifics will be slightly different.
Neurophysiological Changes Associated with
Religious and Spiritual Practices
A number of neurophysiological changes have
been described in relation to meditation prac-
tices and various spiritual states. Brain imaging
studies suggest that willful acts and tasks that
require sustained attention are initiated via
activity in the prefrontal cortex (PFC) and
anterior cingulate cortex (Ingvar, 1994; Frith
et al., 1991; Posner and Petersen, 1990). Since
practices like meditation and prayer require
intense focus of attention, they also have been
shown to activate these areas (Herzog et al.,
1990−1991; Newberg et al., 2001; Lazar et al.,
2000). A study of Tibetan Buddhist meditators
©American Society on Aging
Pages 83–91 Neuroscience of the Aging Brain: Perspectives on Brain Health and Lifestyle

showed increased activity in the PFC bilaterally
(greater on the right side) and the cingulate
gyrus during meditation.
Brain imaging studies of meditation practices
have generally demonstrated increased thalamic
activity, mediated by the excitatory neurotrans-
mitter glutamate, which may be proportional to
the activity in the PFC. It should also be noted
that the dopaminergic system, via the basal
ganglia, is believed to participate in regulating
the glutamate system and the interactions
between the prefrontal cortex and subcortical
structures. A PET study utilizing 11C-Raclopride
to measure the dopaminergic tone during Yoga
Nidra meditation demonstrated a significant
increase in dopamine levels during the medita-
tion practice (Kjaer et al., 2002). Dopamine is
also part of the reward system in the brain; this
may help explain some of the positive emotional
elements of meditation and prayer practices.
Another brain structure, the parietal lobe,
might be involved in meditation, prayer prac-
tices, and other spiritual experiences. The
parietal regions are heavily involved in the
analysis and integration of higher-order visual,
auditory, and somaesthetic information, and
are part of a complex attentional network that
includes the PFC and thalamus (Fernandez-
Duque and Posner, 2001). These functions of the
posterior superior parietal lobe might be critical
for distinguishing between the self and the
external world. Changes in the orienting areas
of the parietal lobe have been thought to be an
important mediator in the physiology of medi-
tative and spiritual experiences (Newberg and
Iversen, 2003). Some studies have revealed
decreased activity in the parietal lobe during
meditation practices, which might be associated
with the altered sense of self and space frequent-
ly described by practitioners.

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GE NER ATIO NS – Journal of the American Society on Aging
In addition to the complex cortical-thalamic
activity, meditation might also be expected to
alter activity in the limbic system, especially
since stimulation of limbic structures is associ-
ated with the kind of emotional experiences
similar to those described during meditation and
other spiritual experiences (Fish et al., 1993;
Saver and Rabin, 1997). The results of several
studies, such as the fMRI study by Lazar and col-
leagues, support the notion of increased activity
in the regions of the amygdala and hippocampus
during meditation (Lazar et al., 2000).
The hypothalamus is extensively intercon-
nected with the limbic system. Stimulation of
the right lateral amygdala has been shown to
result in stimulation of the ventromedial
portion of the hypothalamus, with a subse-
quent stimulation of the peripheral parasym-
pathetic system. Increased parasympathetic
activity should be associated first with the
subjective sensation of relaxation and eventu-
ally with a more profound quiescence. Acti-
vation of the parasympathetic system would
also cause a reduction in heart rate and
respiratory rate. All of these physiological
responses have been observed during medi-
tation (Jevning et al., 1992).
More recent studies have shown, however,
that meditation practices are associated with
a dynamic interplay between the parasympa-
thetic and sympathetic nervous systems. A
recent study of two separate meditative
techniques suggested a mutual activation of
parasympathetic and sympathetic systems by
demonstrating an increase in the variability
of heart rate during meditation (Peng et al.,
1999). The increased variation in heart rate
was hypothesized to reflect activation of both
arms of the autonomic nervous system. This
notion also fits the characteristic description
of meditative states in which there is a sense
of overwhelming calmness as well as signifi-
cant alertness. Also, the notion of mutual
activation of both arms of the autonomic
nervous system is consistent with recent
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Pages 83–91
developments in the study of autonomic
interactions (Hugdahl, 1996).
Other neurotransmitters, such as serotonin
and the brain’s endorphins, may also play a role
in meditation practices and experiences. Drugs
affecting serotonin can have hallucinatory
effects such as via lysergic acid. Opiates can
result in feelings of euphoria, similar to some of
the experiences people have in deep meditative
or spiritual states.
Given the foregoing physiological changes
that might be associated with meditation, prayer,
or other spiritual engagement, we can more
clearly consider some of these practices’ mental
health effects.
The Positive Effects of Spirituality
on Mental Health
A number of studies have demonstrated how
religious and spiritual practices can help improve
brain function in both psychological and neuro-
logical conditions: the impact of these practices
on mental health has been widely studied.
Practices such as mindfulness meditation have
generally been shown to reduce depression
symptoms under a variety of circumstances. In
fact, mindfulness meditation has been introduced
relatively successfully into a cognitive therapy
paradigm to help individuals suffering from
depression. Mindfulness approaches are not
considered relaxation or mood management
techniques, but rather endeavors for cultivating
greater self-awareness and acceptance. Practicing
mindfulness has the potential to expand human
perspective, understanding, and self-acceptance.
Mindfulness training cultivates the ability to
observe thoughts and feelings as events, similar
to objects of sensory awareness, thereby helping
people to respond reflectively rather than
habitually or automatically.
Mindfulness meditation via the Mindfulness-
Based Stress Reduction Program (MBSR) is one
of the most widely studied practices and has
been shown to have therapeutic benefits in
several chronic illness populations, including
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Pages 83–91 Neuroscience of the Aging Brain: Perspectives on Brain Health and Lifestyle

those with mood disorders (Grossman et al., The effectiveness of Mindfulness-Based

2004). An early study of MBSR in fourteen Cognitive Therapy (MBCT) in chronic recur-
patients with anxiety found a reduction in bloodrent depression has also been evaluated. One
pressure and decreases in depression, anxiety, study comparing MBCT along with usual
and general psychological distress in patients treatment in one group and only usual treat-
undergoing MBSR therapy (Kabat-Zinn, Mas- ment in a control group found a decrease in
sion, and Kristeller, 1992). Meta-analyses have reported symptoms in the MBCT group and no
conflicting conclusions regarding MBSR’s significant change in the usual-treatment group
efficacy in patients with mood disorders. While (Barnhofer, Crane, and Hargus, 2009). Another
one review of fifteen studies on the effects of study found that patients who had MBCT
MBSR found no clear positive effects on depres- training along with usual treatment had
sion symptoms in patients with comorbid significantly fewer episodes of relapse or
medical disorders or in patients with mood recurrence than those who did not have MBCT
disorders alone (Toneatto and Nguyen, 2007), training (Teasdale, Segal, and Williams, 2000).
another systematic review and meta-analysis Religiosity may confer benefits for some
found mindfulness-based therapies to have individuals. Religious service attendance is
robust within-group effect in patients with predictive of higher life satisfaction among elders
anxiety and mood disorders, results that were (Levin and Markides, 1988; Ho et al., 1995).
maintained at follow up (Hoffman et al., 2010). Similar findings occurred in a population of
nursing home residents
Recent studies have shown that meditation practices (House, Robbins, and
Metzner, 1982). Hope
are associated with a dynamic interplay between the and optimism seemed
parasympathetic and sympathetic nervous systems. to run higher among
religious individuals
A review of MBSR for its effectiveness on than nonreligious individuals in some study popu-
chronic illnesses concluded that it may help a lations (Idler and Kasl, 1997a, 1997b). Using
broad range of individuals to cope with their religious attendance as one of the markers of
clinical and nonclinical problems, including social engagement, another study determined that
clinical depression, stress, and anxiety (Niazi social disengagement was linked with cognitive
and Niazi, 2010). Another meta-analysis of decline in non-institutionalized elders (Bassuk,
MBSR effectiveness for depression, anxiety, and Glass, and Berkman, 1999). This is a longstanding
psychological distress across populations with problem regarding elders and religious involve-
different chronic somatic diseases found a ment. It may be that people with cognitive decline
reduction of anxiety and depression in patients participate less in social and religious activities,
getting the therapy compared to wait-list especially if they are confined to a nursing home.
controls (Bohlmeijer, Prenger, and Taal, 2010). Whether this is because of the cognitive decline
A recent randomized wait-list control study of itself or the loss of interest in religion has not
MBSR for patients with heterogeneous anxiety been adequately determined.
disorders found that compared to controls, the Prospective cohort studies have shown
MBSR group showed medium-to-large effect religious activity to be associated with remission
sizes on measures of anxiety and a large effect of depression in Protestant and Catholic Nether-
size for symptoms of depression, that were landers and ill older adults (Braam et al., 1997;
maintained at six-month follow up (Vollestad, Koenig, George, and Peterson, 1998). Thus, there
Sivertsen, and Nielsen, 2011). appears to be an array of benefits from religious

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GE NER ATIO NS – Journal of the American Society on Aging Pages 83–91

and spiritual practices and experiences that meditators and non-meditators. Collectively,
benefit physical and mental health. these findings suggest that meditation practice
affects cognitive function and that the beneficial
Meditation and Cognition effects of meditation are moderated by intensity
Researchers have also begun to investigate the and length of training.
long-term effects of meditation practices on Several other studies have also pointed out
cognitive processes involved in memory; research the potential effects of meditation on memory
shows that meditation practice and increased and cognition. Chambers, Lo, and Allen (2008)
mindfulness are related to improved attention examined the impact of a ten-day Vipassana
functions and cognitive flexibility (Carter et al., meditation retreat on novice meditators’ work-
2005; Jha, Krompinger, and Baime, 2007; Slagter ing memory capacity, response time on a novel
et al., 2007; Lutz et al., 2008a, 2008b). This may attention task requiring participants to attend
have the most important implication for aging and update information between two categories
as there is a great deal of interest in helping to (e.g., food and household objects, or positive and
maintain high brain function as people age. negative affective words), and five self-report
Pagnoni and Cekic (2007) used a rapid visual measures of cognitive processes and affect.
presentation task to investigate age-related effects They found that meditation training increased
of meditation practice in meditators and non- mindfulness, enhanced working memory
meditators. The authors found an age-related capacity, reduced switch costs in the attention
decrease of attention performance in their task, and reduced anxiety, negative affect,
meditation-naive control group, whereas no such and depression.
decrease was present in meditators. Chan and Tang et al. (2007) examined the impact of five
Woollacott (2007) compared the effects of days of integrative body-mind training (IBMT) on
meditation practice on the Stroop task (which measures assessing visual reasoning, mood, and
measures executive network) and Global−Local physiological responses to stress. This training is
Letters task (which measures orientation net- an approach to meditation that stresses no effort
work) and found that meditation practice was to control thoughts, but has the goal of creating a
associated with increased efficiency of the state of restful alertness. The authors found that
executive attention network, but had no effect meditation benefited performance in conflict
on the orienting network. monitoring and reasoning. They also found that
Moore and Malinowski (2009) compared meditation reduced anxiety, depression, anger,
meditators with a meditation-naive control and fatigue, and increased stress regulation. In
group on tasks that
measure cognitive Meditation practice and increased mindfulness are related
flexibility and speed
of processing visual to improved attention functions and cognitive flexibility.
information and found
that meditators outperformed non-meditators contrast, Jha, Krompinger, and Baime (2007)
on all measures. Also, performance was positive- examined the impact of participation in an
ly correlated to participants’ self-reported scores eight-week MBSR course and found that a group
on the levels of mindfulness measures. A similar of novice meditators who underwent meditation
pattern of results was reported by Valentine and training had improved performance in orienting
Sweet (1999) who found that long-term medita- their attention.
tion practitioners scored significantly higher on We recently performed a study that used a
a test of sustained attention than short-term type of meditation called Kirtan Kriya in which

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Pages 83–91 Neuroscience of the Aging Brain: Perspectives on Brain Health and Lifestyle

the individual repetitively vocalizes consonant-
vowel combinations (“sa, ta, na, ma”) while
touching their thumb to each of their fingers in
sequence (Newberg et al., 2010). The practice
takes twelve minutes per day, and our subjects
were asked to perform the practice for eight
weeks. Before and after the eight-week meditation
program, subjects were evaluated using brain
imaging and also cognitive testing. Overall, we
found significant increases in blood flow in the
frontal lobes, which are involved with our ability
to focus attention. We found approximately a 10
percent improvement in verbal memory and
general cognitive function. Overall, there does
seem to be some important effects of meditation
on cognition, but more research is needed to
elucidate how and why these effects occur.
Negative Effects of Meditation and
Spirituality on Health
Although most studies have shown positive
effects of meditation, religious practices, and
spirituality, they may cause a negative impact on
health. Meditation’s most common detrimental
effect is usually frustration: the practitioner
struggles to perform the meditation practice.
This might be for a variety of reasons, from not
being able to follow the instructions properly, or
trying to meditate in a distracting environment,
to the individual not enjoying the practice. As
this frustration can turn to embarrassment and
anxiety, it is important that individuals try to do
meditation practices that they feel comfortable
with and can perform with relative ease. While
rare, there are some cases in which intense
meditation has caused people to have dissocia-
tive experiences, which can be frightening. Such
experiences, however, usually do not occur
unless the practice is performed for many hours
a day over a period of years.
Even positive experiences can sometimes
have damaging effects if an individual has
problems incorporating them into their current
religious or spiritual belief system. Such a
dichotomy can lead to anxiety and depression if
it sparks a “spiritual crisis.” Additionally, self-
perceived religious transgressions can cause
emotional and psychological anguish. When a
mix of religious, spiritual, and organic sources is
causing mental illness, treatment can become
complicated. Healthcare workers must properly
balance treating each source.
Existing evidence suggests that meditation,
prayer, and other related religious and spiritual
practices may have significant effects on the
aging brain. Many of these effects appear to
be positive, helping to improve memory and
cognition, mood, and overall mental health.
However, there are potential negative effects
that must also be considered when beginning
a particular practice. We will look to future
research that may better delineate the
physiological and clinical effects of these
spiritual practices.
Andrew B. Newberg, M.D., is director of research at
the Jefferson-Myrna Brind Center of Integrative
Medicine, Thomas Jefferson University in Philadelphia.

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