Introduction

The risk of falling is a common problem among the elderly, occurring as a result of certain diseases or as a result of the aging process. According to the World Health Organization (WHO), a fall is defined as an event that results in an unintentional fall to the floor or a lower level. Injuries from falls can be fatal or non-fatal. Falls are associated with reduced quality of life and higher healthcare costs. In older age, the health effects and costs of falls increase significantly worldwide. In many cases, falls are due to impaired balance. In fact, mobility and balance are essential for functional independence, reduced risk of falls, and quality of life [1]. On the other hand, as people age, they may experience a decline in cognitive abilities, which is a natural part of the aging process. However, if this cognitive decline becomes more severe, it can lead to mild cognitive impairment or potentially progress to neurocognitive impairment or major cognitive decline [2]. Therefore, interventions that target cognitive and motor abilities in older adults are indeed essential for improving brain function and health in older adults. In this regard, studies have reported the potential of meditation practice to reduce age-related cognitive decline [3]. Meditation is a form of relaxation with attentional control that influences sensory processes by influencing attention span, beliefs, expectations, mood, and emotional regulation [4]. In other words, meditation involves a receptive, nonjudgmental awareness of current events. Mindful individuals perceive internal and external events freely and without distortion and have a great ability to cope with a wide range of thoughts, emotions, and experiences (both pleasant and unpleasant) [5]. There are findings on the effects of meditation practice on cognitive functions such as attention, memory, executive function, processing speed, and brain structure and function, which could have important implications for the elderly population [6]. A meta-analysis by Whitfield et al. provided some support for the positive effects of meditation training on cognitive function in adults, including both clinical and non-clinical populations [7]. In a study in Singapore, a 3-month meditation intervention was shown to increase functional brain connectivity and recognition memory in community-dwelling older adults with mild cognitive impairment compared with an active control group undergoing a health education program [8]. In contrast, another local study examined the effects of a meditation intervention compared with a health education program in community-dwelling older adults with cognitive impairment and found that both groups showed improved emotional well-being (less depression and anxiety) but no significant changes in cognitive function [9].

Cognitive behavioral interventions have been shown to be effective in improving motor function and cognitive abilities in various populations [10]. However, the results in this area are inconsistent. Improving cognitive and motor abilities can be helpful for educators and rehabilitation professionals, motor behavior specialists, and older adults. Therefore, identifying the optimal interventions to improve these factors in the elderly is of great importance. Therefore, the present study aims to investigate the effect of meditation exercises on cognitive abilities and maintaining stability in inactive elderly people.

Method: The research method is semi-experimental, in which the experimental group and the control group were studied with a pre-test-post-test design. The statistical population of this study consisted of all elderly people in Qom province. To select the statistical sample, a convenient and purposive sampling method was used, in which a total of 16 elderly people with a history of falling were selected and placed in two groups: meditation exercises (8 people) and control (8 people). The sample size was obtained by using the G*Power statistical software with the input of the components of a significance level of 5 percent (α=0.05), a test power of 80 percent (β=0.05), and a medium effect size (d=0.05), and the number was equal to 16 cases (8 subjects in each group). Among the volunteers, 16 elderly people with a history of falling were selected and placed in two experimental and control groups. In the experimental group, the purpose of the training was first stated in the introductory session, and the method of holding meetings and the general regulations governing the meetings were explained to the members.Finally, the data were analyzed using the analysis of covariance method was used to determine the location of the differences between groups and SPSS software version 27.

Results: The results showed that meditation exercises had no significant effect on cognitive abilities at the post-test (P=0.142). The results showed that meditation exercises had no significant effect on static balance at the post-test (P=0.113). The results showed that meditation exercises had no significant effect on dynamic balance at the post-test (P=0.113).

Conclusion: The results of the present study showed that meditation training resulted in non-significant improvements in cognitive abilities in inactive elderly people. Some studies suggest that mindfulness training may lead to improvements in certain aspects of attention, memory, and executive functions.

Researchers also showed that meditation-based treatment reduced anxiety in elderly people and increased adaptive emotional regulation when faced with stress. In explaining this finding, it can be said that meditation techniques are effective in increasing muscle relaxation and reducing worry, and consequently in reducing anxiety and stress. Insights and skills are learned through meditation practices and then used to cope with stressors and complaints that people often raise.

Research shows that meditation can reduce the activity of the amygdala and thalamus and increase the activity of the insular cortex, prefrontal cortex, and anterior cingulate cortex. These areas are involved in the regulation of emotion and alertness, and it is possible that after the intervention, these areas are involved and anxiety-related emotions are somewhat modulated.

They believe that cognitive abilities increase physical self-monitoring and body awareness, which may lead to improved physical mechanisms, including improved motor coordination and, subsequently, increased balance [20]. Also, individuals may have considered meditation as a coping strategy to increase motor coordination by learning it and using it to exploit and improve balance, which in itself could be a sign of facilitating balance. In general, it can be concluded that as a result of the meditation intervention, they were able to increase their balance by accepting their ability and increasing alertness and motor coordination.

In addition, meditation shows a relative moderating role in the mediating relationships between experiences of improved balance and life and mental health. Erickson et al. found that cognitive training and exercise both improve inhibitory control; Also, the size of the significant positive effect on inhibitory control is greater in the exercise group; in other words, exercise can improve cognitive skills and inhibitory control performance in elderly people with mild cognitive impairment, in addition to cognitive training. Meditation includes physical, cognitive, social, and meditative components and has unique benefits for enhancing cognitive performance, especially in executive functions.

Research limitations:

Among the limitations of this research is the lack of control over the stressful conditions of the subjects outside of training, the limitedness of the examined sample and as a result the problem of generalizing it to other athletes in different disciplines, the existing research gap in relation to the study of the research variables, the research sample. One of the limitations of the present study is the small number of samples. Given the limited sample size, it is recommended that more extensive studies with a larger sample size be conducted to investigate the effectiveness of meditation exercises on cognitive and motor benefits for elderly people with a history of falling. It is also suggested that a similar study be conducted among elderly people with cognitive impairments and the results be compared.

Keywords: Exercises, meditation, cognitive, maintaining stability, elderly, inactive.

Ethical Considerations

Compliance with ethical guidelines

The ethical principles observed in the article, such as the informed consent of the participants, the confidentiality of information, the permission of the participants to cancel their participation in the research. Ethical approval was obtained from the Research Ethics Committee of the  Medical University of Qom.

Funding

This study was extracted from the thesis of first author.

Authors' contribution

All authors contributed equally to the conceptualization of the article and writing of the original and subsequent drafts.

Conflict of interest

The authors declared no conflict of interest.

Acknowledgements

The authors would like to thank all participants of the present study.