BRIEF RESEARCH REPORT article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicFocus on Physical Activity and Healthy AgingView all articles
Mindfulness training combined with cold water immersion effects on mood and perception of executive functioning in middle-aged and older adults: a pilot study
Provisionally accepted
Ambra Gentile1*
Sara Vivirito2
Musa Kirkar2Konstantinos Paschos3Luka Tuđan4Jakub Kulhánek5Pelin Öztürk6
Marianna Alesi1- 1Universita degli Studi di Palermo, Palermo, Italy
- 2Centro Internazionale per la Promozione dell'Educazione e Sviluppo, Palermo, Italy
- 3European Network of Active Living for Mental Health, Brussels, Belgium, Brussels, Belgium
- 4Swimming Club Zagreb, Zagreb, Croatia
- 5SHUT UP AND SWIM, Praha, Czechia
- 6Innovative Education Center, Wien, Austria
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Background. Age-related cognitive decline typically begins during middle age and persists into old age. In parallel, mood (and, in particular, anxiety and depression) can be a significant predictor of neurodegenerative pathologies. To prevent these negative consequences, mindfulness trainings were used to improve mood and executive functioning in middle-aged and older adults. Less is known about cold water immersion, which apparently favors cognitive enhancement and mood restoration. Methods. The current pilot study involved a sample of 46 adult participants (63% F; mean age: 60.67 years, SD: ±8.51), who completed a combined mindfulness and cold-water immersion program of 20 weeks. Before and after the training period, participants completed questionnaires about depressive and anxiety symptoms and executive functioning perception. A linear mixed model was run to evaluate pre-post differences with the presence of potential confounders (i.e., country, occupation, physical activity practice). Results. The results showed a positive effect of the combined training on depression (mean difference= -2.59, t= -3.10, p= 0.003), with higher effectiveness for older adults compared to middle-aged participants (mean difference= -3.26, p=0.042). Moreover, a significant effect of the training was found concerning anxiety (F1,50.08= 7.70, p=0.008), without differences between the two age groups (F1,51.06= 0.10, p=0.75). Finally, a non-significant effect of the combined training was found between pre-and post-treatment phase concerning executive functioning perception (F1,52.64=3.61, p=0.06). Conclusion. Cold water immersion combined with mindfulness sessions could be considered by future researchers as a possible training for healthy aging.
Keywords: healthy aging, Elderly, mindfulness, middle-aged adults, cold water
Received: 16 Oct 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Gentile, Vivirito, Kirkar, Paschos, Tuđan, Kulhánek, Öztürk and Alesi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ambra Gentile, ambra.gentile01@unipa.it
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