People even join “polar bear clubs,” where they swim in the winter ocean for purported longevity. Cold-water immersion can stimulate the production of norepinephrine, a neurotransmitter linked to attention and mood regulation. Combining mindfulness with cold water immersion might be more effective than mindfulness alone for improving mood and forestalling cognitive decline in middle age and beyond.

Gentile et al. [Frontiers in Public Health] studied the feasibility of combining two interventions—mindfulness and cold-water immersion—and examined their joint effects on mood and perceived executive functioning in adults.

The researchers recruited a sample of 54 healthy adult volunteers aged 50 years or older (average age about 61) from Italy, Croatia, Austria, Belgium, Czechia. Participants enrolled in a 20-week program consisting of 40 twice-weekly group sessions that combined mindfulness practice with supervised cold-water immersion. Each session began with 40 minutes of mindfulness practice, including present-moment awareness, a body scan with progressive muscle relaxation, and guided breathing exercises, followed by a brief group discussion.

Afterward, participants stood immersed from feet to shoulders in cold water. They started with a 1-minute immersion at 57°F, and over subsequent sessions the water temperature was gradually cooled and immersion time increased until they were able to remain in 46°F water for up to 20 minutes. 

For analysis, participants were grouped as middle-aged (50-59 years) and older adults (60+ years). They completed questionnaires at baseline and after the intervention assessing depressive symptoms, anxiety, and perceived executive functioning (attention, planning, and self-control).

Due to withdrawal from the program and non-completion of the post assessment, the final analyzed sample consisted of 46 participants (63% female). All 46 participants attended all of the training sessions and all were able to remain in cold water for the targeted length of time by the end of the program.

In within-subject analysis, results showed a moderate-sized, significant drop in depressive symptoms (Cohen’s d=0.58) and anxiety (d=0.42) scores immediately after the intervention. The small improvement in perceived executive functioning scores did not reach statistical significance in their mixed-model analysis (p=.06). Older adults showed a larger reduction in depressive symptoms than middle-aged participants, whereas anxiety improvements were similar across age groups.

This novel pilot study suggests that mindfulness training combined with cold-water immersion can improve mood in healthy middle-aged and older adults, with greatest benefit for depressive symptoms.

The study is limited by lack of a comparison group, no follow-up beyond the immediate post-treatment assessment, and no assessment of factors such as prior cold-water exposure. Because all participants received both interventions, there is no way to determine whether the combined treatment is superior, equivalent to, or inferior to its component alone.

Reference:

Gentile, A., Vivirito, S., Kirkar, M., Paschos, K., Tuđan, L., Kulhánek, J., Öztürk, P., & Alesi, M. (2025). Mindfulness training combined with cold water immersion effects on mood and perception of executive functioning in middle-aged and older adults: A pilot study. Frontiers in Public Health.

Link to study