Mindfulness-based stress reduction for community-dwelling older adults with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in primary care: a mixed-methods feasibility randomized control trial.
Todd Tran, Catherine Donnelly, Emily Nalder, Tracy Trothen, Marcia Finlayson
BMC primary care February 9, 2023 DOI: 10.1186/s12875-023-02002-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Convergent mixed-methods, single-blind pilot randomized controlled trial Qualitative Peer reviewed |
|---|---|
| Sample size | 27 |
| Population | Community-dwelling older adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI), plus occupational therapists who are qualified MBSR teachers |
| Interventions | Mindfulness-based stress reduction (MBSR) computer tablet and App Insight Timer® |
| Duration | 9-week MBSR program; post-intervention follow-up |
| Topics | Meditation |
| Keywords | Interprofessional primary care Mild cognitive impairment Occupational therapy Subjective cognitive decline Technology |
| Registration | NCT03867474 |
| Key findings | The 9-week MBSR program delivered in interprofessional primary care did not meet preset feasibility benchmarks: retention was 64.3%, true adherence 50%, and attrition 21.4%, though post-intervention follow-up was 100%. The authors argue that with minor modifications, including changing how drop-outs are analyzed, extending recruitment, and adding multiple sites, the intervention would be suitable for a full-scale RCT. Qualitative data highlighted participant satisfaction and perceived benefits, and tablet use was acceptable and consistent. |
Abstract
Primary care is often the first point of contact when community-dwelling older adults experience subjective cognitive decline (SCD) or mild cognitive impairment (MCI). Living with SCD or MCI can be life-altering, resulting in low mood and increased anxiety, further exacerbating cognitive decline. However, there is scant literature on interventions that interprofessional primary care providers can provide to support those living with SCD or MCI. Practicing mindfulness-based stress reduction (MBSR) in an interprofessional primary care setting may support emotional health and well-being for those with cognitive decline, but it has not been studied in an interprofessional primary care context. This study's primary aim was to determine the feasibility of, and perceived benefits to and satisfaction with, a 9-Week MBSR program delivered in a team-based primary care setting. The secondary aim was to examine the acceptability of using technology (computer tablet and App Insight Timer®) for program delivery and home practice. A convergent mixed-methods, single-blind pilot randomized controlled trial (RCT) study design was used. A quantitative strand was used to evaluate the feasibility of the MBSR program. The qualitative strand used a focus group with older adult participants with SCD or MCI. Individual semi-structured interviews with occupational therapists who are qualified-MBSR teachers were conducted to explore the acceptability of using computer tablets for program delivery and home practice. 27 participants were randomized (14 MBSR; 13 Control) with retention rates of 64.3% (9/14 completed ≥6 sessions), true adherence rates of 50% (7/14 met ≥19.5 hrs of home practice), 21.4% attrition rates, and 100% post-intervention follow-up. No participants who used computer tablets at the beginning of the intervention switched to low technology. Older adult participants found the use of computer tablets in the MBSR course acceptable and appreciated the portability of the tablets. Based on the lower-than-expected rates of recruitment, retention, and adherence, our study, as designed, did not meet the feasibility benchmarks that were set. However, with minor modifications to the design, including changing how participants who drop-out are analyzed, extending recruitment, and adding multiple sites, this intervention would be well suited to further study using a full-scale RCT. However, we found that embedding MBSR in an interprofessional primary care setting was feasible in practice and qualitative data highlighted the satisfaction and perceived benefits based on the intervention. The use of technology was acceptable and portable, as participants utilized their computer tablets consistently until the study's end. Our study showed that older adults living with SCD or MCI were highly receptive to learning how to use technology, and future group intervention programs in interprofessional primary care settings may also incorporate tablet use. This study was reviewed and approved by the Research Ethics Board in Toronto, Ontario, Canada (REB# 2017-0056-E); Queen's University (REB# 6026418) in Kingston, Ontario, Canada, and Clinicaltrials.gov (08/03/2019; NCT03867474).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 5
- Occupational Therapist-Led Mindfulness Training Program for Older Adults Living with Early Cognitive Decline in Primary Care: A Pilot Randomized Controlled Trial. Journal of Alzheimer's disease reports 2023
- Exploring Mechanisms, Methods, and Measurement in Mindfulness Research: A Scoping Review of Community-Based Interventions Mindfulness September 15, 2026
- [Expérience d'une introduction à la pleine conscience chez des personnes vieillissantes à risque de déclin cognitif]. Canadian Journal on Aging June 2, 2026
- Mindfulness-based stress reduction combined with reminiscence therapy: a non-pharmacological approach for older adults with mild cognitive impairment or mild dementia due to Alzheimer's disease. Frontiers in Aging Neuroscience April 20, 2026
- A Mixed-Methods Narrative Review of Feasibility, Acceptability, and Mechanism-Level Studies of Mindfulness-Based Interventions in People with Dementia and Cognitive Impairment Mindfulness April 1, 2026
Cites 17
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis Cognitive Behaviour Therapy February 8, 2019
- Monitoring mindfulness practice quality: An important consideration in mindfulness practice Psychotherapy Research October 9, 2012
- Feasibility and Acceptability of Mindfulness-based Cognitive Therapy Compared with Mindfulness-based Stress Reduction and Treatment as Usual in People with Depression and Cardiovascular Disorders: a Three-Arm Randomised Controlled Trial Mindfulness July 21, 2018
- A pilot randomised trial comparing a mindfulness-based stress reduction course, a locally-developed stress reduction intervention and a waiting list control group in a real-life municipal health care setting BMC Public Health December 1, 2020
and 12 more in the library