Mindfulness-Based Stress Reduction for Older Adults With Stress Disorders and Neurocognitive Difficulties: A Randomized Controlled Trial.
Julie Loebach Wetherell, Tamara Hershey, Steven Hickman, Susan Tate, David Dixon, Emily S Bower, Eric J Lenze
The Journal of Clinical Psychiatry July 2017 DOI: 10.4088/jcp.16m10947 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 103 |
| Population | Adults aged 65 years or older with an anxiety or depressive disorder diagnosed by DSM-IV criteria and subjective neurocognitive difficulties, recruited in St. Louis, Missouri, or San Diego, California |
| Interventions | Mindfulness-based stress reduction (MBSR) health education control condition |
| Duration | Outcomes measured immediately post-intervention and, for clinical outcomes only, at 3- and 6-month follow-up |
| Measures | immediate and delayed paragraph and list recall, Delis-Kaplan Executive Function System Verbal Fluency Test, Delis-Kaplan Executive Function System Color Word Interference Test, worry, depression, anxiety, Clinical Global Impressions-Improvement scale, peak salivary cortisol |
| Topics | Meditation |
| Registration | NCT01693874 |
| Key findings | Mindfulness-based stress reduction improved a memory composite score and clinical outcomes including worry and depression at posttreatment and worry, depression, and anxiety at follow-up compared with a health education control, with no group difference in cognitive control. Cortisol decreased more in the mindfulness group only among participants with high baseline cortisol, which the authors propose as a possible mechanism. |
Abstract
To determine whether neurocognitive performance and clinical outcomes can be enhanced by a mindfulness intervention in older adults with stress disorders and cognitive complaints. To explore decreased hypothalamic-pituitary-adrenal (HPA) axis activity as a possible mechanism. 103 adults aged 65 years or older with an anxiety or depressive disorder (diagnosed according to DSM-IV criteria) and subjective neurocognitive difficulties were recruited in St. Louis, Missouri, or San Diego, California, from September 2012 through August 2013 and randomly assigned in groups of 5-8 to mindfulness-based stress reduction (MBSR) or a health education control condition matched for time, attention, and credibility. The primary outcomes were memory (assessed by immediate and delayed paragraph and list recall) and cognitive control (Delis-Kaplan Executive Function System Verbal Fluency Test and Color Word Interference Test). Other outcomes included clinical symptoms (worry, depression, anxiety, and global improvement). HPA axis activity was assessed using peak salivary cortisol. Outcomes were measured immediately post-intervention and (for clinical outcomes only) at 3- and 6-month follow up. On the basis of intent-to-treat principles using data from all 103 participants, the mindfulness group experienced greater improvement on a memory composite score (P = .046). Groups did not differ on change in cognitive control. Participants receiving MBSR also improved more on measures of worry (P = .042) and depression (P = .049) at posttreatment and on worry (P = .02), depression (P = .002), and anxiety (P = .002) at follow-up and were more likely to be rated as much or very much improved as rated by the Clinical Global Impressions-Improvement scale (47% vs 27%, χ² = 4.5, P = .03). Cortisol level decreased to a greater extent in the mindfulness group, but only among those participants with high baseline cortisol. In this population of older adults with stress disorders and neurocognitive difficulties, a mindfulness intervention improves clinical outcomes such as excessive worry and depression and may include some forms of immediate memory performance. ClinicalTrials.gov identifier: NCT01693874.
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 41
- The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis Neuropsychology Review August 4, 2021
- Towards a computational phenomenology of mental action: modelling meta-awareness and attentional control with deep parametric active inference. Neuroscience of Consciousness 2021
- Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions Frontiers in Psychology June 13, 2018
- Cognitive, psychological, and physiological effects of a web-based mindfulness intervention in older adults during the COVID-19 pandemic: an open study. BMC Geriatrics February 14, 2024
- Towards a computational (neuro)phenomenology of mental action: modelling meta-awareness and attentional control with deep-parametric active inference PsyArXiv June 10, 2020
and 36 more in the library