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Chen LA, Boyle K. The Role of the Gut Microbiome in Health and Disease in the Elderly. Curr Gastroenterol Rep 2024; 26:217-230. [PMID: 38642272 PMCID: PMC11282161 DOI: 10.1007/s11894-024-00932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE OF REVIEW Growing evidence supports the contribution of age in the composition and function of the gut microbiome, with specific findings associated with health in old age and longevity. RECENT FINDINGS Current studies have associated certain microbiota, such as Butyricimonas, Akkermansia, and Odoribacter, with healthy aging and the ability to survive into extreme old age. Furthermore, emerging clinical and pre-clinical research have shown promising mechanisms for restoring a healthy microbiome in elderly populations through various interventions such as fecal microbiota transplant (FMT), dietary interventions, and exercise programs. Despite several conceptually exciting interventional studies, the field of microbiome research in the elderly remains limited. Specifically, large longitudinal studies are needed to better understand causative relationships between the microbiome and healthy aging. Additionally, individualized approaches to microbiome interventions based on patients' co-morbidities and the underlying functional capacity of their microbiomes are needed to achieve optimal results.
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Affiliation(s)
- Lea Ann Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers, New Brunswick, NJ, USA.
| | - Kaitlyn Boyle
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Talebisiavashani F, Mohammadi-Sartang M. The Effect of Mindfulness-Based Interventions on Mental Health and Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis. J Aging Health 2024:8982643241263882. [PMID: 39046424 DOI: 10.1177/08982643241263882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
OBJECTIVES To assess whether mindfulness-based interventions (MBIs) affect mental health and cognitive abilities in older adults. METHODS A systematic search was performed in PubMed, SCOPUS, Web of Science, and Google Scholar up to June 2023. Weight mean difference and 95% confidence intervals were provided as summary statistics. RESULTS In total, 26 articles were eligible. Overall, MBIs showed a statistically significant improvement in depression, anxiety, quality of life, and working memory compared to controls. However, no significant effects of MBIs on other cognitive parameters were found. In moderator analysis, less than eight weeks of MBIs showed greater improvement in anxiety and quality of life than longer periods. There was no evidence for publication bias. DISCUSSION Mindfulness-based interventions can be an encouraging alternative in place of conventional treatments in improving depression, anxiety, quality of life and working memory in cognition among older adults. However, findings strongly recommend future research to have definite conclusion.
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Wang Y, Li Q, Yao L, He N, Tang Y, Chen L, Long F, Chen Y, Kemp GJ, Lui S, Li F. Shared and differing functional connectivity abnormalities of the default mode network in mild cognitive impairment and Alzheimer's disease. Cereb Cortex 2024; 34:bhae094. [PMID: 38521993 DOI: 10.1093/cercor/bhae094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/25/2024] Open
Abstract
Alzheimer's disease (AD) and mild cognitive impairment (MCI) both show abnormal resting-state functional connectivity (rsFC) of default mode network (DMN), but it is unclear to what extent these abnormalities are shared. Therefore, we performed a comprehensive meta-analysis, including 31 MCI studies and 20 AD studies. MCI patients, compared to controls, showed decreased within-DMN rsFC in bilateral medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC), precuneus/posterior cingulate cortex (PCC), right temporal lobes, and left angular gyrus and increased rsFC between DMN and left inferior temporal gyrus. AD patients, compared to controls, showed decreased rsFC within DMN in bilateral mPFC/ACC and precuneus/PCC and between DMN and left inferior occipital gyrus and increased rsFC between DMN and right dorsolateral prefrontal cortex. Conjunction analysis showed shared decreased rsFC in mPFC/ACC and precuneus/PCC. Compared to MCI, AD had decreased rsFC in left precuneus/PCC and between DMN and left inferior occipital gyrus and increased rsFC in right temporal lobes. MCI and AD share a decreased within-DMN rsFC likely underpinning episodic memory deficits and neuropsychiatric symptoms, but differ in DMN rsFC alterations likely related to impairments in other cognitive domains such as language, vision, and execution. This may throw light on neuropathological mechanisms in these two stages of dementia.
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Affiliation(s)
- Yaxuan Wang
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Qian Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Li Yao
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Ning He
- Department of Psychiatry, West China Hospital of Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan, P.R. China
| | - Yingying Tang
- Department of Neurology, West China Hospital of Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan, P.R. China
| | - Lizhou Chen
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Fenghua Long
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Yufei Chen
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Graham J Kemp
- Institute of Life Course and Medical Sciences, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, United Kingdom
| | - Su Lui
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
| | - Fei Li
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular lmaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wuhou District, Chengdu 610041, Sichuan Province, P.R. China
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Lannon-Boran C, Hannigan C, Power JM, Lambert J, Kelly M. The effect of mindfulness-based intervention on cognitively unimpaired older adults' cognitive function and sleep quality: a systematic review and meta-analysis. Aging Ment Health 2024; 28:23-35. [PMID: 37485984 DOI: 10.1080/13607863.2023.2228255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023]
Abstract
Objective: This systematic review and meta-analysis aimed to investigate the effect of mindfulness-based intervention (MBI) on cognitively unimpaired older adults' cognitive function and sleep quality.Method: Studies published in English since 2010 were considered for inclusion. Databases searched were PubMed, Embase, Web of Science, and PsycInfo. We included randomized controlled trials (RCTs) with adults over 55 with no known cognitive impairment, that recorded cognitive outcomes and/or sleep quality pre- and post-intervention, and that implemented Mindfulness-Based Stress Reduction (MBSR), or an MBI closely based on MBSR protocol.Results: Seven RCTs fit the inclusion criteria, with 276 participants in MBI groups and 287 in controls. Four studies investigated mindfulness and cognitive function, two investigated mindfulness and sleep quality, and one investigated mindfulness, cognitive function, and sleep quality. Some studies were not reported in sufficient detail to be included in meta-analyses. Results of meta-analyses showed no significant differences between MBI groups vs controls on cognitive measures of executive function, free recall, and delayed recall. Meta-analysis revealed that MBI significantly improved sleep quality compared to controls.Conclusion: Given that poor sleep quality is strongly linked to increased risk of cognitive decline, further research investigating sleep quality's role in the mindfulness-cognitive function relationship in cognitively unimpaired older adults is recommended.
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Affiliation(s)
- Colm Lannon-Boran
- Department of Psychology, National College of Ireland, Dublin, Ireland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Caoimhe Hannigan
- Department of Psychology, National College of Ireland, Dublin, Ireland
| | | | - Jonathan Lambert
- School of Computing, National College of Ireland, Dublin, Ireland
| | - Michelle Kelly
- Department of Psychology, National College of Ireland, Dublin, Ireland
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Leow Y, Rashid NLBA, Klainin-Yobas P, Zhang Z, Wu XV. Effectiveness of mindfulness-based interventions on mental, cognitive outcomes and neuroplastic changes in older adults with mild cognitive impairment: A systematic review and meta-analysis. J Adv Nurs 2023; 79:4489-4505. [PMID: 37248564 DOI: 10.1111/jan.15720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 04/01/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023]
Abstract
AIMS To evaluate the effectiveness of mindfulness-based interventions (MBIs) on mental and cognitive outcomes including, anxiety, depression, attention, memory, global cognition and neuroplastic changes in older adults with mild cognitive impairment (MCI). DESIGN Systematic review and meta-analysis. DATA SOURCE A three-step search strategy was conducted on eight electronic databases, grey literature and reference lists from inception to February 2022. REVIEW METHODS Randomized controlled trials (RCTs) examining MBIs on older adults with MCI were screened and assessed for risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was conducted using RevMan using a random-effect model. Narrative synthesis was performed for studies where results could not be pooled statistically. RESULTS Ten RCTs were included in the review. Results suggested that right frontal parietal and left inferior temporal gyrus of the brain showed increased cortical thickness after receiving MBIs. There were significant interaction effects for global efficiency and significant interactions in the insular and gyrus regions. Functional connectivity between the posterior cingulate cortex, bilateral medial prefrontal cortex and left hippocampus were increased in participants undergoing MBIs. Nevertheless, meta-analysis showed non-significant pooled effects, favouring control groups on anxiety, depression, attention, memory and global cognition. CONCLUSION This review suggested the potential effects of MBIs in improving cortical thickness and connectivity in regions associated with memory and attention. Nevertheless, the effects of MBIs compared to active control groups on depression, anxiety, attention, memory and global cognition are inconclusive due to the lack of studies and non-significant results. IMPACT The review advocates for more rigorous studies with larger sample size and utilizing wait-list controls to evaluate the effects of MBIs. MBIs can be considered as an adjunct with other therapies to further enhance the effect on psychological and cognitive outcomes for older adults with MCI. No Patient or Public Contribution as this is a meta-analysis.
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Affiliation(s)
- Yihong Leow
- Emergency Medicine, Woodlands Health, Singapore, Singapore
| | | | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zemiao Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- NUSMED Healthy Longevity Translational Research Programme, National University of Singapore, Singapore, Singapore
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Rose Sin Yi L, Jing Jing S, Hammoda AO, Jonathan B. Effects of mindfulness-based interventions on neuropsychiatric symptoms and psychological well-being on people with subjective cognitive decline and mild cognitive impairment: A meta-analysis. Int J Geriatr Psychiatry 2023; 38:e5986. [PMID: 37592713 DOI: 10.1002/gps.5986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/01/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVES Neuropsychiatric symptoms (NPS) are highly prevalent in individuals with subjective cognitive decline (SCD) and mild cognitive impairment (MCI), and are strongly linked to accelerated cognitive decline and dementia onset. While mindfulness-based interventions have shown promise in improving psychological well-being in clinical and community settings, their efficacy for individuals in these pre-dementia stages remains unclear. This meta-analysis examined the effects of mindfulness-based interventions on NPS and psychological outcomes in these preclinical cohorts. METHODS Eligible studies were retrieved from PubMed, EMBASE, JBI EPB, Web of Science, and Cochrane library. Two independent researchers conducted the literature search and data extraction. Cochrane Risk-of-Bias Assessment Tool was used to assess the methodological quality of included studies. Quality of evidence was evaluated using the GRADE approach. Intervention effects were estimated by Hedge's g and 95% confidence interval (CI). RESULTS A total of 18 randomized controlled trials (including 974 participants from 21 studies) were included in the meta-analysis. The results demonstrated statistically significant immediate post-intervention effects of mindfulness-based interventions on anxiety (g = -0.30, 95% CI -0.49 to -0.11), stress (g = -0.58, 95% CI -0.91 to -0.24), and quality of life (g = 0.50, 95% CI 0.12-0.87). However, no significant effects were found for depression, apathy, mindfulness, and stress-related biomarkers. Follow-up data analysis also did not reveal significant effects for depression and anxiety. CONCLUSIONS The findings of this meta-analysis suggest that mindfulness-based interventions may improve anxiety, stress, and quality of life in individuals with SCD and MCI. However, more rigorous randomized controlled trials with larger sample sizes and evaluation using physiological parameters are needed to establish more definitive conclusions. Future interventions could consider incorporating cognitive training and health education to address the specific needs of the pre-dementia population. REGISTRATION NUMBER PROSPERO: CRD42022359906.
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Affiliation(s)
- Lin Rose Sin Yi
- School of Nursing, Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester, Rochester, New York, USA
| | - Su Jing Jing
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Abu-Odah Hammoda
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Bayuo Jonathan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
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Lopes S, Shi L, Pan X, Gu Y, Dengler-Crish C, Li Y, Tiwari B, Zhang D. Meditation and Cognitive Outcomes: A Longitudinal Analysis Using Data From the Health and Retirement Study 2000-2016. Mindfulness (N Y) 2023; 14:1705-1717. [PMID: 37808263 PMCID: PMC10557979 DOI: 10.1007/s12671-023-02165-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 10/10/2023]
Abstract
Objective We aimed to assess the association between meditation practice and cognitive function over time among middle-aged and older adults. Method We included Health and Retirement Study (HRS) participants assessed for meditation practice in the year 2000 as part of the HRS alternative medicine module (n = 1,160) and were followed up for outcomes over 2000-2016 period. We examined the association between meditation ≥ twice a week vs none/less frequent practice and changes in the outcomes of recall, global cognitive function, and quantitative reasoning using generalized linear regression models. Stratified analyses among persons with/without self-reported baseline depressive symptoms were conducted to assess the link between meditation and cognitive outcomes. Results Among our full study sample, meditation ≥ twice a week was not significantly associated with total recall [β ; 95% CI: -0.97, 0.57; p = 0.61], global cognitive function [β ; 95% CI: -1.01, 1.12; p = 0.92], and quantitative reasoning [β ; 95% CI: -31.27, 8.32; p = 0.26]. However, among those who did not have self-reported depressive symptoms at baseline, meditation ≥ twice a week was associated with improvement in cognitive outcomes such as total recall [β ; 95% CI: 0.03, 0.18; p = 0.01] and global cognitive function [β ; 95% CI: 0.05, 0.40; p = 0.01] over time. Conclusions Frequent meditation practice might have a protective effect on cognitive outcomes over time, but this protection could be limited to those without self-reported baseline depressive symptoms. Future studies could incorporate more precise meditation practice assessment, investigate the effect of meditation on cognitive outcomes over time, and include more rigorous study designs with randomized group assignment. Pre-registration This study is not preregistered.
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Affiliation(s)
- Snehal Lopes
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, Texas 78666, USA
| | - Yian Gu
- The Department of Neurology, The Department of Epidemiology, The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, and The Gertrude H. Sergievsky Center, Columbia University, New York, NY 10032, USA
| | - Christine Dengler-Crish
- Department of Pharmaceutical Sciences, Northeast Ohio Medical University, Rootstown, OH 44272, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Biplav Tiwari
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA 30602, USA
| | - Donglan Zhang
- New York University Long Island School of Medicine, Mineola, NY 11501, USA
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Pommy J, Smart CM, Bryant AM, Wang Y. Three potential neurovascular pathways driving the benefits of mindfulness meditation for older adults. Front Aging Neurosci 2023; 15:1207012. [PMID: 37455940 PMCID: PMC10340530 DOI: 10.3389/fnagi.2023.1207012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Mindfulness meditation has been shown to be beneficial for a range of different health conditions, impacts brain function and structure relatively quickly, and has shown promise with aging samples. Functional magnetic resonance imaging metrics provide insight into neurovascular health which plays a key role in both normal and pathological aging processes. Experimental mindfulness meditation studies that included functional magnetic resonance metrics as an outcome measure may point to potential neurovascular mechanisms of action relevant for aging adults that have not yet been previously examined. We first review the resting-state magnetic resonance studies conducted in exclusively older adult age samples. Findings from older adult-only samples are then used to frame the findings of task magnetic resonance imaging studies conducted in both clinical and healthy adult samples. Based on the resting-state studies in older adults and the task magnetic resonance studies in adult samples, we propose three potential mechanisms by which mindfulness meditation may offer a neurovascular therapeutic benefit for older adults: (1) a direct neurovascular mechanism via increased resting-state cerebral blood flow; (2) an indirect anti-neuroinflammatory mechanism via increased functional connectivity within the default mode network, and (3) a top-down control mechanism that likely reflects both a direct and an indirect neurovascular pathway.
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Affiliation(s)
- Jessica Pommy
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Andrew M. Bryant
- Department of Neurology, The Ohio State University, Columbus, OH, United States
| | - Yang Wang
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
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Wu C, Feng Y. Exploring the potential of mindfulness-based therapy in the prevention and treatment of neurodegenerative diseases based on molecular mechanism studies. Front Neurosci 2023; 17:1097067. [PMID: 37383106 PMCID: PMC10293639 DOI: 10.3389/fnins.2023.1097067] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 05/03/2023] [Indexed: 06/30/2023] Open
Abstract
Neurodegenerative diseases (ND) have received increasing attention due to their irreversibility, but there is still no means to completely cure ND in clinical practice. Mindfulness therapy (MT), including Qigong, Tai Chi, meditation, and yoga, etc., has become an effective complementary treatment modality in solving clinical and subclinical problems due to its advantages of low side effects, less pain, and easy acceptance by patients. MT is primarily used to treat mental and emotional disorders. In recent years, evidence has shown that MT has a certain therapeutic effect on ND with a potential molecular basis. In this review, we summarize the pathogenesis and risk factors of Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS), relating to telomerase activity, epigenetics, stress, and the pro-inflammatory transcription factor nuclear factor kappa B (NF-κB) mediated inflammatory response, and analyze the molecular mechanism basis of MT to prevent and treat ND, to provide possible explanations for the potential of MT treatments for ND.
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Long Y, Ouyang X, Yan C, Wu Z, Huang X, Pu W, Cao H, Liu Z, Palaniyappan L. Evaluating test-retest reliability and sex-/age-related effects on temporal clustering coefficient of dynamic functional brain networks. Hum Brain Mapp 2023; 44:2191-2208. [PMID: 36637216 PMCID: PMC10028647 DOI: 10.1002/hbm.26202] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/25/2022] [Accepted: 01/01/2023] [Indexed: 01/14/2023] Open
Abstract
The multilayer dynamic network model has been proposed as an effective method to understand the brain function. In particular, derived from the definition of clustering coefficient in static networks, the temporal clustering coefficient provides a direct measure of the topological stability of dynamic brain networks and shows potential in predicting altered brain functions. However, test-retest reliability and demographic-related effects on this measure remain to be evaluated. Using a data set from the Human Connectome Project (157 male and 180 female healthy adults; 22-37 years old), the present study investigated: (1) the test-retest reliability of temporal clustering coefficient across four repeated resting-state functional magnetic resonance imaging scans as measured by intraclass correlation coefficient (ICC); and (2) sex- and age-related effects on temporal clustering coefficient. The results showed that (1) the temporal clustering coefficient had overall moderate test-retest reliability (ICC > 0.40 over a wide range of densities) at both global and subnetwork levels, (2) female subjects showed significantly higher temporal clustering coefficient than males at both global and subnetwork levels, particularly within the default-mode and subcortical regions, and (3) temporal clustering coefficient of the subcortical subnetwork was positively correlated with age in young adults. The results of sex effects were robustly replicated in an independent REST-meta-MDD data set, while the results of age effects were not. Our findings suggest that the temporal clustering coefficient is a relatively reliable and reproducible approach for identifying individual differences in brain function, and provide evidence for demographically related effects on the human brain dynamic connectomes.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangshaHunanChina
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangshaHunanChina
| | - Chaogan Yan
- CAS Key Laboratory of Behavioral Science, Institute of PsychologyChinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
- International Big‐Data Center for Depression Research, Institute of PsychologyChinese Academy of SciencesBeijingChina
| | - Zhipeng Wu
- Department of Psychiatry, and National Clinical Research Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangshaHunanChina
| | - Xiaojun Huang
- Department of PsychiatryJiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical CollegeNanchangChina
| | - Weidan Pu
- Medical Psychological InstituteThe Second Xiangya Hospital, Central South UniversityChangshaChina
| | - Hengyi Cao
- Center for Psychiatric NeuroscienceFeinstein Institute for Medical ResearchManhassetNew YorkUSA
- Division of Psychiatry ResearchZucker Hillside HospitalGlen OaksNew YorkUSA
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental DisordersThe Second Xiangya Hospital of Central South UniversityChangshaHunanChina
| | - Lena Palaniyappan
- Department of PsychiatryUniversity of Western OntarioLondonOntarioCanada
- Robarts Research InstituteUniversity of Western OntarioLondonOntarioCanada
- Lawson Health Research InstituteLondonOntarioCanada
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Tran T, Donnelly C, Nalder E, Trothen T, Finlayson M. 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. BMC PRIMARY CARE 2023; 24:44. [PMID: 36759766 PMCID: PMC9912594 DOI: 10.1186/s12875-023-02002-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND 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. OBJECTIVES 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. METHODS 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. RESULTS 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. CONCLUSIONS 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. TRIAL REGISTRATION 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).
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Affiliation(s)
- Todd Tran
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario, K7L 3N6, Canada. .,Clinical Site: Women's College Hospital, 76 Grenville St., Toronto, Ontario, M5S 1B2, Canada.
| | - Catherine Donnelly
- grid.410356.50000 0004 1936 8331School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Emily Nalder
- grid.17063.330000 0001 2157 2938Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7 Canada
| | - Tracy Trothen
- grid.410356.50000 0004 1936 8331Jointly appointed to the School of Rehabilitation Therapy and School of Religion (Theological Hall), Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
| | - Marcia Finlayson
- grid.410356.50000 0004 1936 8331School of Rehabilitation Therapy, Queen’s University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6 Canada
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12
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Reitano MR, Guidetti M, Maiorana NV, De Sandi A, Carusi F, Rosci C, Ruggiero F, Poletti B, Ticozzi N, Mameli F, Barbieri S, Silani V, Priori A, Ferrucci R. The Effects of a New Integrated and Multidisciplinary Cognitive Rehabilitation Program Based on Mindfulness and Reminiscence Therapy in Patients with Parkinson's Disease and Mild Cognitive Impairment: A Pilot Study. Brain Sci 2023; 13:201. [PMID: 36831744 PMCID: PMC9954653 DOI: 10.3390/brainsci13020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Background: Mindfulness trainings have shown promising results as treatment for behavioural symptoms in several pathologies. In addition, mindfulness protocols induced an improvement in memory and attention. Therefore, mindfulness could be an effective intervention for patients affected by Parkinson's disease (PD) and mild cognitive impairment (MCI), who are characterized by both behavioural and cognitive dysfunctions. Methods: We assessed differences in Montreal Cognitive Assessment (MoCA) scores and in Beck Depression Inventory II (BDI-II) scores in patients affected by PD and MCI enrolled in two different rehabilitation programs (an experimental vs. an usual structured program for cognitive rehabilitation). Participants in the experimental group (MILC-tr) underwent innovative rehabilitation program involving mindfulness and reminiscence activities. Assessments were performed before (T0) and at the end of the rehabilitation program (T1). Results: Friedman test showed a significant improvement between timepoints in MoCA global score (x2 = 4.000, p = 0.046), MoCA memory sub-scale score (x2 = 4.571, p = 0.033), and BDI-II cognitive and affective factors (x2 = 4.000, p = 0.046) only for patients in MILC-tr group. Mann-Whitney test showed a significant difference between group comparing differences in Δ scores between T0 and T1 in the MoCA memory sub-scale score (U = 190.50, p = 0.035). Conclusions: Mindfulness-based rehabilitation programs could be effective in patients affected by PD and MCI.
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Affiliation(s)
- Maria Rita Reitano
- ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy
| | - Matteo Guidetti
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Natale Vincenzo Maiorana
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Angelica De Sandi
- ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy
| | - Fabrizio Carusi
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Chiara Rosci
- ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy
| | - Fabiana Ruggiero
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Barbara Poletti
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Francesca Mameli
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sergio Barbieri
- Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Vincenzo Silani
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, University of Milan, 20122 Milan, Italy
| | - Alberto Priori
- ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Roberta Ferrucci
- ASST Santi Paolo e Carlo, San Paolo University Hospital, 20142 Milan, Italy
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
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13
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Wang X, Si K, Gu W, Wang X. Mitigating effects and mechanisms of Tai Chi on mild cognitive impairment in the elderly. Front Aging Neurosci 2023; 14:1028822. [PMID: 36760710 PMCID: PMC9906996 DOI: 10.3389/fnagi.2022.1028822] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
Mild cognitive impairment (MCI) is a major public health concern that endangers health and decreases the quality of life of the elderly around the world. A recent clinical guideline has recommended regular exercise (twice per week) for patients with MCI as part of an overall approach to management. Tai Chi, a form of light-to-moderate-intensity mind-body exercise, is particularly suitable for seniors. This review aims to summarize epidemiological studies related to the effects of Tai Chi on symptom remission in older adults with MCI and reveal the potential mechanisms. Evidence suggested that Tai Chi can improve cognitive functions and alleviate the accompanying symptoms of MCI in the elderly potentially by activating the expression of signals in different brain regions, altering their connectivity, increasing the brain volume, and modulating brain-derived neurotropic and inflammation factors. Studies comparing various types of Tai Chi may contribute to the identification of paradigms that have appropriate intensities and difficulty and exert good effects on older people with MCI. In addition, studies are warranted to determine the frequency and duration of training that can optimize the beneficial effects of Tai Chi on MCI.
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Affiliation(s)
- Xin Wang
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Keyi Si
- Department of Military Health Statistics, Naval Medical University, Shanghai, China
| | - Wei Gu
- Faculty of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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14
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Guu SF, Chao YP, Huang FY, Cheng YT, Ng HYH, Hsu CF, Chuang CH, Huang CM, Wu CW. Interoceptive awareness: MBSR training alters information processing of salience network. Front Behav Neurosci 2023; 17:1008086. [PMID: 37025109 PMCID: PMC10070746 DOI: 10.3389/fnbeh.2023.1008086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
Mindfulness refers to a mental state of awareness of internal experience without judgment. Studies have suggested that each mindfulness practice may involve a unique mental state, but the underlying neurophysiological mechanisms remain unknown. Here we examined how distinct mindfulness practices after mindfulness-based intervention alter brain functionality. Specifically, we investigated the functional alterations of the salience network (SN) using functional magnetic resonance imaging (fMRI) among the two interoceptive mindfulness practices-breathing and body scan-associated with interoceptive awareness in fixed attention and shifted attention, respectively. Long-distance functional connectivity (FC) and regional homogeneity (ReHo) approaches were applied to measure distant and local neural information processing across various mental states. We hypothesized that mindful breathing and body scan would yield a unique information processing pattern in terms of long-range and local functional connectivity (FC). A total of 18 meditation-naïve participants were enrolled in an 8-week mindfulness-based stress reduction (MBSR) program alongside a waitlist control group (n = 14), with both groups undergoing multiple fMRI sessions during breathing, body scan and resting state for comparison. We demonstrated that two mindfulness practices affect both the long-distance FC SN and the local ReHo, only apparent after the MBSR program. Three functional distinctions between the mindfulness practices and the resting state are noted: (1) distant SN connectivity to occipital regions increased during the breathing practice (fixed attention), whereas the SN increased connection with the frontal/central gyri during the body scan (shifting attention); (2) local ReHo increased only in the parietal lobe during the body scan (shifting attention); (3) distant and local connections turned into a positive correlation only during the mindfulness practices after the MBSR training, indicating a global enhancement of the SN information processing during mindfulness practices. Though with limited sample size, the functional specificity of mindfulness practices offers a potential research direction on neuroimaging of mindfulness, awaiting further studies for verification.
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Affiliation(s)
- Shiao-Fei Guu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
- Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Feng-Ying Huang
- Department of Education, National Taipei University of Education, Taipei, Taiwan
| | - Yu-Ting Cheng
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Clinical Mental Health Counseling Program, Johns Hopkins University, Baltimore, MD, United States
| | - Hei-Yin Hydra Ng
- Department of Educational Psychology and Counseling, College of Education, National Tsing Hua University, Hsinchu, Taiwan
- Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Chia-Fen Hsu
- Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chun-Hsiang Chuang
- Research Center for Education and Mind Sciences, College of Education, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- *Correspondence: Chih-Mao Huang,
| | - Changwei W. Wu
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, Shuang Ho Hospital-Taipei Medical University, New Taipei, Taiwan
- Changwei W. Wu,
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15
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Liu J, Qiang F, Dang J, Chen Q. Depressive Symptoms as Mediator on the Link between Physical Activity and Cognitive Function: Longitudinal Evidence from Older Adults in China. Clin Gerontol 2023; 46:808-818. [PMID: 35603686 DOI: 10.1080/07317115.2022.2077158] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study examines the extent to which depressive symptoms mediate the link between physical activity and cognitive function among older adults in China. METHODS This study utilizes the 2013-18 China Health and Retirement Longitudinal Study (CHARLS) dataset, of which 3,658 subjects over the age of 50 satisfied inclusion criteria. Degree of physical activity, prevalence of depressive symptoms, and performance in cognitive function are measured by the International Physical Activity Questionnaire (IPAQ), Center for Epidemiological Studies Depression Scale (CESD), the Mini-Mental State Examination (MMSE) instruments. A structural mediation model was built to assess the degree to which depressive symptoms act as mediator between physical activity and cognitive function. RESULTS Physical activity is positively and significantly associated with cognitive function (std β = 0.034, p-value = .007), while physical activity is negatively and significantly associated with prevalence of depressive symptoms (std β = -0.088, p-value < .001). Results indicate that depressive symptoms partially and significantly mediate the relationship between physical activity and cognitive function (std β = 0.003, p-value = .035). Total influence of physical activity on cognitive performance is evaluated to be 0.037 standard deviations (p-value = .035). CONCLUSIONS Findings uncover an underexamined mental well-being channel through which physical activity can positively influence late adulthood cognition. CLINICAL IMPLICATIONS In recommending behavioral modifications to reduce risks of late adulthood cognitive decline, encouraging physical activity for older individuals is key, since it is both directly associated with better cognitive performance, as well as indirectly through lowering prevalence of depressive symptoms.
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Affiliation(s)
- Ji Liu
- Faculty of Education, Shaanxi Normal University, Xian, Shaanxi, China
| | - Faying Qiang
- Faculty of Education, Shaanxi Normal University, Xian, Shaanxi, China
| | - Jingxia Dang
- The First Affiliated Hospital, Xian Jiaotong University, Xian, Shaanxi, China
| | - Qiaoyi Chen
- School of Basic Medical Sciences, Xian Jiaotong University, Xian, Shaanxi, China
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16
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Ng TKS, Tan XR, Todd M, Chen ACC, Feng L, Lu Y, Yu F, Kua EH, Mahendran R. Effects of Mindful Awareness Practice (MAP) on Subclinical Depressive and Anxiety Symptoms and General Cognitive Function in Older Adults with Mild Cognitive Impairment: A 5-Year Follow-Up of the MAP-Randomized Controlled Trial. J Alzheimers Dis 2022; 90:1677-1688. [PMID: 36314204 DOI: 10.3233/jad-220641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Few randomized controlled trials (RCTs) investigated the effects of mindfulness intervention on affective and cognitive symptoms in older adults with mild cognitive impairment (MCI). Furthermore, no RCTs on mindfulness followed participants beyond two years. OBJECTIVE To examine the longitudinal effects of a mindful awareness practice (MAP) intervention on depressive, anxiety, and cognitive symptoms in MCI. METHODS In this parallel-arm and assessor-blinded RCT, 55 community-dwelling older adults with MCI were randomized into the MAP or active control, i.e., health education program (HEP). Intervention sessions were conducted weekly for three months and monthly for the subsequent six months. Assessments and follow-up were conducted at baseline, 3-month, 9-month, and 5-year time points. Depressive, anxiety, and cognitive symptoms were measured using the Geriatric Depression Scale-15 (GDS-15), Geriatric Anxiety Inventory-20 (GAI-20), and Mini-Mental State Examination (MMSE), respectively. Linear-mixed models, following the intention-to-treat principle, were used for data analyses. RESULTS A total of 55 participants aged 60 to 86 (Mean age: 71.3±6 years old) was recruited, with n = 28 allocated to the MAP arm and n = 27 allocated to the HEP arm. Compared to HEP, GDS-15, GAI-20, and MMSE scores did not differ significantly in MAP during follow-ups. CONCLUSION Compared to HEP, MAP did not improve affective symptoms nor delay deteriorations in general cognition in community-dwelling older adults with MCI. Compared to our previous findings showing domain-specific improvements in MAP over HEP in attention and memory up to 9 months, this study highlights the importance of examining domain-specificity using detailed cognitive measures in non-pharmacological intervention with MCI.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.,Center for Innovation in Healthy and Resilient Aging (CIHRA), Phoenix, AZ, USA
| | - Xiang Ren Tan
- Health and Social Sciences, Singapore Institute of Technology, Singapore
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Angela Chia-Chen Chen
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fang Yu
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.,Center for Innovation in Healthy and Resilient Aging (CIHRA), Phoenix, AZ, USA
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
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17
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Ng TKS, Feng L, Chua RY, Goh LG, Kua EH, Mahendran R. A 5-year community program in Singapore to prevent cognitive decline. Asia Pac Psychiatry 2022; 14:e12518. [PMID: 35922040 DOI: 10.1111/appy.12518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/09/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There is a scarcity of naturalistic follow-up studies on cognitive stimulating activities (CSAs), particularly in a real-world setting and over long-term. We thus investigated a pooled novel CSA intervention to prevent cognitive decline amongst community-dwelling older adults without dementia. METHODS Nested within a community-based longitudinal follow-up cohort study of community-dwelling and multi-ethnic older adults (N = 991), a subset of the cohort (n = 264) underwent four single-blinded randomized controlled trials involving four novel CSAs, including mindfulness, horticulture, art therapy, and choral singing. At the cohort's 5-year follow-up, we examined if involvements in the CSAs improved cognition, compared to controls (n = 727). The primary outcomes were changes in global cognition and specific cognitive domain scores measured by the mini-mental state examination (MMSE). Exploratory subgroup analyses stratified by baseline cognitive status and the number of CSAs were also conducted. RESULTS Compared to the control group, there was a small improvement in the CSA group on the total MMSE score (d = 0.108) and MMSE-immediate recall score (d = 0.199). Furthermore, subgroup analyses revealed medium effect sizes of improvements (d = 0.420) in cognitive domains in mild cognitive impairment (MCI) (vs. cognitively healthy) and those involved in two CSAs (vs. one CSA). DISCUSSION In summary, a CSA intervention improved cognition. MCI and those involved in two CSAs gained greater benefits from the CSAs. These sustained improvements in cognitive functions could have a significant impact on delaying or preventing dementia.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, USA
| | - Lei Feng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, NUS, Singapore, Singapore.,Centre for Healthy Longevity, NUHS, Singapore, Singapore
| | - Ru Yuan Chua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Lee Gan Goh
- Department of Family Medicine, National University of Singapore, Singapore, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore, Singapore
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18
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Liu W, Li H, Lin X, Li P, Zhu X, Su S, Shi J, Lu L, Deng J, Sun X. Blunted superior temporal gyrus activity to negative emotional expression after mindfulness-based cognitive therapy for late-life depression. Front Aging Neurosci 2022; 14:1001447. [PMID: 36329872 PMCID: PMC9623567 DOI: 10.3389/fnagi.2022.1001447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Facial emotion recognition plays an important role in social functioning. Patients with late-life depression (LLD) often have abnormal facial emotion recognition. Mindfulness-based cognitive therapy (MBCT) is beneficial in treating depression. This study examined whether MBCT can act as an effective augmentation of antidepressants and improve facial emotion recognition in patients with LLD and its underlying neural mechanism. Patients with LLD were randomized into two groups (n = 30 per group). The MBCT group received an eight-week MBCT in conjunction with stable medication treatment. The other group was treated as usual (TAU group) with stable medication treatment. The positive affect (PA) scale, negative affect (NA) scale, and facial emotion recognition task with an fMRI scan were performed before and after the trial. After eight weeks of treatment, the repeated ANOVA showed that the PA score in the MBCT group significantly increased [F(1,54) = 13.31, p = 0.001], but did not change significantly [F(1,54) = 0.58, p = 0.449] in the TAU group. The NA scores decreased significantly in both the MBCT group [F(1,54) = 19.01, p < 0.001] and the TAU group [F(1,54) = 16.16, p < 0.001]. Patients showed an increase in recognition accuracy and speed of angry and sad faces after 8 weeks of MBCT. No improvement was detected in the TAU group after treatment. A significant interaction effect was found in the change of activation of the left superior temporal gyrus (L-STG) to negative emotional expression between time and groups. Furthermore, a decrease in activation of L-STG to negative emotional expression was positively correlated with the increase in PA score. The MBCT is beneficial for improving affect status and facial emotion recognition in patients with LLD, and the L-STG is involved in this process.
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Affiliation(s)
- Weijian Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hui Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xiao Lin
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Peng Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ximei Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Sizhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- *Correspondence: Lin Lu,
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Jiahui Deng,
| | - Xinyu Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Xinyu Sun,
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19
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Pelegrini LNDC, Casemiro FG, Zanarelli P, Rodrigues RAP. Socio-cognitive mindfulness predicts memory complaint and cognitive performance of older adults with different years of education. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 36121110 DOI: 10.1080/23279095.2022.2124374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Even though the effect of education on cognitive performance has been widely reported, the relationship between socio-cognitive mindfulness, cognitive performance, and memory complaint among the elderly with heterogeneous educational levels has not yet been investigated. AIM This study aimed to analyze the potential relationship between cognitive performance, memory complaint, and socio-cognitive mindfulness in a sample of healthy older adults with different years of education. METHODS In this quantitative, cross-sectional, observational, and analytical study, participants (n = 68) were assessed with a sociodemographic questionnaire, cognitive performance test (ACE-III), levels of socio-cognitive mindfulness (LSM-21), and memory complaint (Memory Complaint Scale). Descriptive statistics, as well as Pearson's correlation, and linear regression analysis were performed, and significance was assumed if p < .05. RESULTS Years of education correlated with cognitive performance and socio-cognitive mindfulness, but not with memory complaint. Socio-cognitive mindfulness had a positive correlation with cognitive performance and a negative correlation with memory complaint. Also, socio-cognitive mindfulness predicted cognitive performance and memory complaint both in bivariate analysis and when controlling for years of education. CONCLUSION Our findings suggested that older adults with higher levels of socio-cognitive mindfulness showed better cognitive performance and less memory complaint.
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Affiliation(s)
| | | | - Paloma Zanarelli
- Department of Gerontology, Federal University of São Carlos, Sao Carlos, Brazil
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20
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Sanchez-Lara E, Lozano-Ruiz A, Perez-Garcia M, Caracuel A. Efficacy of mindfulness-based interventions in cognitive function in the elderly people: a systematic review and meta-analysis. Aging Ment Health 2022; 26:1699-1709. [PMID: 34587844 DOI: 10.1080/13607863.2021.1976724] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The main objective was to determine the efficacy of Mindfulness-Based Interventions in improving the cognitive function of older adults (healthy adults or adults with mild cognitive impairment). METHODS A search was conducted in 4 databases. The effect sizes were extracted to perform a meta-analysis of the cognitive functions, as well as subgroup meta-analyses according to each domain: attention, memory and executive function. RESULTS The meta-analysis of cognitive functions showed an average effect size of g = .07, 95% CI [-.013; .160], p = .09, with the following values for each domain: g = .02, 95% CI [-.167; .204] for attention; g = .06, 95% CI [-.148; .262] for memory; and g = .14, 95% CI [-.042; .329] for executive function. CONCLUSION The MBI had a null global effect. The attention and memory results showed a null effect size and a small effect size was found for executive function. The methodological quality of the studies, however, was poor, so the results need to be interpreted with caution.
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Affiliation(s)
| | - Alvaro Lozano-Ruiz
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain
| | - Miguel Perez-Garcia
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Personality, Evaluation, and Psychological Treatment, University of Granada, Granada, Spain
| | - Alfonso Caracuel
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
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21
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Jensen DA, Lundervold AJ, Stubberud J, Halmøy A, Haavik J, Sørensen L. Goal management training improves executive control in adults with ADHD: an open trial employing attention network theory to examine effects on attention. BMC Psychol 2022; 10:207. [PMID: 36028907 PMCID: PMC9414421 DOI: 10.1186/s40359-022-00902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) typically experience poorer attentional control. According to the attention network theory, attentional control relies on three interacting networks of alerting, orienting, and executive control. In ADHD, it is mainly the alerting and executive control networks that are suggested and found to be compromised. Methods In the current study, we investigated if a group-based metacognitive remediation program (Goal Management Training [GMT]) in adults with ADHD would enhance attentional control using an experimental measure of the attention network theory. We expected that GMT would specifically enhance the executive control and alerting networks. Results Data from post- and follow up-assessments of 21 adults (age: 39.05 [11.93]) with ADHD who had completed GMT were included. Linear mixed-effects modeling revealed significant improvements in the functioning of the executive control network for the majority of the participants, although a small subset of participants showed a negative development following the intervention. Results also showed an improvement in the orienting network at follow up, but no change in the alerting network. Conclusion The results may indicate that improvements in the functioning of the executive control network are central to the positive effects of GMT reported in disorders characterized by impaired attentional control. Trial registration: The study was retrospectively registered in the ISRCTN (Identifier: ISRCTN91988877) on the 18/01/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00902-9.
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Affiliation(s)
- Daniel A Jensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway. .,Division of Mental Health, Betanien Hospital, Bergen, Norway.
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway.,Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anne Halmøy
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Lin Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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22
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Cai ZZ, Lin R, Wang XX, Yan YJ, Li H. Effects of mindfulness in patients with mild cognitive impairment with insomnia: A double-blind randomized controlled trial. Geriatr Nurs 2022; 47:239-246. [PMID: 36027785 DOI: 10.1016/j.gerinurse.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Current research on the effects of mindfulness therapy on MCI and insomnia has been inconsistent. It is still a hot topic of research and discussion. This study aimed to improve the sleep quality, cognition, and mental state of patients with mild cognitive impairment (MCI) with insomnia. METHODS A double-blind randomized controlled trial was conducted. Seventy-five patients who met the eligibility criteria were randomly assigned to the mindfulness (n = 38) or health education (n = 37) treatment group. The primary outcomes were sleep, measured by the Pittsburgh Sleep Quality Inventory, and cognition, measured by The Montreal Cognitive Assessment and Mini-Mental State Examination. Secondary outcomes included insomnia, measured by the Insomnia Severity Index, depression, anxiety, and perceived stress. EEG signals were collected at rest with eyes closed in the mindfulness state. The power spectrum was analyzed from these data. RESULTS Cognitive function and sleep quality were significantly improved in the mindfulness group (95% confidence interval 0.04 - 0.05, 0.03 - 0.04, -5.58 - -1.55, respectively). Anxiety and perceived stress scores were significantly lower than those in the control group (95% confidence interval 0.002 - 0.004, 0.009 - 0.013, respectively). The power spectrum differences in δ, θ, β, and γ bands were significant between the rest and mindfulness states (P < .05). Good safety was achieved in both groups with no deaths or serious adverse events. CONCLUSION Mindfulness improved sleep quality, cognitive function, and mentality of patients. Mindfulness practice caused deep relaxation in the brain and changes in electrical frequency bands associated with attention and cognitive tasks. Mindfulness learning can be performed successfully for individuals with MCI. Additionally, it is suitable for adoption in nursing homes.
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Affiliation(s)
- Zhen-Zhen Cai
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- Post-Doctoral Research Center, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Xia Wang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Yuan-Jiao Yan
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Hong Li
- School of Nursing, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Nursing, Fujian Provincial Hospital, Fuzhou, China.
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23
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Han A. Mindfulness-Based Interventions for Older Adults with Dementia or Mild Cognitive Impairment: A Meta-Analysis. Clin Gerontol 2022; 45:763-776. [PMID: 34693892 DOI: 10.1080/07317115.2021.1995561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of mindfulness-based interventions (MBIs) on psychological symptoms, cognitive functions, and quality of life in older adults with dementia or mild cognitive impairment (MCI). METHODS A comprehensive search was conducted within four databases to identify relevant randomized controlled trials (RCTs). Heterogeneity was assessed using the I2 statistic. Depending on I2 statistic values, either a random effects model or fixed effects model was used. RESULTS 10 RCTs published in 11 articles met the eligibility criteria. The present meta-analysis study found no significant effect of MBIs on depressive symptoms, anxiety, quality of life, memory, and overall cognitive functions compared to control groups. CONCLUSIONS Future high-quality studies involving different types of MBIs are needed to better understand the effects of MBIs on psychological symptoms, quality of life, and cognitive functions in older adults with MCI and dementia and examine effective intervention features. CLINICAL IMPLICATIONS There is insufficient evidence to determine whether or not practitioners should be routinely providing MBIs to older adults with MCI and dementia due to the lack of studies currently.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA
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24
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Vance DE, Lee Y, Batey DS, Li W, Chapman Lambert C, Nakkina SR, Anderson JN, Triebel K, Byun JY, Fazeli PL. Emerging directions of cognitive aging with HIV: practice and policy implications for social work. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2022; 65:476-494. [PMID: 34511048 DOI: 10.1080/01634372.2021.1978028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 06/13/2023]
Abstract
Cognitive impairments have been endemic to the HIV epidemic since its beginning and persist to this day. These impairments are attributed to HIV-induced neuroinflammation, the long-term effects of combination antiretroviral therapy, lifestyle factors (e.g., sedentary behavior, substance use), neuro-comorbidities (e.g., depression), age-associated comorbidities (e.g., heart disease, hypertension), and others causes. Normal aging and lifestyle also contribute to the development of cognitive impairment. Regardless of the etiology, such cognitive impairments interfere with HIV care (e.g., medication adherence) and everyday functioning (e.g., driving safely, financial management). With more than half of people with HIV (PWH) 50 years and older, and ~45% of all PWH meeting the criteria for HIV-Associated Neurocognitive Disorder (HAND), those aging PWH are more vulnerable for developing cognitive impairment. This article provides an update to a social work model to identify and monitor PWH for cognitive impairment. Within this update, the state of the science on protecting brain health and cognitive reserve within the context of neuroHIV is also presented. From this, implications for practice and policy to promote successful cognitive functioning in older PWH are provided.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yookyong Lee
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David Scott Batey
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Sai Rashmi Nakkina
- College of Arts and Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Joseph N Anderson
- School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kristen Triebel
- School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jun Y Byun
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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25
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Prather JG, Baughman B, Alexandrov AW, Grimes Stanfill A. A Conceptual Model of the Influence of Mindfulness-Based Interventions on Stress and Quality of Life in Patients With Chronic Conditions. Holist Nurs Pract 2022; 36:67-75. [PMID: 35166247 DOI: 10.1097/hnp.0000000000000500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Individuals with chronic conditions are susceptible to stress-related health complications. Left unattended, chronic stress exacerbates inflammation, diminishes quality of life (QOL), and increases all-cause mortality. Here, we suggest a theoretical framework promoting the use of mindfulness-based interventions (MBIs) in patients with chronic conditions and a conceptual model of how MBIs may influence stress and QOL.
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Affiliation(s)
- Jenifer G Prather
- Department of Acute and Tertiary Care, College of Nursing, University of Tennessee Health Science Center, Memphis (Ms Prather and Drs Alexandrov and Grimes Stanfill); Semmes Murphy Clinic, Memphis, Tennessee (Dr Baughman); and Departments of Neurosurgery (Dr Baughman) and Neurology (Dr Alexandrov), College of Medicine, University of Tennessee Health Science Center, Memphis
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26
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Dwivedi M, Dubey N, Pansari AJ, Bapi RS, Das M, Guha M, Banerjee R, Pramanick G, Basu J, Ghosh A. Effects of Meditation on Structural Changes of the Brain in Patients With Mild Cognitive Impairment or Alzheimer's Disease Dementia. Front Hum Neurosci 2021; 15:728993. [PMID: 34867239 PMCID: PMC8633496 DOI: 10.3389/fnhum.2021.728993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
Previous cross-sectional studies reported positive effects of meditation on the brain areas related to attention and executive function in the healthy elderly population. Effects of long-term regular meditation in persons with mild cognitive impairment (MCI) and Alzheimer's disease dementia (AD) have rarely been studied. In this study, we explored changes in cortical thickness and gray matter volume in meditation-naïve persons with MCI or mild AD after long-term meditation intervention. MCI or mild AD patients underwent detailed clinical and neuropsychological assessment and were assigned into meditation or non-meditation groups. High resolution T1-weighted magnetic resonance images (MRI) were acquired at baseline and after 6 months. Longitudinal symmetrized percentage changes (SPC) in cortical thickness and gray matter volume were estimated. Left caudal middle frontal, left rostral middle frontal, left superior parietal, right lateral orbitofrontal, and right superior frontal cortices showed changes in both cortical thickness and gray matter volume; the left paracentral cortex showed changes in cortical thickness; the left lateral occipital, left superior frontal, left banks of the superior temporal sulcus (bankssts), and left medial orbitofrontal cortices showed changes in gray matter volume. All these areas exhibited significantly higher SPC values in meditators as compared to non-meditators. Conversely, the left lateral occipital, and right posterior cingulate cortices showed significantly lower SPC values for cortical thickness in the meditators. In hippocampal subfields analysis, we observed significantly higher SPC in gray matter volume of the left CA1, molecular layer HP, and CA3 with a trend for increased gray matter volume in most other areas. No significant changes were found for the hippocampal subfields in the right hemisphere. Analysis of the subcortical structures revealed significantly increased volume in the right thalamus in the meditation group. The results of the study point out that long-term meditation practice in persons with MCI or mild AD leads to salutary changes in cortical thickness and gray matter volumes. Most of these changes were observed in the brain areas related to executive control and memory that are prominently at risk in neurodegenerative diseases.
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Affiliation(s)
- Madhukar Dwivedi
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Neha Dubey
- Department of Neurology, Apollo Gleneagles Hospital, Kolkata, India.,Department of Applied Psychology, University of Calcutta, Kolkata, India
| | - Aditya Jain Pansari
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Raju Surampudi Bapi
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Meghoranjani Das
- Department of Neurology, Apollo Gleneagles Hospital, Kolkata, India
| | - Maushumi Guha
- Department of Philosophy, Jadavpur University, Kolkata, India
| | - Rahul Banerjee
- Crystallography and Molecular Biology Division, Saha Institute of Nuclear Physics, Kolkata, India
| | | | - Jayanti Basu
- Department of Applied Psychology, University of Calcutta, Kolkata, India
| | - Amitabha Ghosh
- Department of Neurology, Apollo Gleneagles Hospital, Kolkata, India
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27
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Ng TKS, Feng L, Fam J, Rawtaer I, Kumar AP, Rane G, Cheah IKM, Mahendran R, Lee YK, Tan EC, Goh LG, Kua EH, Mahendran R. Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10205. [PMID: 34639513 PMCID: PMC8508350 DOI: 10.3390/ijerph181910205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND With an aging population, developing non-pharmacological interventions (NPIs) to delay dementia has become critical. Apart from cognitive decline, dementia is associated with multiple pathophysiology, including increased oxidative stress, dysregulated gene expressions, cytokine, neurotrophin, and stress markers, telomere shortening, and deteriorations in brain connectivity. Although mindfulness practices have been proposed to ameliorate these biological changes, no empirical studies were conducted. We thus aimed to investigate the effects of mindfulness awareness practice (MAP) to prevent cognitive decline and improve peripheral biomarkers in community-dwelling older adults diagnosed with mild cognitive impairment (MCI). METHODS/DESIGN This was a single-blinded and parallel-group randomized controlled trial with two arms (intervention and active control arms), conducted over nine months. A total of 60 consenting community-dwelling older adults diagnosed with MCI were planned to be randomized in a 1:1 ratio to either the MAP or the Health Education Program (HEP). Interventions were performed weekly for the initial 12 weeks, and monthly for the subsequent six months. Outcome measures were assessed at baseline, 3-month, and 9-month post-intervention by blinded assessors. Primary outcomes were neurocognitive tests, comprehensive peripheral biomarkers, and brain imaging scans. Secondary outcomes included basic health screening measures, affective symptoms, and measures of physical functions. Linear-mixed models were used to examine the effects of MAP on these outcome measures. SIGNIFICANCE This is the first randomized controlled trial to systematically investigate the effects of a mindfulness intervention in improving cognitive functions and various biomarkers in community-dwelling older adults diagnosed with MCI. Our findings have the potential to inform mindfulness intervention as a novel approach to delay dementia.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Lei Feng
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Johnson Fam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Iris Rawtaer
- Department of Psychiatry, Sengkang General Hospital & SingHealth Duke-NUS Centre of Memory and Cognitive Disorders, Singapore 544886, Singapore;
| | - Alan Prem Kumar
- Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore; (A.P.K.); (G.R.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore
| | - Grishma Rane
- Cancer Science Institute of Singapore, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore; (A.P.K.); (G.R.)
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, 28 Medical Drive, Singapore 117599, Singapore
| | - Irwin Kee-Mun Cheah
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, 8 Medical Drive, Singapore 117597, Singapore;
| | - Ratha Mahendran
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Yuan Kun Lee
- Department of Microbiology, Yong Loo Lin School of Medicine, National University of Singapore, 5 Science Drive 2, Singapore 117545, Singapore;
| | - Ene Choo Tan
- Division of Clinical Support Services, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore;
| | - Lee Gan Goh
- Department of Family Medicine, National University Health System, 1E Kent Ridge Rd, Singapore 119228, Singapore;
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (J.F.); (E.H.K.)
- Department of Psychological Medicine, National University Hospital, 1E Kent Ridge Road, Singapore 117599, Singapore;
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28
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Ochi S, Mori T, Iga JI, Ueno SI. 5-HT 1A Partial Agonist Tandospirone for Behavioral and Psychological Symptoms in Oldest-old Patients with Dementia at a Special Elderly Nursing Home. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2021; 19:514-520. [PMID: 34294620 PMCID: PMC8316653 DOI: 10.9758/cpn.2021.19.3.514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/24/2020] [Accepted: 10/19/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the efficacy of tandospirone, an azapirone anxiolytic similar to buspirone that is used in Japan, for behavioral and psychological symptoms of dementia (BPSD), especially in oldest-old patients. METHODS This was an open-label observational study involving residents with BPSD in a special elderly nursing home between August 2013 and August 2018. The severity of dementia was assessed using the Clinical Dementia Rating (CDR) scale; as the main outcomes, the severity of BPSD was assessed using the Clinical Global Impressions-Severity scale (CGI-S) and Neuropsychiatric Inventory-12 (NPI-12) at baseline and 4 weeks after the maintenance dose of tandospirone was reached. The administration of tandospirone started at 30 mg, divided into three doses per day. Two weeks later, if the efficacy was sufficient based on the clinical nursing record, that dose was continued; if the efficacy was insufficient, the daily dose was increased from 40 mg/day to a maximum dose of 60 mg/day. RESULTS Thirty-three participants (25 females [76%], mean age 87.1 ± 5.4 years) completed the study. Twenty-three participants (70%) were oldest-old (18 females [78%], mean age 89.9 ± 3.4 years). The mean CDR score was 2.9 ± 0.3 in all participants. Tandospirone treatment showed few or no obvious adverse effects and significantly improved CGI-S scores, as well as total scores and many subscale scores on the NPI-12, in both the sample at large and the oldest-old participants. CONCLUSION This study demonstrated the efficacy and safety of tandospirone for BPSD in oldest-old participants.
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Affiliation(s)
- Shinichiro Ochi
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Takaaki Mori
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Jun-ichi Iga
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
| | - Shu-ichi Ueno
- Department of Neuropsychiatry, Ehime University Graduate School of Medicine, Toon, Japan
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29
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The Effect of Mindfulness-based Programs on Cognitive Function in Adults: A Systematic Review and Meta-analysis. Neuropsychol Rev 2021; 32:677-702. [PMID: 34350544 PMCID: PMC9381612 DOI: 10.1007/s11065-021-09519-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 07/19/2021] [Indexed: 11/28/2022]
Abstract
Mindfulness-based programs (MBPs) are increasingly utilized to improve mental health. Interest in the putative effects of MBPs on cognitive function is also growing. This is the first meta-analysis of objective cognitive outcomes across multiple domains from randomized MBP studies of adults. Seven databases were systematically searched to January 2020. Fifty-six unique studies (n = 2,931) were included, of which 45 (n = 2,238) were synthesized using robust variance estimation meta-analysis. Meta-regression and subgroup analyses evaluated moderators. Pooling data across cognitive domains, the summary effect size for all studies favored MBPs over comparators and was small in magnitude (g = 0.15; [0.05, 0.24]). Across subgroup analyses of individual cognitive domains/subdomains, MBPs outperformed comparators for executive function (g = 0.15; [0.02, 0.27]) and working memory outcomes (g = 0.23; [0.11, 0.36]) only. Subgroup analyses identified significant effects for studies of non-clinical samples, as well as for adults aged over 60. Across all studies, MBPs outperformed inactive, but not active comparators. Limitations include the primarily unclear within-study risk of bias (only a minority of studies were considered low risk), and that statistical constraints rendered some p-values unreliable. Together, results partially corroborate the hypothesized link between mindfulness practices and cognitive performance. This review was registered with PROSPERO [CRD42018100904].
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30
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Song Y, Xu W, Chen S, Hu G, Ge H, Xue C, Qi W, Lin X, Chen J. Functional MRI-Specific Alterations in Salience Network in Mild Cognitive Impairment: An ALE Meta-Analysis. Front Aging Neurosci 2021; 13:695210. [PMID: 34381352 PMCID: PMC8350339 DOI: 10.3389/fnagi.2021.695210] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/01/2021] [Indexed: 01/03/2023] Open
Abstract
Background Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia. Amnestic MCI (aMCI) and non-amnestic MCI are the two subtypes of MCI with the former having a higher risk for progressing to Alzheimer's disease (AD). Compared with healthy elderly adults, individuals with MCI have specific functional alterations in the salience network (SN). However, no consistent results are documenting these changes. This meta-analysis aimed to investigate the specific functional alterations in the SN in MCI and aMCI. Methods: We systematically searched PubMed, Embase, and Web of Science for scientific neuroimaging literature based on three research methods, namely, functional connectivity (FC), regional homogeneity (ReHo), and the amplitude of low-frequency fluctuation or fractional amplitude of low-frequency fluctuation (ALFF/fALFF). Then, we conducted the coordinate-based meta-analysis by using the activation likelihood estimation algorithm. Results: In total, 30 functional neuroimaging studies were included. After extracting the data and analyzing it, we obtained specific changes in some brain regions in the SN including decreased ALFF/fALFF in the left superior temporal gyrus, the insula, the precentral gyrus, and the precuneus in MCI and aMCI; increased FC in the thalamus, the caudate, the superior temporal gyrus, the insula, and the cingulate gyrus in MCI; and decreased ReHo in the anterior cingulate gyrus in aMCI. In addition, as to FC, interactions of the SN with other networks including the default mode network and the executive control network were also observed mainly in the middle frontal gyrus and superior frontal gyrus in MCI and inferior frontal gyrus in aMCI. Conclusions: Specific functional alternations in the SN and interactions of the SN with other networks in MCI could be useful as potential imaging biomarkers for MCI or aMCI. Meanwhile, it provided a new insight in predicting the progression of health to MCI or aMCI and novel targets for proper intervention to delay the progression. Systematic Review Registration: [PROSPERO], identifier [No. CRD42020216259].
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Affiliation(s)
- Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenwen Xu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Guanjie Hu
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Chen Xue
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
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31
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Ng TKS, Slowey PD, Beltran D, Ho RCM, Kua EH, Mahendran R. Effect of mindfulness intervention versus health education program on salivary Aβ-42 levels in community-dwelling older adults with mild cognitive impairment: A randomized controlled trial. J Psychiatr Res 2021; 136:619-625. [PMID: 33199051 DOI: 10.1016/j.jpsychires.2020.10.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Few randomized controlled trials have investigated the effects of mindfulness intervention on older adults diagnosed with mild cognitive impairment (MCI). Specifically, scarce literature exists on the potential benefits of mindfulness intervention on biomarkers representing AD hallmarks. Our previous studies showed the potential of Mindful Awareness Practice (MAP) in improving multiple biomarkers of gut microbiota, systemic inflammation, and synaptic functions. Extending these findings, in this study, we conducted analysis on bio-banked saliva samples, examining whether MAP improved salivary amyloid beta-42 (Aβ-42) levels in community-dwelling older adults diagnosed with MCI. We also explored the moderating role of education level, an indicator of cognitive reserve, on intervention effect. METHODS A total of 55 community-dwelling older adults diagnosed with MCI were randomized into either the treatment arm, MAP, or the active control arm, the health education program (HEP). Interventions were performed for a total of nine months. Field and laboratory investigators who were blinded to the treatment allocations collected saliva samples at baseline, 3-month, and 9-month follow-ups. Salivary Aβ-42 levels were quantified using a commercial assay. Linear-mixed models were used to examine the effect of MAP on salivary Aβ-42 levels. RESULTS Compared to the HEP arm, MAP participants had no significantly modified Aβ-42 levels throughout the 9-month intervention period, regardless of subgroup analyses stratified by either sex or MCI-subtypes (amnestic and non-amnestic). Exploring the moderating effect of education, participants in the HEP arm with higher education levels had significantly lower salivary Aβ-42 at 3-month time-point. DISCUSSION Taken together with our previous findings and other mindfulness interventional studies failing to find a significant effect on peripheral Aβ-42, we conclude the non-significant effects of mindfulness intervention on ameliorating peripheral Aβ-42 levels. Conversely, participants in the HEP arm with higher cognitive reserve had significantly improved salivary Aβ-42, highlighting the role of cognitive reserve in moderating treatment response in MCI.
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Affiliation(s)
- Ted Kheng Siang Ng
- Department of Psychological Medicine, National University of Singapore, Singapore.
| | - Paul D Slowey
- Oasis Diagnostics® Corporation, Vancouver, WA, USA; Central South University, Changsha, China
| | | | - Roger C M Ho
- Department of Psychological Medicine, National University Hospital, Singapore; Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore; Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Faculty of Education, Huaibei Normal University, Vietnam, China
| | - Ee Heok Kua
- Department of Psychological Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore; Department of Psychological Medicine, National University Hospital, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore
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Reynolds GO, Willment K, Gale SA. Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood. Am J Med 2021; 134:444-455. [PMID: 33385339 DOI: 10.1016/j.amjmed.2020.10.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.
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Affiliation(s)
| | - Kim Willment
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
| | - Seth A Gale
- Department of Neurology, Brigham and Women's Hospital, Boston, Mass
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Oyler DL, Price-Blackshear MA, Pratscher SD, Bettencourt BA. Mindfulness and intergroup bias: A systematic review. GROUP PROCESSES & INTERGROUP RELATIONS 2021. [DOI: 10.1177/1368430220978694] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People’s proclivity for favoring their ingroups over outgroups has negative consequences for individuals, groups, and societies. Social psychologists have explored a variety of techniques to reduce these intergroup biases. Emerging research suggests that mindfulness may be effective for this purpose. Mindfulness is defined as present-moment attention and awareness with an accepting attitude, and it is often cultivated through meditation. Our systematic review of the mindfulness-intergroup literature suggests that, across the heterogeneity of paradigms, mindfulness attenuates intergroup bias. Supporting this supposition, for all studies in the current review, regardless of operationalization of mindfulness (i.e., mindfulness-based intervention, brief mindfulness induction, expert meditators, dispositional mindfulness), the overall effect size was g = +.29 ( k-number of studies = 36; 95% CI [0.20, 0.39]; Z = 5.94, p < .0001), suggesting a small but significant effect of mindfulness on improved levels of intergroup bias. In the current work, we review the eligible studies and their findings in detail and conclude by discussing critical issues and implications for future research.
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Innes KE, Montgomery C, Selfe TK, Wen S, Khalsa DS, Flick M. Incorporating a Usual Care Comparator into a Study of Meditation and Music Listening for Older Adults with Subjective Cognitive Decline: A Randomized Feasibility Trial. J Alzheimers Dis Rep 2021; 5:187-206. [PMID: 33981956 PMCID: PMC8075554 DOI: 10.3233/adr-200249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Recent studies suggest meditation and music listening (ML) may improve cognitive and psychosocial outcomes in adults with subjective cognitive decline (SCD). However, lack of a usual care group has limited conclusions. OBJECTIVE To assess the: 1) feasibility of incorporating an enhanced usual care (EUC) comparator in a trial of Kirtan Kriya meditation (KK) and ML for adults experiencing SCD; and 2) preliminary effects of active treatment (KK/ML) versus an EUC program. METHODS Forty participants with SCD were randomized 1:1:2 to a 12-week KK, ML, or EUC program. KK and ML participants were asked to practice 12 minutes/day; EUC participants were given a comprehensive educational packet regarding healthy aging and strategies for improving/maintaining brain health and asked to record any activities or strategies used. Feasibility was assessed using measures of retention, adherence, treatment expectancies, and participant satisfaction, as well as information from exit questionnaires and daily practice/activity logs. Cognitive functioning, stress, mood, sleep-quality, and health-related quality of life (QOL) were measured pre- and post-intervention using well-validated instruments. RESULTS Thirty-two participants (80%) completed the 3-month study, with retention highest in the EUC group (p < 0.05). Active treatment participants averaged 6.0±0.4 practice sessions/week, and EUC participants, 7.5±0.6 brain health activities/week. Treatment expectancies were similar across groups. EUC participants indicated high satisfaction with the program and study. Despite limited study power, the active treatment group showed significantly greater gains in subjective memory functioning (ps≤0.025) and nonsignificant improvements in cognitive performance (TMT-B), perceived stress, QOL, and mood (ps≤0.08) compared to the EUC group. CONCLUSION Findings of this pilot feasibility trial suggest incorporation of an EUC program is feasible, and that participation in a simple 12-week relaxation program may be helpful for adults with SCD versus engagement in an EUC program.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Caitlin Montgomery
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Terry Kit Selfe
- Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Sijin Wen
- Department of Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
| | | | - Madison Flick
- Department of Communication Sciences and Disorders, West Virginia University HSC, Morgantown, WV, USA
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Innis AD, Tolea MI, Galvin JE. The Effect of Baseline Patient and Caregiver Mindfulness on Dementia Outcomes. J Alzheimers Dis 2021; 79:1345-1367. [PMID: 33427746 PMCID: PMC8324319 DOI: 10.3233/jad-201292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Mindfulness is the practice of awareness and living in the present moment without judgment. Mindfulness-based interventions may improve dementia-related outcomes. Before initiating interventions, it would be beneficial to measure baseline mindfulness to understand targets for therapy and its influence on dementia outcomes. OBJECTIVE This cross-sectional study examined patient and caregiver mindfulness with patient and caregiver rating scales and patient cognitive performance and determined whether dyadic pairing of mindfulness influences patient outcomes. METHODS Individuals (N = 291) underwent comprehensive evaluations, with baseline mindfulness assessed using the 15-item Applied Mindfulness Process Scale (AMPS). Correlation, regression, and mediation models tested relationships between patient and caregiver mindfulness and outcomes. RESULTS Patients had a mean AMPS score of 38.0±11.9 and caregivers had a mean AMPS score of 38.9±11.5. Patient mindfulness correlated with activities of daily living, behavior and mood, health-related quality of life, subjective cognitive complaints, and performance on episodic memory and attention tasks. Caregiver mindfulness correlated with preparedness, care confidence, depression, and better patient cognitive performance. Patients in dyads with higher mindfulness had better cognitive performance, less subjective complaints, and higher health-related quality of life (all p-values<0.001). Mindfulness effects on cognition were mediated by physical activity, social engagement, frailty, and vascular risk factors. CONCLUSION Higher baseline mindfulness was associated with better patient and caregiver outcomes, particularly when both patients and caregivers had high baseline mindfulness. Understanding the baseline influence of mindfulness on the completion of rating scales and neuropsychological test performance can help develop targeted interventions to improve well-being in patients and their caregivers.
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Affiliation(s)
- Ashley D. Innis
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Magdalena I. Tolea
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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Lam LCW, Lee ATC, Cheng ST, Yip BHK, Chan WC, Fung AWT, Ma SL, Cheng CPW, Kong R, Chiu HTS, Lai FHY, Wong SYS. Mindfulness Awareness Is Associated With a Lower Risk of Anxiety and Depressive Symptoms in Older Adults With Neurocognitive Disorders. Front Psychiatry 2021; 12:721583. [PMID: 34744817 PMCID: PMC8566433 DOI: 10.3389/fpsyt.2021.721583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored. Objectives: The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment. Methods: The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness. Results: In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted R 2 = 0.447, p < 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted R 2 = 0.33, p < 0.001). Conclusion: Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline.
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Affiliation(s)
- Linda Chiu Wa Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Allen T C Lee
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Sheung Tak Cheng
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, SAR China
| | - Benjamin H K Yip
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Wai Chi Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong, SAR China
| | - Ada W T Fung
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Suk Ling Ma
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Calvin P W Cheng
- Department of Psychiatry, University of Hong Kong, Hong Kong, SAR China
| | - Ryan Kong
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Henry T S Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Frank H Y Lai
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Samuel Yeung Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, SAR China
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37
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Kua E. Positive psychiatry: A dementia and depression prevention program in Singapore. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_43_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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38
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Khine WWT, Voong ML, Ng TKS, Feng L, Rane GA, Kumar AP, Kua EH, Mahendran R, Mahendran R, Lee YK. Mental awareness improved mild cognitive impairment and modulated gut microbiome. Aging (Albany NY) 2020; 12:24371-24393. [PMID: 33318317 PMCID: PMC7762482 DOI: 10.18632/aging.202277] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/13/2020] [Indexed: 12/12/2022]
Abstract
There is ample scientific and clinical evidence of the effects of gut microbiota on the brain but no definitive evidence that the brain can affect changes in gut microbiota under the bi-directional gut-brain axis concept. As there is no pharmacotherapeutic intervention for the early stages of cognitive decline, research has focused on cognitive stimulation in reversing or slowing the impairment. Elderly patients diagnosed with mild cognitive impairment underwent a randomized-control trial of mindful awareness practice. Neuropsychological assessments, inflammatory markers, and gut microbiota profiles were tested. Here, we report that their cognitive impairment was improved and associated with changes in gut bacterial profile. A cognition-score-dependent-abundance was observed in Ruminococcus vs Recognition Trials (RT), Digit Span Backward (DSB), Semantic Fluency Span (SFS) and Memory Domain (MD); Coprococcus vs DSB, Color Trails Test 2 (CTT2) and Block Design (BD); Parabacteroides vs DSB and SFS; Fusobacterium vs DSB and CTT2; Enterobacteriaceae vs BD and SFS; Ruminococcaceae vs DSB; Phascolarctobacterium vs MD. The study showed for the first-time, alteration in the cognitive capacity leading to the corresponding changes in microbiota profiles. This strongly suggests that signals from the different segments of brain could dictate directly or indirectly the abundances of specific gut microbes.
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Affiliation(s)
- Wei Wei Thwe Khine
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore.,Functional Foods Forum, Faculty of Medicine, University of Turku, Turku 20014, Finland
| | - Miao Lian Voong
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore
| | - Ted Kheng Siang Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore 119228, Singapore
| | - Grishma Avinash Rane
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
| | - Alan Prem Kumar
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore 117599, Singapore.,Medical Sciences Cluster, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore 119228, Singapore
| | - Ratha Mahendran
- Department of Surgery, National University Hospital, Singapore 119228, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117549, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore 119228, Singapore.,Duke-NUS Medical School, Singapore 169857, Singapore
| | - Yuan-Kun Lee
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117545, Singapore.,Department of Surgery, National University Hospital, Singapore 119228, Singapore
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