Mindfulness-Based Interventions Targeting Modifiable Lifestyle Behaviors Associated With Brain Health: A Systematic Review and Meta-Analysis

Effectiveness of relaxation techniques for stress management and quality of life improvement in cardiovascular disease and hypertensive patients: a systematic review

BACKGROUND AND OBJECTIVES

Cardiovascular diseases (CVD) and hypertension are leading causes of morbidity and mortality worldwide, significantly affecting quality of life (QoL). Stress, anxiety, and poor psychological well-being often exacerbate these conditions, creating a vicious cycle. Relaxation techniques, including progressive muscle relaxation (PMR) and diaphragmatic breathing, assist in contracting and relaxing muscle groups to aid individuals in identifying and reducing physical tension and foster relaxation due to increased parasympathetic nerve activity, resulting in emotional tranquility. This systematic review explores the efficacy of relaxation techniques in reducing stress and improving QoL in patients with CVD and hypertension.

MATERIALS AND METHODS

The review adhered to PRISMA guidelines, searching five major databases (PubMed, EBSCOhost, Web of Science, PsychINFO, and Scopus) with a search time range from 2014 to 2024. This review has been registered on Open OSF (n) 6HYG9.

RESULTS

The results from several studies highlight the positive effects of relaxation techniques on both cardiovascular health and psychological well-being. Various methods, such as PMR, breathing exercises, and biofeedback, significantly reduced blood pressure (BP), anxiety, and stress levels in hypertensive and cardiovascular patients. Additionally, interventions like Benson's relaxation and jaw relaxation demonstrated improvements in patient QoL and cardiovascular health outcomes, underscoring the potential benefits of integrating relaxation techniques into treatment programs for heart-related conditions.

CONCLUSIONS

By targeting both the physiological and psychological aspects of the patient's well-being, these methods contribute to improved BP regulation, reduced heart rate, and alleviation of anxiety and stress symptoms. When incorporated into cardiac rehabilitation programs, these techniques have shown positive effects on emotional well-being and overall QoL, making them a valuable tool for patients recovering from cardiovascular events or managing chronic CVD. More robust, high-quality studies are needed to refine the optimal methods, duration, and frequency of these interventions.

Dispositional mindfulness and psychological well-being: investigating the mediating role of meaning in life

Introduction

Mindfulness has been widely recognized for its positive impact on various aspects of psychological well-being. Prior research has investigated the role of mindfulness in enhancing hope and life satisfaction as separate constructs. However, limited attention has been given to the simultaneous influence of mindfulness on both hope and life satisfaction and the underlying mechanisms that may explain these relationships. This study examines the role of dispositional mindfulness in fostering hope and life satisfaction concurrently and explores the potential mediating role of meaning in life in this relationship.

Methods

A total of 1,766 Chinese college students from Shandong Xiehe University participated in the study. Participants completed the Mindful Attention Awareness Scale (MAAS) to assess dispositional mindfulness, the Adult Hope Scale (AHS) to measure hope, the Satisfaction with Life Scale (SWLS) to evaluate life satisfaction, and the Meaning in Life Questionnaire (MLQ) to assess their perceived meaning in life. Statistical analyses, including mediation analysis, were conducted to explore the relationships among these variables.

Results

The findings indicated that meaning in life partially mediated the relationship between dispositional mindfulness and both hope and life satisfaction. Specifically, higher levels of dispositional mindfulness were associated with greater hope and life satisfaction, and this relationship was partially explained by increased perceptions of meaning in life.

Discussion

These results underscore the critical role of meaning in life as a mediator in the positive effects of mindfulness on psychological well-being. The findings suggest that interventions aimed at enhancing mindfulness may benefit from incorporating strategies to foster meaning in life, thereby amplifying their impact on hope and life satisfaction. This study advances our understanding of the mechanisms linking mindfulness to key indicators of psychological well-being and highlights the integrative role of meaning in life in these processes.

A Meta-Regression of psychosocial factors associated with sleep outcomes in mindfulness-based intervention trials

OBJECTIVES

In this meta-regression, we aimed to explore associations between changes in psychosocial factors and changes in sleep disturbance during mindfulness-based interventions (MBIs). We also investigated participant-specific and methodological factors associated with sleep disturbance during MBIs.

METHOD

We utilized data from a published meta-analysis of 40 randomized controlled trials of MBIs (published from inception to 2020) with a sleep disturbance outcome measure in healthy and clinical adult populations. We conducted meta-regressions to test associations between sleep improvements following MBIs and psychosocial factors, as well as demographic and methodological factors.

RESULTS

MBIs were associated with significant reductions in sleep disturbance (SMD = -0.523; 95% CI = -0.678 to -0.368) and psychosocial factors (SMD = -0.213 - -0.894). Reductions in sleep disturbance were associated with reductions in stress (r = 0.74, p = .02) and depression (r = 0.90, p < .001).

CONCLUSIONS

MBIs improve sleep disturbance across a wide range of healthy and clinical populations. Stress and depression may be important psychosocial factors associated with sleep disturbance. Future RCTs should include measures of additional factors and should investigate longitudinal associations between psychosocial, demographic, and methodological factors with changes in sleep disturbance to test mechanisms and to identify "active ingredients" of MBIs.

A Mindfulness-Based Lifestyle Intervention for Dementia Risk Reduction: Protocol for the My Healthy Brain Feasibility Randomized Controlled Trial

BACKGROUND

Lifestyle behavior change and mindfulness have direct and synergistic effects on cognitive functioning and may prevent Alzheimer disease and Alzheimer disease-related dementias (AD/ADRD). We are iteratively developing and testing My Healthy Brain (MHB), the first mindfulness-based lifestyle group program targeting AD/ADRD risk factors in older adults with subjective cognitive decline. Our pilot studies (National Institutes of Health [NIH] stage 1A) have shown that MHB is feasible, acceptable, and associated with improvement in lifestyle behavior and cognitive outcomes.

OBJECTIVE

We will compare the feasibility of MHB versus an education control (health enhancement program [HEP]) in 50 older adults (aged ≥60 y) with subjective cognitive decline and AD/ADRD risk factors. In an NIH stage 1B randomized controlled trial (RCT), we will evaluate feasibility benchmarks, improvements in cognitive and lifestyle outcomes, and engagement of hypothesized mechanisms.

METHODS

We are recruiting through clinics, flyers, web-based research platforms, and community partnerships. Participants are randomized to MHB or the HEP, both delivered in telehealth groups over 8 weeks. MHB participants learn behavior modification and mindfulness skills to achieve individualized lifestyle goals. HEP participants receive lifestyle education and group support. Assessments are repeated after the intervention and at a 6-month follow-up. Our primary outcomes are feasibility, acceptability, appropriateness, credibility, satisfaction, and fidelity benchmarks. The secondary outcomes are cognitive function and lifestyle (physical activity, sleep, nutrition, alcohol and tobacco use, and mental and social activity) behaviors. Data analyses will include the proportion of MHB and HEP participants who meet each benchmark (primary outcome) and paired samples 2-tailed t tests, Cohen d effect sizes, and the minimal clinically important difference for each measure (secondary outcomes).

RESULTS

Recruitment began in January 2024. We received 225 inquiries. Of these 225 individuals, 40 (17.8%) were eligible. Of the 40 eligible participants, 21 (52.5%) were enrolled in 2 group cohorts, 17 (42.5%) were on hold for future group cohorts, and 2 (5%) withdrew before enrollment. All participants have completed before the intervention assessments. All cohort 1 participants (9/21, 43%) have completed either MHB or the HEP (≥6 of 8 sessions) and after the intervention assessments. The intervention for cohort 2 (12/21, 57%) is ongoing. Adherence rates for the Garmin Vivosmart 5 (128/147, 87.1% weeks) and daily surveys (105/122, 86.1% weeks) are high. No enrolled participants have dropped out. Enrollment is projected to be completed by December 2024.

CONCLUSIONS

The RCT will inform the development of a larger efficacy RCT (NIH stage 2) of MHB versus the HEP in a more diverse sample of older adults, testing mechanisms of improvements through theoretically driven mediators and moderators. The integration of mindfulness with lifestyle behavior change in MHB has the potential to be an effective and sustainable approach for increasing the uptake of AD/ADRD risk reduction strategies among older adults.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05934136; https://www.clinicaltrials.gov/study/NCT05934136.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/64149.

Neurobiological Changes Induced by Mindfulness and Meditation: A Systematic Review

Background and Objectives: Meditation and mindfulness, rooted in ancient traditions, enhance mental well-being by cultivating awareness and emotional control. It has been shown to induce neuroplasticity, increase cortical thickness, reduce amygdala reactivity, and improve brain connectivity and neurotransmitter levels, leading to improved emotional regulation, cognitive function, and stress resilience. This systematic review will synthesize research on neurobiological changes associated with mindfulness and meditation practices. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, Cochrane Library, and Embase databases without any search time range. This review has been registered on Open OSF (n) GV2JY. Results: Mindfulness-Based Stress Reduction (MBSR) enhances brain regions related to emotional processing and sensory perception, improves psychological outcomes like anxiety and depression, and exhibits unique mechanisms of pain reduction compared to placebo. Conclusions: This review highlights that mindfulness, particularly through MBSR, improves emotional regulation and brain structure, reduces anxiety, and enhances stress resilience. Future research should focus on diverse populations and naturalistic settings to better understand and optimize these benefits.

Moving Beyond Raising Awareness: Addressing Barriers

Awareness of issues and health concerns can prompt individuals to change their lifestyle behaviors. In fact, awareness is typically one of the first steps towards behavior change. However, awareness alone does not necessarily initiate or sustain behavioral changes. Specifically, many individuals experience significant barriers that prevent behavior change. Providers can address such barriers through ecological models of behavior change. Including concepts from an ecological model in health care settings can support positive lifestyle behavior change post-diagnosis. Moving beyond awareness alone and addressing barriers to change is an important goal that ultimately increases the probability of change for patients.