Beneficial for dementia patients and their caregivers

Paller, K. A., et al. (2014). Benefits of Mindfulness Training for Patients With Progressive Cognitive Decline and Their Caregivers. American Journal of Alzheimer’s Disease and Other Dementias. Full Text (accepted prepublication version with authors’ names in different order).

Abstract. New strategies are needed to help people cope with the repercussions of neurodegenerative disorders such as Alzheimer’s disease. Patients and caregivers face different challenges, but here we investigated an intervention tailored for this combined population. The program focused on training skills such as attending to the present moment nonjudgmentally, which may help reduce maladaptive emotional responses. Patients participated together with caregivers in weekly group sessions over 8 weeks.

An assessment battery was individually administered before and after the program. Pre–post analyses revealed several benefits, including increased quality-of-life ratings, fewer depressive symptoms, and better subjective sleep quality. In addition, participants indicated that they were grateful for the opportunity to learn to apply mindfulness skills and that they would recommend the program to others.

In conclusion, mindfulness training can be beneficial for patients and their caregivers, it can be delivered at low cost to combined groups, and it is worthy of further investigation.

Interventions in mild cognitive impairment and Alzheimer’s disease

Larouche, E., Hudon, C., & Goulet, S. (2014). Potential benefits of mindfulness-based interventions in mild cognitive impairment and Alzheimer’s disease: An interdisciplinary perspective. Behavioural Brain Research. In Press. Abstract.

Highlights: • Hippocampal damage is central in MCI/AD and could be prevented or delayed by mindfulness-based interventions (MBI).  • MBI reduce MCI/AD adverse factors (stress, depression, metabolic syndrome).  • Multiple pathways could explain MBI’s effects on modifiable adverse factors.  • Effects seem based on neuro- endocrine, immune, and transmission regulation.  • MBI show great potential to prevent the neurodegenerative cascade leading to AD.

The present article is based on the premise that the risk of developing Alzheimer’s disease (AD) from its prodromal phase (mild cognitive impairment; MCI) is higher when adverse factors (e.g., stress, depression, and metabolic syndrome) are present and accumulate. Such factors augment the likelihood of hippocampal damage central in MCI/AD aetiology, as well as compensatory mechanisms failure triggering a switch toward neurodegeneration. Because of the devastating consequences of AD, there is a need for early interventions that can delay, perhaps prevent, the transition from MCI to AD.

We hypothesize that mindfulness-based interventions (MBI) show promise with regard to this goal. The present review discusses the associations between modifiable adverse factors and MCI/AD decline, MBI’s impacts on adverse factors, and the mechanisms that could underlie the benefits of MBI. A schematic model is proposed to illustrate the course of C specific to MCI/AD, as well as the possible preventive mechanisms of MBI. Whereas regulation of glucocorticosteroids, inflammation, and serotonin could mediate MBI’s effects on stress and depression, resolution of the metabolic syndrome might happen through a reduction of inflammation and white matter hyperintensities, and normalization of insulin and oxidation.

The literature reviewed in this paper suggests that the main reach of MBI over MCI/AD development involves the management of stress, depressive symptoms, and inflammation. Future research must focus on achieving deeper understanding of MBI’s mechanisms of action in the context of MCI and AD. This necessitates bridging the gap between neuroscientific subfields and a cross-domain integration between basic and clinical knowledge.

Impact on brain regions related to mild cognitive impairment

Wells, R. E., et al., (2013). Meditation’s impact on default mode network & hippocampus in mild cognitive impairment: a pilot study. Neuroscience Letters. Abstract.

Highlights

  • We conducted a randomized trial of meditation for mild cognitive impairment (MCI).
  • Meditation may increase functional connectivity in the default mode network in MCI.
  • Mediation may reduce hippocampal volume atrophy in MCI.
  • Meditation may have a positive impact on brain regions most related to dementia.
  • Further research with larger sample sizes and longer-follow-up are needed.

Those with high baseline stress levels are more likely to develop mild cognitive impairment (MCI) and Alzheimer’s Disease (AD). While meditation may reduce stress and alter the hippocampus and default mode network (DMN), little is known about its impact in these populations.

Our objective was to conduct a “proof of concept” trial to determine whether Mindfulness Based Stress Reduction (MBSR) would improve DMN connectivity and reduce hippocampal atrophy among adults with MCI. 14 adults with MCI were randomized to MBSR vs. usual care and underwent resting state fMRI at baseline and follow-up. Seed based functional connectivity was applied using posterior cingulate cortex as seed.

The results showed that after the intervention, MBSR participants had increased functional connectivity between the posterior cingulate cortex and bilateral medial prefrontal cortex and left hippocampus compared to controls. In addition, MBSR participants had trends of less bilateral hippocampal volume atrophy than control participants.

These preliminary results indicate that in adults with MCI, MBSR may have a positive impact on the regions of the brain most related to MCI and AD. Further research with larger sample sizes and longer-follow-up are needed to further investigate the results from this pilot study.

Reduces stress and depression in family caregivers of Alzheimer’s patients

Danucalov, M.A.D., et al. (2013). A Yoga and Compassion Meditation Program Reduces Stress in Familial Caregivers of Alzheimer’s Disease Patients. Evidence-Based Complementary and Alternative Medicine, online. Full text.

From the Abstract: Familial caregivers of patients with Alzheimer’s disease exhibit reduced quality of life and increased stress levels. The aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress, anxiety, depression, and salivary cortisol levels in familial caregivers.

A total of 46 volunteers were randomly assigned to participate in a stress-reduction program for a 2-month period (yoga and compassion meditation program—YCMP group, or an untreated group for the same period of time (control group). The levels of stress, anxiety, depression, and morning salivary cortisol of the participants were measured before and after intervention. The groups were initially homogeneous; however, after intervention, the groups diverged significantly. The YCMP group exhibited a reduction of the stress, anxiety, and depression levels, as well as a reduction in the concentration of salivary cortisol.

Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress, anxiety, depression, and salivary cortisol in familial caregivers.

Reduces perceived stress in Alzheimer’s patients and caregivers

Innes, K. E., et al. (2012). The Effects of Meditation on Perceived Stress and Related Indices of Psychological Status and Sympathetic Activation in Persons with Alzheimer’s Disease and Their Caregivers: A Pilot Study. Evidence-Based Complementary and Alternative Medicine. Go to journal and click on “Full Text.”

Conclusions (from the Abstract): Findings of this exploratory trial suggest that an 8-week meditation program* may offer an acceptable and effective intervention for reducing perceived stress and improving certain domains of sleep, mood, and memory in adults with cognitive   impairment and their caregivers.

*MBSR

Reduces loneliness in older adults

In the study, 40 adults between the ages of 55 and 85 were randomly assigned to either a mindfulness meditation group or a control group that did not meditate. All the participants were assessed at the beginning and the end of the study using an established loneliness scale. Blood samples were also collected at the beginning and end to measure gene expression and levels of inflammation. The meditators attended weekly two-hour meetings in which they learned the techniques of mindfulness, including awareness and breathing techniques. They also practiced mindfulness meditation for 30 minutes each day at home and attended a single daylong retreat.

These MBSR participants self-reported a reduced sense of loneliness, while their blood tests showed a significant decrease in the expression of inflammation-related genes. “While this was a small sample, the results were very encouraging,” said Dr. Michael Irwin, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA and director of the Cousins Center. “It adds to a growing body of research that is showing the positive benefits of a variety of meditative techniques, including tai chi and yoga.”

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