A Systematic Review of Mindfulness-Based Interventions for Patients with Mild Cognitive Impairment or Dementia and Caregivers

Abstract

The aim of this article was to systematically review the quality and efficacy of the current evidence for mindfulness-based interventions (MBIs) in patients with mild cognitive impairment (MCI), patients with dementia (PwD), and their caregivers. We identified 20 randomized controlled trials (RCTs) (11 for patients, 9 for caregivers) published in the last 15 years. Evidence suggested that MBIs are highly acceptable and credible treatments for patients with MCI, PwD and caregivers. Specifically, for PwD, the results indicated that the magnitude of post-treatment effects of MBIs are in the medium to large range for psychosocial outcomes, and in the small to medium range for cognitive functioning; however, treatment effects on dementia biomarkers were mixed, ranging from small to large, depending on the outcome measure. Findings also evidenced salutary effects of MBIs for caregivers of PwD, with post-treatment effects ranging from medium to large for caregiver stress and burden and large effects for quality of life, and mixed outcomes for cognitive functioning, with effects in the small to large range. However, confidence in these findings is relatively limited due to methodological limitations, especially in terms of poor consistency in intervention strategies, outcome measures, and other key criteria across studies. To better assess the value of MBIs for these populations and optimize treatment outcomes, we recommend further research with improved study methodology (e.g., multi-method assessment, universal criterion and outcome measures, use of active control groups, larger sample sizes, long-term follow-up) to replicate current findings and enhance our understanding of underlying treatment mechanisms of MBIs.

Assessing mindfulness-based training for neuropsychological outcomes in mild cognitive impairment

“…Smaller pilot studies have generally not found positive effects 28,29 . In a two-year trial, Quintana-Hernández, Miró- Overall, the literature of using MBIs to combat cognitive decline in the early stages of dementia is highly mixed, comprising small effects that are heterogeneous across cognitive domains 15 . Consistent with this pattern, we did not observe a clear benefit of MBI over TAU, even though the treatment was effective in improving global cognition (MMSE scores) and superior to CRT in improving delayed memory.…”

“…There is currently some evidence that MBIs can slow or reverse cognitive decline in persons with neurodegenerative disorders, [11][12][13][14] with a recent systematic review suggesting that effect sizes are in the small-to-medium range. 15 In particular, it has been suggested that early intervention, such as at the stage of mild cognitive impairment (MCI), is more effective than when patients progress to more severe disease. MCI is a transitional state between normal aging and very early dementia marked by progressive cognitive decline.…”

Exploring the Impacts of COVID-19 Public Health Measures on Community-Dwelling People Living With Dementia and Their Family Caregivers: A Longitudinal, Qualitative Study

“…Furthermore, given the limitations public health measures place on the provision of in-person supports, service providers are encouraged to consider alternative psychosocial interventions to strengthen caregiver well-being. For example, preliminary evidence suggests that mindfulness-based interventions (e.g., sitting/walking meditation, deep breathing, mindful movement, and visualization) have the potential to reduce stress, depressive symptoms, and anger and improve self-efficacy and quality of life over the short-term ( Liu et al, 2017 ; Shim et al, 2021 ). Similarly, cognitive behavioral therapy interventions that focus on cognitive-reappraisal techniques, and self-care practices ( Wiegelmann et al, 2021 ), and individual counseling sessions and telephone counseling at monthly intervals ( Phung et al, 2013 ; Tremont et al, 2015 ) have also been shown to promote caregiver mental health through the reduction of depressive symptoms.…”

Mindfulness Awareness Practice (MAP) to Prevent Dementia in Older Adults with Mild Cognitive Impairment: Protocol of a Randomized Controlled Trial and Implementation Outcomes

“…This RCT thus filled the gap in the literature for a robust and rigorously conducted RCT with the inclusion of an active control group to determine the effectiveness of a mindfulness intervention with older adults clinically diagnosed with MCI [ 51 ]. In particular, this study contributes to addressing the scarcity in the literature on mindfulness intervention focusing on an array of multiple cognitive abilities and diverse peripheral biomarkers in older adults with MCI, utilizing parallel-group RCT design, which is conducted with an Asian population.…”

“…Based on previous studies [ 35 , 49 , 50 , 51 ] examining the effects of mindfulness on the means and SDs for co-primary outcomes chosen for this study, i.e., fluid biomarkers and neurocognitive tests, we estimated the effect sizes to be 0.5. Hence, we required 24 participants in each group to have a power of 80% to detect statistical significance at 5% level.…”