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

Abstract

Background: Current pharmacological and behavioural treatment options for mild cognitive impairment and dementia are limited, motivating a search for alternative therapies that might slow the progression of cognitive decline in these disorders. In this study, we aimed to investigate the effectiveness of a cognition-focused mindfulness-based intervention in achieving this aim.Design: Open-label, three-arm randomized controlled trial, Setting: Public tertiary medical centreParticipants: Older persons (ages 45-75; N = 76) diagnosed with mild cognitive impairment (MCI)Intervention: Mindfulness-based training (MBT), cognitive rehabilitation therapy (CRT), and treatment as usual (TAU). Participants in the intervention arms received 8 weekly 2-hour sessions delivered in a group setting and were encouraged to engage in home practice.Measurements: Primary outcomes measures of this trial were change in index scores for attention, immediate memory, and delayed memory measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Depression was a secondary outcome.Results: Using intent-to-treat analysis, we found that participants receiving MBT showed significant improvements in global cognition (d = 0.26; [95% CI 0.03 - 0.56]) and delayed memory (d = 0.36; [95% CI 0.17 - 0.57]), with significantly greater improvements in delayed memory than CRT (ηp2 = 0.10). However, there was no benefit of MBT over TAU. No change in depression was observed in the MBT group. Reductions in depression were associated with improvements in cognitive functioning in the MBT group only.Conclusion: Our results suggest that a cognition-focused MBT did not improve cognitive functioning in MCI patients substantially more than spontaneous reversion rates, possibly as mood symptoms were not significantly alleviated in this group.

Mindfulness Prevents Depression and Psychopathology in Elderly People with Mild to Moderate Alzheimer’s Disease: A Randomized Clinical Trial

“…However, this study shows that despite maintaining cognitive abilities in at least 2 years of follow-up [26], CST is not sufficient to prevent comorbidity with depression and BPSD, as shown by the data presented. These data are in line with other studies, because despite improving cognition, CST does not improve depressive symptomatology[33,34]. Therefore, a non-pharmacological treatment that specifically addresses the prevention of depression and psychopathology is necessary.…”