By John M. de Castro, Ph.D.
“mindfulness isn’t just a technique to cope with the stress; it’s a way to fully embrace one’s role as a caretaker, living in the present moment with joy and appreciation, no matter what that moment may bring.” – Elisabeth Dykens
There are many characteristics that all human being have in common, but there are also huge individual differences. Virtually everything about us is to some extent unique, including experiences, and physical and psychological characteristics. There is no other face exactly like ours. There is no other brain exactly like ours. There is no other mind exactly like ours. There is no other mind exactly like ours. There is no other personality exactly like ours. These differences are wonderful and define our individuality and uniqueness. There has never been nor will there ever be anyone exactly like you.
This uniqueness extends to our reactions to environmental and physical events and even extends to our responses to treatments. One of the most exciting trends in modern medicine is individualized medicine. It has been realized that people respond differently to treatments. The same drug, procedure, or therapy that cures one person will have negligible effects on another, and may harm yet another. So, tailoring the treatment to the individual can maximize effectiveness. In order to do this predictors, biomarkers, are needed. These are measurable characteristic that predict that a certain treatment will be effective for that person. So cancer treatment now includes genetic analysis looking for particular genes that predict that an individual will respond to one treatment rather than another.
Mindfulness training has been shown to be an effective treatment for a myriad of psychological and physical conditions, including the psychological and physical problems that develop while providing care for an Alzheimer’s patient. But, this effectiveness is “on average.” While many people are helped, some are not, and some even get worse. In order to improve the effectiveness of mindfulness training it would be helpful to identify who is likely to respond positively and who is not. To do this, predictors, markers, of responsiveness are needed. To date, there have been few studies that attempt to identify predictors, markers, of responsivity to mindfulness training.
In today’s Research News article “Biomarkers of Resilience in Stress Reduction for Caregivers of Alzheimer’s Patients.” See:
or below
Ho and colleagues took blood samples from non-professional adult caregivers for Alzheimer’s patients prior to and after an 8-week Mindfulness Based Stress Reduction (MBSR) training. They found, confirming the majority of findings in the research literature, that the MBSR course produce significant increases in the mindfulness and the psychological health of the caregivers. In addition, they found that the greater then increase in mindfulness, the greater the improvements in psychological health.
Ho and colleagues also found considerable individual differences in the degree of improvement. They then separated the caregivers in three groups based upon the amount of benefit in psychological health obtained from the MBSR training; poor, moderate, and good responders. They used measures of gene expressions in these three groups to investigate potential predictors of responsiveness to MBSR training. They found that genes associated with the modulation of the inflammatory response, stress responses, and depression were highly expresses in caregivers who responded to MBSR training.
These results are not surprising as mindfulness training has been previously shown to improve the inflammatory response, stress responses, and depression. Unfortunately, these results do not demonstrate cause and effect. It is equally likely that the improved psychological health produced the changes in gene expression as it is that the changes in gene expression produced the improvements in psychological health, or that some third factor might be responsible for both.
To look for possible causal factors, they then looked at gene expressions present before the MBSR training in the various groups. They found that expressions of genes prior to treatment that modulate the immune system and the insulin system were predictive of positive responses to treatment. It has previously been shown that mindfulness training produces improvements in the immune system. But, it has not been previously demonstrated that the state of the immune system prior to mindfulness training would be associated with positive outcomes.
These are fascinating results and again demonstrate the effectiveness of Mindfulness Based Stress Reduction (MBSR) training for caregivers. But, importantly, the study identifies biomarkers, gene expressions, that predict the individual’s likelihood of having positive improvements in psychological health produced by MBSR training. Caregivers who showed heightened expressions in genes that improve the immune system were those that obtained the greatest benefit. It will require future research to identify how heightened immune system activity might be responsible for MBSR effectiveness.
Regardless, the study demonstrates that biomarkers predict mindfulness’ effectiveness for caregivers. This suggests that it may be possible in the future to tailor mindfulness training based upon individual differences in gene expression, maximizing the effectiveness of the therapy.
So,
“I have discovered that it isn’t so much about what I did or did not say or do that was key to pass on to professionals and family members — it was more about the way in which I was being with the persons who have dementia that seemed important to communicate. […] Each person with dementia has taught me the importance of relaxing into being in the present moment. That moment may be perceived by her to be in a different place or time, but it is her very real and present moment.” – Nancy Pearce
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
Ho L, Bloom PA, Vega JG, Yemul S, Zhao W, Ward L, Savage E, Rooney R, Patel DH, Pasinetti GM. Biomarkers of Resilience in Stress Reduction for Caregivers of Alzheimer’s Patients. Neuromolecular Med. 2016 Mar 17. [Epub ahead of print] PMID: 26984114
Abstract
Caregiving for a dementia patient is associated with increased risk of psychological and physical health problems. We investigated whether a mindfulness-based stress reduction (MBSR) training course for caregivers that closely models the MBSR curriculum originally established by the Center of Mindfulness at the University of Massachusetts may improve the psychological resilience of non-professional caregivers of Alzheimer’s disease patients. Twenty adult non-professional caregivers of dementia patients participated in an 8-week MBSR training course. Caregiver stress, depression, burden, grief, and gene expression profiles of blood mononuclear cells were assessed at baseline and following MBSR. MBSR training significantly improved the psychological resilience of some of the caregivers. We identified predictive biomarkers whose expression is associated with the likelihood of caregivers to benefit from MBSR, and biomarkers whose expression is associated with MBSR psychological benefits. Our biomarker studies provide insight into the mechanisms of health benefits of MBSR and a basis for developing a personalized medicine approach for applying MBSR for promoting psychological and cognitive resilience in caregivers of dementia patients.