Month: July 2023

Improve the Cognitive, Social, and Psychological States of Mild Alzheimer’s Patients with Mindfulness

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Improve the Cognitive, Social, and Psychological States of Mild Alzheimer’s Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You have to be patient with Alzheimer’s. Once you understand that it’s a medical condition, you become a little more compassionate. You get less frustrated.” – Kim Campbell

 

The normal aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly often have problems with attention, thinking, and memory, known as mild cognitive impairment. But sometimes the decline is rapid and results in dementia; a progressive loss of mental function produced by degenerative diseases of the brain. It is quite common with about 3% of adults ages 70 to 74, 22% of adults ages 85 to 89 and 33% of adults ages 90 and older. Between 60% to 80% of dementia cases are classified as Alzheimer’s Disease.

 

An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. This suggests that mindfulness may help to relieve some of the symptoms and/or slow the progression of mild Alzheimer’s Disease.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046197/ )  Giulietti and colleagues recruited elderly (>70 years old) patients suffering from mild Alzheimer’s disease. They were randomly assigned to either receive no treatment or a once a week for 6-month mindfulness-based intervention including stress management, relaxation, and 15-minute meditations once in treatment and twice at home per week. At baseline and after 6-months the patients were measured with the Mini Mental States Inventory, and for health-related quality of life, depression, spiritual well-being, social status, everyday cognition, and neuropsychiatric symptoms.

 

In comparison to baseline the patients that received the mindfulness-based intervention had significantly greater levels of everyday cognition, spiritual well-being, and social functioning, and lower levels of depression, agitation/aggression, anxiety, apathy, euphoria, sleep, apathy, and appetite. Whereas the control patients had significantly worsening Mini Mental States Inventory, apathy, appetite, and depression.

 

Caution should be exercised in interpreting these results as it was a relatively small pilot study without an active control condition.

 

But the results suggest that mindfulness training improved the cognitive, social, and psychological states of mild Alzheimer’s disease patients while the untreated patients showed a worsening of their cognitive and psychological states.

 

 “People do not realize that Alzheimer’s is not old age. It is a progressive and fatal disease and staggering amounts of people develop Alzheimer’s every day.” – Melina Kanakaredes

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Giulietti MV, Spatuzzi R, Fabbietti P, Vespa A. Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study. Brain Sci. 2023 Mar 13;13(3):484. doi: 10.3390/brainsci13030484. PMID: 36979294; PMCID: PMC10046197.

 

Abstract

Bachground In this study, we hypothesize that mindfulness-based interventions (MBIs) may improve well-being and the related outcomes in Alzheimer’s dementia patients (AD-P) at an early stage. MBIs consist of the practice of consciously observing the psychic contents in the present moment (thoughts, sensations, feelings, and other events). This attention allows one to become aware of the psychic contents and integrate them, thus favoring the quality of life and an increase in the mood of practitioners. Methods The randomized controlled study enrolled 22 AD-P at an early stage (age ≥ 60 years) treated with MBIs and 22 patients without treatment (six months of MBI training). Tests (T0–T1 six months): Mini-Mental State Examination (MMPI); Spiritual Well-Being (SWB); Beck Depression Inventory (BDI); SF36. Test-Caregiver: Everyday Cognition scales (ECOG). Results AD-P with mindfulness: Improvement of ECOG (p = 0.026), quality of life (p < 0.001), spiritual well-being (p < 0.001); decrease in depression BDI (p < 0.001). The MMSE remains unchanged. The control group of untreated patients showed a significant worsening in all these dimensions. Conclusions MBI training is effective in increasing quality of life and preventing worsening in patients with early-stage Alzheimer’s dementia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10046197/

 

Long-Term Meditation Changes Large-Scale Brain Connectivity

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Long-Term Meditation Changes Large-Scale Brain Connectivity

 

By John M. de Castro, Ph.D.

 

There has accumulated a large amount of research demonstrating that meditation practice has significant benefits for psychological, physical, and spiritual wellbeing. One way that meditation practices may produce these benefits is by altering the brain. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. Over the last decade neuroscience has been studying the effects of contemplative practices on the brain and has identified neuroplastic changes in widespread areas. In other words, meditation practice appears to mold and change the brain structures and connectivity, producing psychological, physical, and spiritual benefits, especially mindfulness.

 

Two in particular types of meditation can be characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. In open monitoring meditation, the individual opens up awareness to everything that’s being experienced regardless of its origin. These include bodily sensations, external stimuli, and even thoughts. The meditator just observes these thoughts and lets them arise and fall away without paying them any further attention. These differences are likely to produce different effects on the practitioners, their psychology and their brains.

 

In today’s Research News article “Long-Term and Meditation-Specific Modulations of Brain Connectivity Revealed Through Multivariate Pattern Analysis.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164028/ )  Guidotti  and colleagues recruited established long-term meditators (Buddhist Monks) and novice meditators. The novices practiced both focused and open monitoring meditation for 30 minutes per day for 10 days. Both groups then practiced both focused and open monitoring meditation while having their brains scanned with functional Magnetic Resonance Imaging (fMRI).

 

The found that large-scale functional interactions in the brain could better predict both focused and open monitoring meditation styles in practiced meditators as opposed to novices. Open Monitoring meditation enhanced connectivity between regions that process somatosensory, auditory, and visual information. On the other hand, Focused Meditation enhanced connectivity between regions that are involved in attentional control and self-awareness.

 

These findings suggest that long-term meditation changes the brain to process different information in large-scale networks for focused versus open monitoring meditations, but not so much in novice meditators. Hence, long-term meditation practice changes the brain to facilitate brain processing of meditation type specific functions.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Guidotti R, D’Andrea A, Basti A, Raffone A, Pizzella V, Marzetti L. Long-Term and Meditation-Specific Modulations of Brain Connectivity Revealed Through Multivariate Pattern Analysis. Brain Topogr. 2023 May;36(3):409-418. doi: 10.1007/s10548-023-00950-3. Epub 2023 Mar 28. PMID: 36977909; PMCID: PMC10164028.

 

Abstract

Neuroimaging studies have provided evidence that extensive meditation practice modifies the functional and structural properties of the human brain, such as large-scale brain region interplay. However, it remains unclear how different meditation styles are involved in the modulation of these large-scale brain networks. Here, using machine learning and fMRI functional connectivity, we investigated how focused attention and open monitoring meditation styles impact large-scale brain networks. Specifically, we trained a classifier to predict the meditation style in two groups of subjects: expert Theravada Buddhist monks and novice meditators. We showed that the classifier was able to discriminate the meditation style only in the expert group. Additionally, by inspecting the trained classifier, we observed that the Anterior Salience and the Default Mode networks were relevant for the classification, in line with their theorized involvement in emotion and self-related regulation in meditation. Interestingly, results also highlighted the role of specific couplings between areas crucial for regulating attention and self-awareness as well as areas related to processing and integrating somatosensory information. Finally, we observed a larger involvement of left inter-hemispheric connections in the classification. In conclusion, our work supports the evidence that extensive meditation practice modulates large-scale brain networks, and that the different meditation styles differentially affect connections that subserve style-specific functions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10164028/

 

Prevent Depression and Dementia-Related Behavioral Symptoms in Alzheimer’s Disease with Mindfulness

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Prevent Depression and Dementia-Related Behavioral Symptoms in Alzheimer’s Disease with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Alzheimer’s is not about the past—the successes, the accolades, the accomplishments… Alzheimer’s is about the present and the struggle, the scrappy brawl, the fight to live with a disease. It’s being in the present, the relationships, the experiences, which is the core of life, the courage to live in the soul”. – Greg O’Brien

 

The normal aging process involves a systematic progressive decline in every system in the body, the brain included. The elderly frequently have problems with attention, thinking, and memory, known as mild cognitive impairment. But sometimes the decline is rapid and results in dementia; a progressive loss of mental function produced by degenerative diseases of the brain. It is quite common with about 3% of adults ages 70 to 74, 22% of adults ages 85 to 89 and 33% of adults ages 90 and older. Between 60% to 80% of dementia cases are classified as Alzheimer’s Disease. Depression is a common symptom.

 

An encouraging new development is that mindfulness practices such as meditation training and mindful movement practices can significantly reduce these declines in cognitive ability. In addition, it has been found that mindfulness practices reduce the deterioration of the brain that occurs with aging restraining the loss of neural tissue. This suggests that mindfulness may also help to relieve some of the psychological symptoms of the disease; particularly mindfulness practices ability to prevent the development of depression in patients with mild to moderate Alzheimer’s Disease.

 

In today’s Research News article “Mindfulness Prevents Depression and Psychopathology in Elderly People with Mild to Moderate Alzheimer’s Disease: A Randomized Clinical Trial” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881020/ ) Quintana-Hernández and colleagues recruited patients with mild to moderate Alzheimer’s Disease who were not showing depressive symptoms and randomly assigned them to receive either no treatment, mindfulness practice (Mindfulness-based Alzheimer’s Stimulation), cognitive stimulation, or progressive muscle relaxation. They were provided with three weekly sessions over 2 years. Mindfulness-based Alzheimer’s Stimulation involves caregiver and patient joint activities emphasizing present moment awareness.

 

The participants were measured at baseline and every 6 months thereafter for depression, and caregiver rated dementia-related behavioral symptoms, including delusions, hallucinations, agitation/aggression, dysphoria, anxiety, euphoria, apathy, disinhibition, irritability/lability, aberrant motor activity, night-time behavioral disturbances and appetite and eating abnormalities.

 

They found that, over the 2-year study period, mindfulness training and practice prevented the onset of depression and dementia-related behavioral symptoms in these patients while these symptoms increased progressively and significantly in all other groups.

 

These findings are remarkable and demonstrate that mindfulness training can prevent the development of depression and neuropsychiatric symptoms in early-stage Alzheimer’s Disease patients over a substantial period of time. This suggests that mindfulness training should be incorporated into the routine treatment of patients with mild to moderate Alzheimer’s Disease.

 

“You have to be patient with Alzheimer’s. Once you understand that it’s a medical condition, you become a little more compassionate. You get less frustrated.” – Kim Campbell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on the Contemplative Studies Blog  http://contemplative-studies.org

 

Study Summary

 

Quintana-Hernández DJ, Rojas-Hernández J, Santana-Del Pino A, Céspedes Suárez C, Pellejero Silva M, Miró-Barrachina MT, Ibáñez Fernández I, Estupiñán López JA, Borkel LF. Mindfulness Prevents Depression and Psychopathology in Elderly People with Mild to Moderate Alzheimer’s Disease: A Randomized Clinical Trial. J Alzheimers Dis. 2023;91(1):471-481. doi: 10.3233/JAD-220889. PMID: 36442199; PMCID: PMC9881020.

 

Background:

This longitudinal study addressed whether mindfulness practice prevents psychological and behavioral symptoms, especially mood disorders, in Alzheimer’s disease (AD).

Objective:

To assess the incidence of depression in the course of AD and to determine which non-pharmacological treatment (NPT) is most effective in preventing psychopathological symptoms.

Methods:

We conducted a longitudinal, non-inferiority and equivalence randomized clinical trial, repeated-measures design, with a control group and three experimental treatments: mindfulness, cognitive stimulation, and relaxation. Each experimental group performed three weekly sessions for two years. The pharmacological treatment of all participants was donepezil (10 mg). Participants were patients with probable AD without diagnosed depression from the public neurology services of the Canary Health Service, Spain. Psychological evaluation was performed using the Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), and Neuropsychiatric Inventory (NPI-Q). The statistical analysis included only patients who attended at least 75% of the sessions. A nonparametric, repeated-measures analysis was performed with Kruskal-Wallis H test and between-group differences with Mann-Whitney U test with Bonferroni correction (p < 0.008). Effect size was calculated with partial eta-squared.

Results:

The results showed significant differences with large effect sizes (η2p>0.14) between mindfulness and the rest of the experimental groups as well as the control in the GDS, HDRS, and NPI-Q scales.

Conclusion:

Compared to the other experimental groups, only mindfulness prevented the onset of depression and other psychopathologies in early-stage AD. Based on its effectiveness in maintaining cognitive functions and preventing psychopathology, we recommend mindfulness as the first-choice NPT for mild to moderate AD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881020/