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Effects of a mindfulness-based intervention and a health self-management programme on psychological well-being in older adults with subjective cognitive decline: Secondary analyses from the SCD-Well randomised clinical trial

Contact Information

Keywords

Natalie L. Marchant, n.marchant@ucl.ac.uk

Mindfulness, Compassion, Anxiety, Subjective cognitive decline

Abstract

Objectives: Older adults with subjective cognitive decline (SCD) recruited from memory clinics have an increased risk of developing dementia and regularly experience reduced psychological well-being related to memory concerns and fear of dementia. Research on improving well-being in SCD is limited and lacks non-pharmacological approaches. We investigated whether mindfulness-based and health education interventions can enhance well-being in SCD. Methods: The SCD-Well trial (ClinicalTrials.gov: NCT03005652) randomised 147 older adults with SCD to an 8-week caring mindfulness-based approach for seniors (CMBAS) or an active comparator (health self-management programme [HSMP]). Well-being was assessed at baseline, post-intervention, and 6-month post-randomisation using the Psychological Well-being Scale (PWBS), the World Health Organisation's Quality of Life (QoL) Assessment psychological subscale, and composites capturing meditation-based well-being dimensions of awareness, connection, and insight. Mixed effects models were used to assess between- and within-group differences in change. Results: CMBAS was superior to HSMP on changes in connection at post-intervention. Within both groups, PWBS total scores, psychological QoL, and composite scores did not increase. Exploratory analyses indicated increases in PWBS autonomy at post-intervention in both groups. Conclusion: Two non-pharmacological interventions were associated with only limited effects on psychological well-being in SCD. Longer intervention studies with waitlist/retest control groups are needed to assess if our findings reflect intervention brevity and/or minimal base rate changes in well-being.

Citation

Schlosser, M., Demnitz-King, H., Barnhofer, T., Collette, F., Gonneaud, J., Chételat, G., Jessen, F., Kliegel, M., Klimecki, O. M., Lutz, A., Marchant, N. L., & Medit-Ageing Research Group (2023). Effects of a mindfulness-based intervention and a health self-management programme on psychological well-being in older adults with subjective cognitive decline: Secondary analyses from the SCD-Well randomised clinical trial. PloS one, 18(12), e0295175. https://doi.org/10.1371/journal.pone.0295175

DOI

10.1371/journal.pone.0295175

Model

Human

Conent Area

Marco Schlosser

EWB-Related Construct

(1) goal pursuit;
(2) life satisfaction;
(5) sense of meaning
(3) positive affect;

Study Design

Species or Study Population

(5) RCT

Sex (%Female)

64%

Age (Mean, SD)

72.7, 6.9

Younger Controls?

No

Longitudinal Data?

Yes

Sample Size

147

Interventions

Caring Mindfulness-based Approach for Seniors (CMBAS)

Ethnicity (%white)

95.92%

Inclusion Criteria

(1) Age ≥60 years.
(2) Meeting research criteria proposed by the SCD-I working group.
(3) Normal performance on standardized cognitive tests as per criteria outlined by Jak and Bondi for exclusion of MCI, as recommended by Molinuevo et al.
(4)exclude scoring below normative range on two tests within a single cognitive domain or below normative range on one test within each cognitive domain.
(5) Baseline cognitive assessment results in memory, executive function, and language are reviewed to ensure comparable performance across sites.
(6) Referral to memory clinic by physician or self-referral due to memory concerns.
(7) Ability to provide informed consent according to GCP/ICH guidelines and local regulations.
(8) Availability for the trial duration (39 weeks).

Exclusion Criteria

(1) Presence of a major neurological or psychiatric disorder according to ICD-10 and/or DSM-5 criteria.
(2) Under legal guardianship or incapacitation.
(3) History of cerebral disease interfering with study aims.
(4) Visual or auditory impairment affecting study aims.
(5) Presence of chronic or acute unstable illness interfering with study aims.
(6) Use of medications that may interfere with cognition.
(7) Regular or intensive practice of meditation or comparable practices exceeding specified frequency and duration.

EWB Measures

(1) Psychological Well-being Scale (PWBS)
(2) World Health Organization WHOQOL-BREF Quality of Life Assessment

Non-EWB Behavioral
Measures

(3) The Multidimensional Assessment of Interoceptive Awareness (MAIA)
(4) Five Facet Mindfulness Questionnaire (FFMQ-39)
(5) The Compassionate Love Scale (stranger-humanity version)
(6)The Drexel Defusion Scale [The Drexel Defusion Scale]

Physiological Measures

N/A

Brain IMaging Modality

Brain IMaging Paradigm

N/A

Brain Region/Circuit

N/A

Biological Measures

N/A

Other Neural Measures

Data Availability?

Yes

Data Avalability Details

Data Availability: The data underlying this report are made available on request following approval by the executive committee and a formal data sharing agreement (https://silversantestudy.eu/2020/09/25/data-sharing). The Material can be mobilized, under the conditions and modalities defined in the Medit-Ageing Charter by any research team belonging to an Academic institution, for carrying out a scientific research project relating to the scientific theme of mental health and well-being in older people. The Material may also be mobilized by non-academic third parties, under conditions, in particular financial, which will be established by separate agreement between Inserm and by the said third party. Data sharing policies described in the Medit-Ageing charter are in compliance with our ethics approval and guidelines from our funding body. Data contain potentially identifying or sensitive patient information. To request data, please contact the data access committee via the official project website (https://silversantestudy.eu/2020/09/25/data-sharing).

Diagnostic Measures

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