Lenze Eric J, Hickman Steven, Hershey Tamara, Wendleton Leah, Ly Khanh, Dixon David, Doré Peter, Wetherell Julie Loebach
Washington University School of Medicine, St. Louis, MO, USA.
Int J Geriatr Psychiatry. 2014 Oct;29(10):991-1000. doi: 10.1002/gps.4086. Epub 2014 Feb 18.
Mindfulness-based stress reduction (MBSR) has the potential to reduce worry and improve cognitive functioning.
In this treatment development project, we examined MBSR in older adults with worry symptoms and co-occurring cognitive dysfunction. We examined (i) acceptability of MBSR, (ii) whether MBSR needs to be lengthened providing more repetition, (iii) MBSR's benefits for worry reduction and cognitive improvements, and (iv) continued use of MBSR techniques during follow-up.
Two sites (St. Louis and San Diego) enrolled individuals aged 65 years or older with significant anxiety-related distress plus subjective cognitive dysfunction, into traditional 8-session MBSR groups and 12-session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques.
Participants (N = 34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for 6 months post-instruction and found them helpful in stressful situations. There was no evidence that the extended 12-week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8-week MBSR.
These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co-occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value.
基于正念的减压疗法(MBSR)有减轻担忧并改善认知功能的潜力。
在这个治疗开发项目中,我们对有担忧症状且伴有认知功能障碍的老年人进行了MBSR研究。我们考察了:(i)MBSR的可接受性;(ii)MBSR是否需要延长疗程以增加重复次数;(iii)MBSR在减轻担忧和改善认知方面的益处;(iv)随访期间MBSR技术的持续使用情况。
两个地点(圣路易斯和圣地亚哥)招募了65岁及以上、有明显焦虑相关困扰且伴有主观认知功能障碍的个体,将其分为传统的8节次MBSR组和12节次MBSR组,后者内容相同但主题和技术重复更多。我们在MBSR项目前后考察了正念、担忧以及一套关注记忆和执行功能的神经心理测试指标,并在MBSR结束后对参与者进行了6个月的随访,了解他们对MBSR技术的持续使用情况。
参与者(N = 34)在担忧严重程度、正念水平以及通过段落学习和延迟回忆测量的记忆方面均有改善,所有这些改善的效应量都很大。大多数参与者在接受指导后的6个月内继续使用MBSR技术,并发现这些技术在压力情境中很有帮助。没有证据表明延长至12周的MBSR在认知或临床结果、满意度或MBSR技术的持续使用方面优于8周的MBSR。
这些初步发现为MBSR在患有临床担忧症状且伴有认知功能障碍的老年人中进一步测试和应用带来了希望。这些是广泛老年人群中的常见问题,其中许多人患有焦虑和情绪障碍;因此,对他们进行减压干预可能具有重大的公共卫生价值。