Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Alzheimers Dis. 2021;79(3):1345-1367. doi: 10.3233/JAD-201292.
Mindfulness is the practice of awareness and living in the present moment without judgment. Mindfulness-based interventions may improve dementia-related outcomes. Before initiating interventions, it would be beneficial to measure baseline mindfulness to understand targets for therapy and its influence on dementia outcomes.
This cross-sectional study examined patient and caregiver mindfulness with patient and caregiver rating scales and patient cognitive performance and determined whether dyadic pairing of mindfulness influences patient outcomes.
Individuals (N = 291) underwent comprehensive evaluations, with baseline mindfulness assessed using the 15-item Applied Mindfulness Process Scale (AMPS). Correlation, regression, and mediation models tested relationships between patient and caregiver mindfulness and outcomes.
Patients had a mean AMPS score of 38.0±11.9 and caregivers had a mean AMPS score of 38.9±11.5. Patient mindfulness correlated with activities of daily living, behavior and mood, health-related quality of life, subjective cognitive complaints, and performance on episodic memory and attention tasks. Caregiver mindfulness correlated with preparedness, care confidence, depression, and better patient cognitive performance. Patients in dyads with higher mindfulness had better cognitive performance, less subjective complaints, and higher health-related quality of life (all p-values<0.001). Mindfulness effects on cognition were mediated by physical activity, social engagement, frailty, and vascular risk factors.
Higher baseline mindfulness was associated with better patient and caregiver outcomes, particularly when both patients and caregivers had high baseline mindfulness. Understanding the baseline influence of mindfulness on the completion of rating scales and neuropsychological test performance can help develop targeted interventions to improve well-being in patients and their caregivers.
正念是一种觉察和活在当下的实践，不做评判。基于正念的干预措施可能会改善与痴呆相关的结果。在开始干预之前，测量基线正念水平以了解治疗的目标及其对痴呆结果的影响将是有益的。
本横断面研究使用患者和照护者评定量表评估了患者和照护者的正念水平，并评估了患者认知表现，同时还确定了正念的双元配对是否会影响患者的结局。
共 291 名个体接受了全面评估，使用 15 项应用正念过程量表（AMPS）评估基线正念水平。采用相关、回归和中介模型来检验患者和照护者正念水平与结局之间的关系。
患者的 AMPS 平均得分为 38.0±11.9，照护者的 AMPS 平均得分为 38.9±11.5。患者的正念水平与日常生活活动、行为和情绪、健康相关生活质量、主观认知抱怨以及情景记忆和注意力任务表现相关。照护者的正念水平与准备度、护理信心、抑郁和患者认知表现较好相关。正念水平较高的双元组患者认知表现更好、主观抱怨更少、健康相关生活质量更高（所有 p 值均<0.001）。正念对认知的影响通过身体活动、社会参与、衰弱和血管风险因素来介导。
较高的基线正念水平与患者和照护者的结局更好相关，特别是当患者和照护者的基线正念水平均较高时。了解正念对评分量表和神经心理学测试表现的基线影响有助于制定有针对性的干预措施，以改善患者及其照护者的幸福感。
