Gentile Christina, Starnino Louisia, Dupuis Gilles, D'Antono Bianca
Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.
Psychology Department, Université du Québec à Montréal, Montreal, Quebec, Canada.
Clin Gerontol. 2022 Mar-Apr;45(2):272-286. doi: 10.1080/07317115.2021.1887421. Epub 2021 Mar 15.
Stress influences metabolic activity and increases risk for cardiovascular disease (CVD). We sought to a) examine feasibility and acceptability of mindfulness-based stress reduction (MBSR) in older adults at risk for CVD, and b) obtain preliminary data on its metabolic impact.
A pilot RCT was conducted using a pre-post, 2-month follow-up design. Eighty-one individuals with metabolic syndrome and non-normative responses to stress in a previous investigation were invited. Participants were randomized (by sex and stress response) to a 9-week MBSR or a wait-list control group. Feasibility and acceptability were assessed and blood assayed. Between-subjects (MBSR vs waitlist control) ANOVAs on metabolic parameter change scores, and one-way repeated measures ANOVAs (pre-, post-, follow-up) were performed.
Thirty-three individuals (41%) responded to invitations, 26 were interested, of whom 19 were randomized (M = 67 years, = 7.70). Completion rate of MBSR was 72% and overall attendance was 96%. Reported benefits included increased relaxation, greater interpersonal connection, and increased body awareness. MBSR led to a decrease of 15% in LDL cholesterol and 10% in total cholesterol versus 4.5% and 1%, respectively, in the waitlist. Within group analyses showed notable decreases in LDL, triglycerides, and waist circumference post-MBSR and 2 months later.
A RCT was largely feasible and MBSR acceptable to participants. MBSR may lead to sustained decreases in cholesterol levels, warranting development of large-scale research on this topic.
Given the role of stress in CVD, addition of stress management interventions may serve as a useful complement to risk management among older individuals.
压力会影响代谢活动并增加心血管疾病（CVD）风险。我们试图：a）检验基于正念减压疗法（MBSR）在有CVD风险的老年人中的可行性和可接受性，以及b）获取其对代谢影响的初步数据。
采用前后测、2个月随访设计进行一项试点随机对照试验（RCT）。邀请了81名在先前调查中患有代谢综合征且对应激有非标准反应的个体。参与者按性别和应激反应随机分为9周的MBSR组或等待列表对照组。评估可行性和可接受性并检测血液。对代谢参数变化分数进行组间（MBSR组与等待列表对照组）方差分析，以及进行单向重复测量方差分析（前测、后测、随访）。
33人（41%）回应了邀请，26人感兴趣，其中19人被随机分组（平均年龄 = 67岁，标准差 = 7.70）。MBSR的完成率为72%，总体出勤率为96%。报告的益处包括放松感增强、人际关系改善以及身体意识增强。与等待列表组分别降低4.5%和1%相比，MBSR使低密度脂蛋白胆固醇降低了15%，总胆固醇降低了10%。组内分析显示，MBSR后及2个月后，低密度脂蛋白、甘油三酯和腰围显著下降。
一项RCT在很大程度上是可行的，MBSR为参与者所接受。MBSR可能会使胆固醇水平持续下降，有必要开展关于该主题的大规模研究。
鉴于压力在CVD中的作用，增加压力管理干预措施可能是老年个体风险管理的有益补充。
