Emergency Medicine, Woodlands Health, Singapore, Singapore.
Major Operating Theatre, Woodlands Health, Singapore, Singapore.
J Adv Nurs. 2023 Dec;79(12):4489-4505. doi: 10.1111/jan.15720. Epub 2023 May 29.
To evaluate the effectiveness of mindfulness-based interventions (MBIs) on mental and cognitive outcomes including, anxiety, depression, attention, memory, global cognition and neuroplastic changes in older adults with mild cognitive impairment (MCI).
Systematic review and meta-analysis.
A three-step search strategy was conducted on eight electronic databases, grey literature and reference lists from inception to February 2022.
Randomized controlled trials (RCTs) examining MBIs on older adults with MCI were screened and assessed for risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was conducted using RevMan using a random-effect model. Narrative synthesis was performed for studies where results could not be pooled statistically.
Ten RCTs were included in the review. Results suggested that right frontal parietal and left inferior temporal gyrus of the brain showed increased cortical thickness after receiving MBIs. There were significant interaction effects for global efficiency and significant interactions in the insular and gyrus regions. Functional connectivity between the posterior cingulate cortex, bilateral medial prefrontal cortex and left hippocampus were increased in participants undergoing MBIs. Nevertheless, meta-analysis showed non-significant pooled effects, favouring control groups on anxiety, depression, attention, memory and global cognition.
This review suggested the potential effects of MBIs in improving cortical thickness and connectivity in regions associated with memory and attention. Nevertheless, the effects of MBIs compared to active control groups on depression, anxiety, attention, memory and global cognition are inconclusive due to the lack of studies and non-significant results.
The review advocates for more rigorous studies with larger sample size and utilizing wait-list controls to evaluate the effects of MBIs. MBIs can be considered as an adjunct with other therapies to further enhance the effect on psychological and cognitive outcomes for older adults with MCI. No Patient or Public Contribution as this is a meta-analysis.
评估正念干预（MBI）对轻度认知障碍（MCI）老年人的心理和认知结果的有效性，包括焦虑、抑郁、注意力、记忆、整体认知和神经可塑性变化。
系统评价和荟萃分析。
从开始到 2022 年 2 月，采用三步搜索策略对八个电子数据库、灰色文献和参考文献进行了搜索。
对 MCI 老年患者接受 MBI 的随机对照试验（RCT）进行筛选，并使用 Cochrane 偏倚风险工具评估偏倚风险。使用 RevMan 进行荟萃分析，采用随机效应模型。对于无法进行统计学汇总的研究，进行叙述性综合。
共纳入 10 项 RCT。结果表明，接受 MBI 后大脑右额顶叶和左颞下回皮质厚度增加。大脑岛叶和回区域的全局效率存在显著的交互作用，并且存在显著的交互作用。接受 MBI 的参与者后扣带回皮质、双侧内侧前额叶皮质和左侧海马之间的功能连接增加。然而，荟萃分析显示，MBI 组在焦虑、抑郁、注意力、记忆和整体认知方面的效果不显著，倾向于对照组。
本综述表明 MBI 可能改善与记忆和注意力相关区域的皮质厚度和连通性。然而，由于研究数量较少且结果无统计学意义，MBI 与活性对照组在抑郁、焦虑、注意力、记忆和整体认知方面的效果尚不确定。
该综述主张进行更多的研究，纳入更大的样本量，并采用等待对照来评估 MBI 的效果。MBI 可以被认为是一种辅助治疗方法，与其他治疗方法联合使用，可以进一步提高 MCI 老年患者的心理和认知结果。
本研究无患者或公众参与。
