Effects of a Mindfulness-Based Intervention versus Health Self-Management on Subclinical Anxiety in Older Adults with Subjective Cognitive Decline: The SCD-Well Randomized Superiority Trial

Abstract

<b><i>Introduction:</i></b> Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. <b><i>Objective:</i></b> To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. <b><i>Methods:</i></b> SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). <b><i>Results:</i></b> One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, <i>n</i> = 73; HSMP, <i>n</i> = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. <b><i>Conclusions:</i></b> A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. <b><i>ClinicalTrials.gov identifier:</i></b> NCT03005652.

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

“…The primary outcome of the SCD-Well trial was mean change in levels of trait anxiety from pre- to post-intervention (18). Within both CMBAS and HSMP, trait anxiety was reduced in statistically significant and clinically meaningful ways (9). The magnitude of these effects on the primary outcome did not fully translate to the well-being measures presented here.…”

“…In line with prior research and theory (7,8), MBIs have been proposed as a promising strategy for increasing psychological well-being and human flourishing. However, prior to the SCD-Well trial (9), only one study – a small pilot randomised controlled trial (n = 15; Smart et al, 2016) – had evaluated the effects of mindfulness training in individuals with SCD. This trial primarily focussed on reaction time and EEG/ERP correlates, change in brain volume, self-reported cognitive complaints, and memory self-efficacy; it did not include measures of psychological well-being or related constructs.…”

Effects of a mindfulness-based versus a health self-management intervention on objective cognitive performance in older adults with subjective cognitive decline (SCD): a secondary analysis of the SCD-Well randomized controlled trial

“…Written informed consent was obtained from all participants (please see the “Declarations” section for further details). Further details pertaining to the study’s eligibility criteria, interventions, and assessments are available in the trial protocol [ 21 ], as well as the primary outcome report, which focuses on trait anxiety [ 22 ].…”

REMIND: Music – Movement – Mind

“…Es ist wissenschaftlich sehr gut belegt, dass durch gesundheitsfördernde Lebensstilfaktoren und Trainingsprogramme die Gesundheit von Gehirn und Geist gefördert und somit einer Demenzerkrankung vorgebeugt werden kann [14,15]. Vielversprechende Studien haben beispielsweise gezeigt, dass Lebensstilansätze, wie körperliche und geistige Aktivität sowie gesunde Ernährung, eine positive Wirkung auf das Gehirn und die kognitive Fähigkeiten im Alter haben [16][17][18]. Aktuelle Untersuchungen rücken die Gesundheitsförderung durch soziokulturelle oder künstlerische Aktivitäten, wie Tanzen und Musizieren, in den Fokus [19].…”

“…mindfulness) als essenziell für die zerebrale und mentale Gesundheit [23]. Gezielte Achtsamkeitsübungen reduzieren als eine Art des mentalen Trainings die psychischen Belastungen bei älteren Menschen mit einem erhöhten Risiko, an einer Demenz zu erkranken [17]. Um die Teilnahme derjenigen älteren Menschen zu ermöglichen, die wir erreichen möchten, hat das REMIND-Programm besondere Eigenschaften.…”