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.
[en] INTRODUCTION: 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. OBJECTIVE: To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. METHODS: 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). RESULTS: One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, n = 73; HSMP, n = 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. CONCLUSIONS: 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. ClinicalTrials.gov identifier: NCT03005652.
Research center :
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège
Disciplines :
Neurosciences & behavior
Author, co-author :
Marchant, Natalie L.
Barnhofer, Thorsten
Coueron, Roxane
Wirth, Miranka
Lutz, Antoine
Arenaza-Urquijo, Eider M.
Collette, Fabienne ; Université de Liège - ULiège > Département de Psychologie > Neuropsychologie
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.
Publication date :
2021
Journal title :
Psychotherapy and Psychosomatics
ISSN :
0033-3190
eISSN :
1423-0348
Publisher :
Karger, Basel, Switzerland
Volume :
90
Issue :
5
Pages :
341-350
Peer reviewed :
Peer Reviewed verified by ORBi
European Projects :
H2020 - 667696 - MEDIT-AGEING - Investigating the impact of meditation training on mental health and wellbeing in the ageing population
Rabin LA, Smart CM, Amariglio RE. Subjective Cognitive Decline in Preclinical Alzheimer's Disease. Annu Rev Clin Psychol. 2017 May;13(1):369-96.
Jessen F, Amariglio RE, van Boxtel M, Breteler M, Ceccaldi M, Chételat G, et al.; Subjective Cognitive Decline Initiative (SCD-I) Working Group. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimers Dement. 2014 Nov;10(6):844-52.
Jessen F, Amariglio RE, Buckley RF, van der Flier WM, Han Y, Molinuevo JL, et al. The characterisation of subjective cognitive decline. Lancet Neurol. 2020 Mar;19(3):271-8.
Wolfsgruber S, Kleineidam L, Wagner M, Mösch E, Bickel H, Lhmann D, et al.; Age-CoDe Study Group. Differential Risk of Incident Alzheimer's Disease Dementia in Stable Versus Unstable Patterns of Subjective Cognitive Decline. J Alzheimers Dis. 2016 Oct;54(3):1135-46.
Gulpers B, Ramakers I, Hamel R, Köhler S, Oude Voshaar R, Verhey F. Anxiety as a Predictor for Cognitive Decline and Dementia: A Systematic Review and Meta-Analysis. Am J Geriatr Psychiatry. 2016 Oct;24(10):823-42.
Becker E, Orellana Rios CL, Lahmann C, Rücker G, Bauer J, Boeker M. Anxiety as a risk factor of Alzheimer's disease and vascular dementia. Br J Psychiatry. 2018 Nov;213(5):654-60.
Hill NL, Mogle J, Wion R, Munoz E, De-Pasquale N, Yevchak AM, et al. Subjective Cognitive Impairment and Affective Symptoms: A Systematic Review. Gerontologist. 2016 Dec;56(6):e109-27.
Eysenck MW, Derakshan N, Santos R, Calvo MG. Anxiety and cognitive performance: attentional control theory. Emotion. 2007 May;7(2):336-53.
Bishop SJ. Trait anxiety and impoverished prefrontal control of attention. Nat Neurosci. 2009 Jan;12(1):92-8.
Hazlett-Stevens H, Singer J, Chong A. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy with Older Adults: A Qualitative Review of Randomized Controlled Outcome Research. Clin Gerontol. 2019 Jul-Sep;42(4):347-58.
Helmes E, Ward BG. Mindfulness-based cognitive therapy for anxiety symptoms in older adults in residential care. Aging Ment Health. 2017 Mar;21(3):272-8.
Berk L, Hotterbeekx R, van Os J, van Boxtel M. Mindfulness-based stress reduction in middle-aged and older adults with memory complaints: a mixed-methods study. Aging Ment Health. 2018 Sep;22(9):1107-14.
Chen KW, Berger CC, Manheimer E, Forde D, Magidson J, Dachman L, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depress Anxiety. 2012 Jul;29(7):545-62.
Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, et al. Mindfulnessbased therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013 Aug;33(6):763-71.
Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002 Nov;288(19):2469-75.
Marchant NL, Barnhofer T, Klimecki OM, Poisnel G, Lutz A, Arenaza-Urquijo E, et al.; SCD-WELL Medit-Ageing Research Group. The SCD-Well randomized controlled trial: effects of a mindfulness-based intervention versus health education on mental health in patients with subjective cognitive decline (SCD). Alzheimers Dement (N Y). 2018 Dec;4(1):737-45.
Boutron I, Altman DG, Moher D, Schulz KF, Ravaud P; CONSORT NPT Group. CONSORT Statement for Randomized Trials of Nonpharmacologic Treatments: A 2017 Update and a CONSORT Extension for Nonpharmacologic Trial Abstracts. Ann Intern Med. 2017 Jul;167(1):40-7.
Zellner Keller B, Singh NN, Winton AS. Mindfulness-Based Cognitive Approach for Seniors (MBCAS): Program Development and Implementation. Mindfulness (N Y). 2014;5(4):453-9.
Zipfel S, Junne F, Giel KE. Measuring Success in Psychotherapy Trials: The Challenge of Choosing the Adequate Control Condition. Psychother Psychosom. 2020;89(4):195-9.
Lorig K, Holman H, Sobel D, Laurent D, González V, Minor M. Living a Healthy Life with Chronic Conditions: Self-Management of Heart Disease, Arthritis, Diabetes, Depression, Asthma, Bronchitis, Emphysema and Other Physical and Mental Health Conditions. 4th ed. Boulder (CO): Bull Publishing Company; 2012.
Wetherell JL, Hershey T, Hickman S, Tate SR, Dixon D, Bower ES, et al. Mindfulness-Based Stress Reduction for Older Adults With Stress Disorders and Neurocognitive Difficulties: A Randomized Controlled Trial. J Clin Psychiatry. 2017 Jul;78(7):e734-43.
Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86.
Borrelli B. The Assessment, Monitoring, and Enhancement of Treatment Fidelity In Public Health Clinical Trials. J Public Health Dent. 2011;71 Suppl 1:S52-63.
Barnes LL, Harp D, Jung WS. Reliability Generalization of Scores on the Spielberger State-Trait Anxiety Inventory. Educ Psychol Meas. 2002;62(4):603-18.
Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol J Aging Ment Health. 1986;5(1-2):165-73.
Feingold A. A Regression Framework for Effect Size Assessments in Longitudinal Modeling of Group Differences. Rev Gen Psychol. 2013 Mar;17(1):111-21.
Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol. 1991 Feb;59(1):12-9.
Fava GA, Cosci F, Guidi J, Rafanelli C. The Deceptive Manifestations of Treatment Resistance in Depression: A New Look at the Problem. Psychother Psychosom. 2020;89(5):265-73.
Perrotin A, La Joie R, de La Sayette V, Barré L, Mézenge F, Mutlu J, et al. Subjective cognitive decline in cognitively normal elders from the community or from a memory clinic: differential affective and imaging correlates. Alzheimers Dement. 2017 May;13(5):550-60.
Balsamo M, Cataldi F, Carlucci L, Fairfield B. Assessment of anxiety in older adults: a review of self-report measures. Clin Interv Aging. 2018 Apr;13:573-93.
Guidi J, Brakemeier EL, Bockting CL, Cosci F, Cuijpers P, Jarrett RB, et al. Methodological Recommendations for Trials of Psychological Interventions. Psychother Psychosom. 2018;87(5):276-84.
Smart CM, Segalowitz SJ, Mulligan BP, Koudys J, Gawryluk JR. Mindfulness Training for Older Adults with Subjective Cognitive Decline: Results from a Pilot Randomized Controlled Trial. J Alzheimers Dis. 2016 Apr;52(2):757-74.
Lenze EJ, Hickman S, Hershey T, Wendleton L, Ly K, Dixon D, et al. Mindfulness-based stress reduction for older adults with worry symptoms and co-occurring cognitive dysfunction. Int J Geriatr Psychiatry. 2014 Oct;29(10):991-1000.
Wolfsgruber S, Molinuevo JL, Wagner M, Teunissen CE, Rami L, Coll-Padrós N, et al.; Euro-SCD working group. Prevalence of abnormal Alzheimer's disease biomarkers in patients with subjective cognitive decline: crosssectional comparison of three European memory clinic samples. Alzheimers Res Ther. 2019 Jan;11(1):8.
Molinuevo JL, Rabin LA, Amariglio R, Buckley R, Dubois B, Ellis KA, et al.; Subjective Cognitive Decline Initiative (SCD-I) Working Group. Implementation of subjective cognitive decline criteria in research studies. Alzheimers Dement. 2017 Mar;13(3):296-311.
Bondi MW, Edmonds EC, Jak AJ, Clark LR, Delano-Wood L, McDonald CR, et al. Neuropsychological criteria for mild cognitive impairment improves diagnostic precision, biomarker associations, and progression rates. J Alzheimers Dis. 2014;42(1):275-89.
Knowles KA, Olatunji BO. Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory. Clin Psychol Rev. 2020 Dec;82:101928.
Poisnel G, Arenaza-Urquijo E, Collette F, Klimecki OM, Marchant NL, Wirth M, et al.; Medit-Ageing Research Group. The Age-Well randomized controlled trial of the Medit-Ageing European project: effect of meditation or foreign language training on brain and mental health in older adults. Alzheimers Dement (N Y). 2018 Dec;4(1):714-23.
