Mindfulness, Stress, and Aging

Prevalence of pain phenotypes and co-morbidities of chronic pain in Parkinson's Disease

OBJECTIVE

The prevalence of chronic pain in Parkinson's disease (PD) in neurology practices ranges from 24 % to 83 %. To determine whether this prevalence is accurate across patients with PD, we leveraged data from electronic medical records in 80 inpatient and outpatient general practice settings.

METHODS

We explored the prevalence of chronic pain in patients with PD relative to age and sex-matched controls in a large international database with electronic medical records from over 250 million patients (TriNetX Cambridge, MA, USA). We described demographics, co-morbid conditions and medication differences between patients with PD and without PD who have chronic pain.

RESULTS

Extracted data included 4510 patients with PD and 4,214,982 age-matched control patients without Parkinson's Disease. A chronic pain diagnosis was identified in 19.3 % of males and 22.8 % of females with PD. This differed significantly from age-matched patients without PD who had a significantly lower prevalence of chronic pain 3.78 % and 4.76 %. Significantly more PD patients (both male and females) had received tramadol, oxycodone, and neuropathic agents (p<0.001) than patients without PD. Females with PD more often received anti-depressants than males with PD (p<0.05), corresponding with a significantly higher prevalence of depression.

CONCLUSION

Chronic pain in patients with PD is five times as common as in age-matched controls in general practice settings. Patients with PD have a greater prevalence of comorbid conditions that affect development of chronic pain. Whether the pain or the PD is causative to those conditions remains to be elucidated.

Effects of Mindfulness Based Interventions in Adults and Older Adults Caregivers of Patients with Early Stage Alzheimer's Disease: A Randomized Pilot Study

Background

Many studies have highlighted the effect of training with mindfulness-based interventions (MBIs) on the psycho-physical rebalancing of patients suffering from various pathologies, and their families.

Objective

In this study, the effect of a training with mindfulness-based stress reduction (MBSR) on quality of life and emotion regulation (depression) was verified in caregivers (CGs) of patients affected by Alzheimer's disease at early stage (AD-P).

Methods

In this randomized controlled study, 22 CGs (age≥60 years) were treated with MBIs, in particular MBSR, and 22 CGs had no treatment. Tests (T0-T1 six months) included: SF 36-Quality of Life (QoL); Caregiver Burden Inventory (CBI); FACIT-Spiritual-Well-Being; Beck Depression Inventory (BDI); Everyday Cognition scales; and Mini-Mental State Examination (for AD-P).

Results

Significant differences emerged between T0 and T1 for CGs with MBSR in the following dimensions: Depression-BDI (p > 0.001), Burden CBI-Total (0.001), CBI-Time dependent burden (p < 0.001), CBI-Developmental burden (p < 0.001), CBI-Physical burden (p < 0.001); and pain (p = 0.002) all decreased; while CBI-Social burden (p = 0.004), QoL-Health Role Limitation (p < 0.000), QoL-Role-Limitation-Emotional-Problem (p < 0.000), QoL-Energy-fatigue (p < 0.000), QoL-Emotional Well-Being (p < 0.001), QoL-Social Well Being (p = 0.010), and QoL-General Health (p = 0.004) increased. The control group of untreated CG showed a significant worsening in the dimensions of Physical functioning (p = 0.036) and pain (p = 0.047).

Conclusions

AD-CGs treated with MBI reduced their burden and depression and experienced an improvement in all the dimensions of quality of life.

The MEDITAGING study: protocol of a two-armed randomized controlled study to compare the effects of the mindfulness-based stress reduction program against a health promotion program in older migrants in Luxembourg

BACKGROUND

Migration is a phenomenon worldwide, with older migrants, particularly those with fewer socioeconomic resources, having an increased risk of developing adverse cognitive and health outcomes and social isolation. Therefore, it is of utmost importance to validate interventions that promote healthy aging in this population. Previous studies have shown a positive impact of mindfulness based-stress reduction (MBSR) on outcomes such as cognition and sleep. However, only a few studies verified its potential in older adults, especially with vulnerable populations such as migrants. This article presents the protocol of the MEDITAGING study, which is the first to investigate the MBSR effects in migrants aged ≥55 in comparison to a health promotion program.

METHODS

MEDITAGING is a two-arm randomized, double-blinded, controlled study, which will include older Portuguese-speaking migrants (n = 90). Participants are randomized to the MBSR or a health promotion program. Both interventions are conducted in groups over a total of 8 weeks, incorporating weekly meetings, an additional 4-hour class, and extra at-home tasks. The health promotion program has the same structure as the MBSR but comprises different activities related to dementia prevention, healthy habits, cognitive stimulation, sleeping, nutrition, watercolor painting, and physical activity. The assessment of executive functioning, physiological stress measures, self-reported questionnaires, and qualitative interviews are conducted at baseline, after 8 weeks (post-intervention), and at a follow-up session (from one to 3 months thereafter). Analyzes will be conducted using a modified intention-to-treat approach (all participants with at least 3 days of participation in the group-sessions and one post-intervention observation).

DISCUSSION

This study will test effects of a mindfulness-based intervention against an active control condition in older adult migrants, which few studies have addressed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05615337 (date of registration: 27 September 2022; date of record verification: 14 November 2022).

What matters in aging is signaling for responsiveness

Biological responsiveness refers to the capacity of living organisms to adapt to changes in both their internal and external environments through physiological and behavioral mechanisms. One of the prominent aspects of aging is the decline in this responsiveness, which can lead to a deterioration in the processes required for maintenance, survival, and growth. The vital link between physiological responsiveness and the essential life processes lies within the signaling systems. To devise effective strategies for controlling the aging process, a comprehensive reevaluation of this connecting loop is imperative. This review aims to explore the impact of aging on signaling systems responsible for responsiveness and introduce a novel perspective on intervening in the aging process by restoring the compromised responsiveness. These innovative mechanistic approaches for modulating altered responsiveness hold the potential to illuminate the development of action plans aimed at controlling the aging process and treating age-related disorders.

Tellegacy: An Intergenerational Wellness and Health Promotion Project to Reduce Social Isolation and Loneliness in Older Adults: A Feasibility Study

Emerging research demonstrates that social isolation and loneliness are linked to significant physical and mental health conditions. To address these concerns, the Tellegacy program was developed as an intergenerational health-promoting intervention to ameliorate older adult social isolation and loneliness in an effort to increase wellness. The purpose of this study was to reflect on testing of the Tellegacy program as a behavioral intervention. University students trained in goal setting, mindfulness, and listening strategies were paired with 11 older adults in the northern Midwest area via weekly in-person and phone conversations. Oral reminiscence therapies were used and books containing their stories were given to the older adults after participation. Older adults were surveyed using the University of California Los Angeles Loneliness Scale, Satisfaction of Life Scale, and patient health questionnaire-9 (PHQ-9) scale to elucidate the effectiveness of the intervention. Improved scores in loneliness, satisfaction of life, and PHQ-9 demonstrated favorable improvements in older adults. Additional benefits for the student Legacy Builder were revealed from self-reported changes. This suggests the potential benefits of structured encounters between trained students and isolated or lonely older adults. The Tellegacy intergenerational feasibility program warrants further studies to fully demonstrate its impact on health outcomes.

Effects of Mindfulness-Based Interventions (MBIs) in Patients with Early-Stage Alzheimer’s Disease: A Pilot Study

Bachground In this study, we hypothesize that mindfulness-based interventions (MBIs) may improve well-being and the related outcomes in Alzheimer’s dementia patients (AD-P) at an early stage. MBIs consist of the practice of consciously observing the psychic contents in the present moment (thoughts, sensations, feelings, and other events). This attention allows one to become aware of the psychic contents and integrate them, thus favoring the quality of life and an increase in the mood of practitioners. Methods The randomized controlled study enrolled 22 AD-P at an early stage (age ≥ 60 years) treated with MBIs and 22 patients without treatment (six months of MBI training). Tests (T0–T1 six months): Mini-Mental State Examination (MMPI); Spiritual Well-Being (SWB); Beck Depression Inventory (BDI); SF36. Test-Caregiver: Everyday Cognition scales (ECOG). Results AD-P with mindfulness: Improvement of ECOG (p = 0.026), quality of life (p < 0.001), spiritual well-being (p < 0.001); decrease in depression BDI (p < 0.001). The MMSE remains unchanged. The control group of untreated patients showed a significant worsening in all these dimensions. Conclusions MBI training is effective in increasing quality of life and preventing worsening in patients with early-stage Alzheimer’s dementia.

Higher levels of neuroticism in older adults predict lower executive functioning across time: the mediating role of perceived stress

Neuroticism has been associated with individual differences across multiple cognitive functions. Yet, the literature on its specific association with executive functions (EF) in older adults is scarce, especially using longitudinal designs. To disentangle the specific influence of neuroticism on EF and on coarse cognitive functioning in old adulthood, respectively, we examined the relationship between neuroticism, the Trail Making Test (TMT) and the Mini-Mental State Examination (MMSE) in a 6-year longitudinal study using Bayesian analyses. Data of 768 older adults (M age = 73.51 years at Wave 1) were included in a cross-lagged analysis. Results showed no cross-sectional link between neuroticism and TMT performance at Wave 1 and no longitudinal link between neuroticism at Wave 1 and MMSE at Wave 2. However, neuroticism at Wave 1 predicted TMT performance at Wave 2, indicating that the more neurotic participants were, the lower they performed on the TMT six years later. Additional analyses showed that this relation was fully mediated by participants' perceived stress. Our results suggest that the more neurotic older adults are the more stress they may perceive six years later, which in turn negatively relates to their EF. In sum, this study demonstrates that neuroticism may lead to lower EF in older age across six years. It further suggests older adults' perceived stress as mediator, thereby providing novel insights into the mechanisms underlying this relation. Possible intervention approaches to counter these effects are discussed.

Examining the interrelationships between mindfulness-based interventions, depression, inflammation, and cancer survival

Depression is highly prevalent in those diagnosed with cancer and is also associated with poorer prognostic outcomes. Mindfulness-based interventions are effective in reducing depressive symptoms and improving quality of life in patients with cancer. The objective of this review was to investigate whether mindfulness practices can improve survival and, if so, what mechanisms of action may contribute to these outcomes. Although no long-term studies have investigated this hypothesis, the current literature supports an inflammatory basis for depression, implicating proinflammatory cytokines and hypothalamic-pituitary-adrenal axis dysfunction as contributing factors. Markers of inflammation, such as interleukin-6, tumor necrosis factor-α, and cortisol, are all found at elevated concentrations in many depressed individuals. These exact mechanisms are associated with higher mortality in patients with cancer. Mindfulness has been studied for its effects on cytokine and cortisol levels, and there are promising data to support that the intervention can measurably decrease inflammation. Therefore, it is conceivable that mindfulness programs can affect survival in this population. There are limited data on the long-term effects of mindfulness on depression and inflammatory markers in patients with cancer, and there are potential barriers to the implementation of mindfulness-based interventions as part of a comprehensive treatment plan. Therefore, it is necessary to further explore these questions through longitudinal studies to establish a survival correlation. CA Cancer J Clin. 2022;72:490-502.

The Effectiveness of Mindfulness-Based Intervention on Emotional States of Women Undergoing Fertility Treatment: A Meta-Analysis

For many infertile women, their inability to fulfill their aspirations and match society's expectations of motherhood may lead to mental illness. They frequently select in vitro fertilization (IVF) to achieve their wish to have children. In vitro fertilization is actually a multi-dimensional stressor. There are numerous psychological methods to assist patients decrease stress, among which mindfulness-based intervention is a prominent one. However, the effectiveness of mindfulness intervention in this group remains debatable. Therefore, our research seeks to evaluate the efficacy of mindfulness intervention in improving the emotional state of women undergoing in vitro fertilization by systematic review and meta-analysis, so as to provide a novel treatment plan for psychological therapy of this group. A meta-analysis was undertaken by scanning English databases PubMed, Embase, Cochrane library, Web of science, etc. Among them, the retrieval period is from the foundation of the database until July 5, 2022. Two investigators examined the literature according to the inclusion and exclusion criteria, and conducted meta-analysis using stata15.0 software. Six studies involving 964 infertile women were included. According to the meta-analysis, mindfulness was more effective than the control group in reducing anxiety, depression, and correlations in infertile women [standard mean difference, SMD = -0.31, 95% confidence interval (CI): -0.56 to -0.06], [SMD = -0.94, 95% CI: -1.84 to -0.03], [r = 0.38, 95% CI: 0.25-0.52]. In terms of mindfulness and self-compassion, there was no significant difference between the intervention and control groups [SMD = 0.73, 95% CI: -0.38 to -1.85], [SMD = 0.09, 95% CI: -0.19 to -0.37]. As an intervention strategy for infertile women with anxiety and despair, mindfulness intervention might be a treatment priority.

Effectiveness of emotional freedom techniques (EFT) vs sleep hygiene education group therapy (SHE) in management of sleep disorders among elderly

Sleep disorders are common among elderly persons, with deleterious effects on their physical and mental health. Many approaches are used to manage such disorders. To compare the Emotional Freedom Techniques–Insomnia (EFT-I) and Sleep Hygiene Education (SHE) group therapy as two treatments for insomnia in a geriatric population when delivered, and their effects on sleep quality, depression, and life satisfaction. This open-label randomized controlled trial study was conducted at El-Abbasia Mental Hospital and Osana family wellness elderly nursing home at Maadi, Cairo. It included 60 elderly patients suffering insomnia sleep problems randomized into two equal groups: one group received a Sleep Hygiene Education (SHE) intervention, the other had a form of Emotional Freedom Techniques (EFT) adapted for use with insomnia (EFT-I). A self-administered questionnaire with tools for sleep quality (Pittsburgh Sleep Quality Index [PSQI]), depression, and life satisfaction was used to collect data. The fieldwork was from January to March 2021. The two groups had equal median age (70 years), and almost similar gender and place of residence distribution. After the intervention, 73.3% of the EFT group had good sleep quality, compared to 100.0% in the SHE group (P = 0.005); the median score of depression (3.00) was higher in the EFT group compared with 0.00 in the SHE group (P < 0.001); as for life satisfaction, the difference was not statistically significant. The multivariate analyses identified the study intervention as the main statistically significant negative predictor of PSQI and depression scores, and a positive predictor of life satisfaction. Being in the SHE group was a negative predictor of PSQI and depression scores. Both SHE and EFT approaches are beneficial for elderly patients’ sleep quality, with SHE being more effective in ameliorating sleep. Further replication of this study is needed on a large probability sample from different geographical areas to help for the generalization of the results.

Cerebral Blood Flow and Brain Functional Connectivity Changes in Older Adults Participating in a Mindfulness-Based Stress Reduction Program

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.

The Role of Clinical Activity, Loneliness, and Satisfaction with e-Health Services as Factors Affecting Quality of Life in Patients with Rheumatoid Arthritis During the SARS-CoV-2 Pandemic

INTRODUCTION

During the SARS-CoV-2 pandemic, most primary and specialist care outpatient clinics have started to offer their patients teleconsultation appointments as well as electronic prescriptions and referrals. For many patients, it was the only available way to access medical care.

PURPOSE

The aim of the study was to assess the quality of life in rheumatoid arthritis (RA) patients and determine whether loneliness and satisfaction with telemedicine service can affect their perceived QoL during the SARS-CoV-2 pandemic.

MATERIAL AND METHODS

One hundred and forty-three RA patients (mean age 45.83±13.5 years) were included in the study. The De Jong-Gierveld Loneliness Scale (DJGLS), The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and the questionnaire of satisfaction with teleconsultations were used in the study. The following statistical tests were used in the study: Spearman correlation test, multivariate linear regression. A significance level of 0.05 was used in the analysis.

RESULTS

The patients presented a moderate level of loneliness (DJGLS; 31.1 points). The mean ASQoL score was 11.49±4.64. The correlation analysis showed a significant positive relationship between the level of loneliness and QoL - the higher the level of loneliness, the poorer the QoL (rho=0.283; p=0.001). An analysis of the relationship between satisfaction with teleconsultations and perceived QoL showed a statistically significant negative relationship - the higher the level of satisfaction with teleconsultations, the better the QoL (b=-0.166; p=0.047). The linear multivariate regression analysis showed that the loneliness (rho=0.1; p=0.01) was significant (p<0.05) independent predictor of QoL.

CONCLUSION

During the SARS-CoV-2 pandemic, RA patients experienced loneliness and their QoL was low. Teleconsultation visits proved to be unsatisfactory and negatively perceived by patients. Higher severity of RA symptoms (weakness, fatigue), being unemployed and loneliness during the blockade are independent determinants of reduced QoL in RA patients.

Mindfulness-based schema therapy and forgiveness therapy among women affected by infidelity: A randomized clinical trial

OBJECTIVE

Infidelity causes mental health problems, family disruptions, rumination about events and changes in women's beliefs about the disloyal person. This study aimed to compare the effectiveness of mindfulness-based schema (MBS) therapy and forgiveness therapy in emotional responses, cognitive distortions and self-compassion of women affected by infidelity. Method: It was an experimental research with a pretest-posttest and follow-up design. Eighty-one women affected by infidelity were randomly assigned to two experimental groups and one control group. The experimental groups received interventions for ten 90-minute weekly sessions. Participants completed the questionnaires in the pretest, post-test and follow-up. Repeated measures analysis of variance was used for statistical analysis. Results: Both experimental groups were significantly different from the control group (p<.01). Forgiveness therapy was more effective in emotional responses and self-compassion in the post-test (p<.01) and follow-up (p<.001) stages. MBS therapy was more effective in cognitive distortions in the post-test and follow-up stages (p<.001). Participants of experimental groups were responders and satisfied with treatment and had a good therapeutic relationship. Conclusion: Given the type of problems faced by women affected by infidelity, forgiveness therapy and MBS therapy can be used to reduce mental sufferings and communication problems.