Effects of Mindful Awareness Practice (MAP) on Subclinical Depressive and Anxiety Symptoms and General Cognitive Function in Older Adults with Mild Cognitive Impairment: A 5-Year Follow-Up of the MAP-Randomized Controlled Trial

Article type: Research Article

Authors: Ng, Ted Kheng Siang^{a; b; c; *} | Tan, Xiang Ren^d | Todd, Michael^b | Chen, Angela Chia-Chen^b | Feng, Lei^a | Lu, Yanxia^e | Yu, Fang^{b; c} | Kua, Ee Heok^{a; f} | Mahendran, Rathi^{a; f}

Affiliations: [a] Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore | [b] Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA | [c] Center for Innovation in Healthy and Resilient Aging (CIHRA), Phoenix, AZ, USA | [d] Health and Social Sciences, Singapore Institute of Technology, Singapore | [e] Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China | [f] Department of Psychological Medicine, National University Hospital, Singapore

Correspondence: [*] Correspondence to: Ted Kheng Siang Ng, PhD, Assistant Professor, Edson College of Nursing and Health Innovation & Faculty Scholar, Center for Innovation in Healthy and Resilient Aging (CIHRA), Arizona State University, 500 North 3rd Street, Room 244, Phoenix, AZ 85004, USA. Tel.: +1 602 496 2644; E-mail: ted.ng@asu.edu.

Abstract: Background:Few randomized controlled trials (RCTs) investigated the effects of mindfulness intervention on affective and cognitive symptoms in older adults with mild cognitive impairment (MCI). Furthermore, no RCTs on mindfulness followed participants beyond two years. Objective:To examine the longitudinal effects of a mindful awareness practice (MAP) intervention on depressive, anxiety, and cognitive symptoms in MCI. Methods:In this parallel-arm and assessor-blinded RCT, 55 community-dwelling older adults with MCI were randomized into the MAP or active control, i.e., health education program (HEP). Intervention sessions were conducted weekly for three months and monthly for the subsequent six months. Assessments and follow-up were conducted at baseline, 3-month, 9-month, and 5-year time points. Depressive, anxiety, and cognitive symptoms were measured using the Geriatric Depression Scale-15 (GDS-15), Geriatric Anxiety Inventory-20 (GAI-20), and Mini-Mental State Examination (MMSE), respectively. Linear-mixed models, following the intention-to-treat principle, were used for data analyses. Results:A total of 55 participants aged 60 to 86 (Mean age: 71.3±6 years old) was recruited, with n = 28 allocated to the MAP arm and n = 27 allocated to the HEP arm. Compared to HEP, GDS-15, GAI-20, and MMSE scores did not differ significantly in MAP during follow-ups. Conclusion:Compared to HEP, MAP did not improve affective symptoms nor delay deteriorations in general cognition in community-dwelling older adults with MCI. Compared to our previous findings showing domain-specific improvements in MAP over HEP in attention and memory up to 9 months, this study highlights the importance of examining domain-specificity using detailed cognitive measures in non-pharmacological intervention with MCI.

Keywords: Geriatric anxiety inventory, health education, mild cognitive impairment, mindfulness, mini-mental state examination, geriatric depression scale, non-pharmacological intervention, preclinical dementia

DOI: 10.3233/JAD-220641

Journal: Journal of Alzheimer's Disease, vol. 90, no. 4, pp. 1677-1688, 2022