Posted 01.22.2016 | by AMRA

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Alzheimer’s Disease is a progressive neurodegenerative illness characterized by short-term memory loss, disorientation, and impairments in socialization, self-care and behavioral regulation. It is primarily a disease of old age and affects over 5,000,000 Americans. Medications are often prescribed to manage its symptoms, but no medication has been shown to halt or delay the progression of the disease.

Given the enormous personal, social, and economic consequences of this illness, researchers are actively seeking novel ways to slow and forestall its devastating effects.

In a randomized clinical trial, Quintana-Hernández et al. [Journal of Alzheimer’s Disease] compared the effectiveness of a Mindfulness-Based Alzheimer’s Stimulation (MBAS) program in maintaining cognitive functioning in Alzheimer’s patients to that of two current non-pharmacological interventions for Alzheimer’s disease; namely, Progressive Muscle Relaxation (PMR) and Cognitive Stimulation Therapy (CST).

The researchers randomly assigned 168 Spanish-speaking men and women with Alzheimer’s Disease who were Canary Islands residents to one of four treatment groups: 1) Medication Alone, 2) MBAS+Medication, 3) PMR+Medication, or 4) CST+Medication. The medication was donepezil, a cholinesterase inhibitor that has a small beneficial effect on cognition in Alzheimer’s patients but does not slow or halt the progression of the disease.

All of the non-pharmacological treatments were delivered three times weekly in 90-minute group sessions that continued over a two-year period.

MBAS was based on MBSR, Mindfulness-Based Elder Care, Kirtan Kriya technique, chair yoga, and multi-sensory stimulation. The MBAS patients’ caretakers also assisted the patients in brief moments of mindfulness during home practice.

The CST group employed visual imagery, errorless learning, spaced retrieval, encoding specificity, and external memory aids. The PMR group employed a standard 16 muscle group tensing and releasing sequence. Patient cognition was longitudinally assessed using the Mini-Mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG) at baseline and at 6,12,18 and 24 months into the study.

MBAS and CST patients significantly preserved their cognitive functioning on the MMSE and CAMCOG better than those receiving medication alone, but MBAS and CST patients did not differ significantly from each other. MBAS patients also preserved their cognitive functioning on the MMSE significantly better than PMR patients.

MBAS effect sizes were small for patients with moderate-to-severe disease (Cohen’s d < 0. 20) but large for those with mild-to-moderate disease (Cohen’s d > 0.90).

This study supports the equivalence of MBAS and CST and their superiority to medication alone and to medication plus PMR in limiting the rate of cognitive decline in patients with mild-to-moderately severe Alzheimer’s disease.

Reference:

Quintana-Hernández, D. J., Miró-Barrachina, M. T., Ibáñez-Fernández, I. J., Pino, A. S. -D., Quintana-Montesdeoca, M. P., Rodríguez-de Vera, B., . . . Bravo-Caraduje, N. (2015). Mindfulness in the maintenance of cognitive capacities in alzheimer’s disease: A randomized clinical trial. Journal of Alzheimer’s Disease.

[Link to abstract]