A new study from researchers at the University Miami Miller School of Medicine has shown that Alzheimer’s disease patients who practice mindfulness may have better outcomes than those who do not. This baseline goes up even further if the patient’s primary caregiver also has a mindfulness practice. The study was published in the Journal of Alzheimer’s Disease.
“A patient’s baseline mindfulness corresponded to how they would do on tests,” said James Galvin, M.D., M.P.H., professor of neurology and senior author on the paper. “Likewise, the caregiver's baseline mindfulness influenced how they answered questions about their loved ones. When you put the two together, dyads with high mindfulness did much better than dyads with low mindfulness.”
More than five million people suffer from Alzheimer’s in the U.S., 50 million worldwide. These numbers are expected to increase dramatically in coming decades. At present, there are few effective treatments, and the ones that do exist only mitigate symptoms.
However, a number of studies have shown that as much as 40% of Alzheimer’s risk can be modified through diet, exercise, mindfulness and other means. Previous studies have shown that mindfulness can mitigate depression, loneliness and stress, as well as modulating heart disease — all Alzheimer’s risk factors.
Impact on outcomes
The study, which was co-authored by medical student Ashley Innis and Research Assistant Professor Magdalena Tolea, Ph.D., measured baseline mindfulness to determine its impact on outcomes and develop better strategies to potentially improve these practices in patients and their caregivers.
The researchers evaluated baseline mindfulness among 291 patients and caregivers using the Applied Mindfulness Process Scale (AMPS), which they adapted for this study. AMPS measures three domains: decentering, the ability to create mental distance from difficult situations; how people respond to positive events; and whether people can avoid responding negatively to the challenges they face.
Using these measures, the team found that higher mindfulness, in both patients and caregivers, was associated with greater cognitive abilities and mood in patients, as well as boosting their abilities to perform routine daily activities.
This is the first time mindfulness has been measured in this patient/caregiver group, and it provides many insights that could help refocus care based on baseline mindfulness, helping patients modify their risks of experiencing worsening dementia.
Determining the starting point
“We incorporate mindfulness-based approaches into our therapies and, to make those more effective, we should know where people are starting,” Dr. Galvin said. “If a person has low mindfulness, our approach to introducing mindfulness, diet and exercise should be quite different compared to how we approach a person who has much higher mindfulness levels. This will help us personalize our interventions.”
This work gives clinicians new ways to determine mindfulness baselines in both patients and caregivers. Because much of the information about an Alzheimer’s patient’s activities comes from their caregivers, it will help clinicians interpret that information and work more closely with families.
In addition, while this study focused exclusively on dementia, the results could influence care in other conditions.
“We saw that baseline mindfulness affected outcomes in ways we wouldn’t have necessarily hypothesized,” Dr. Galvin said. “If a patient has congestive heart failure, or cancer or mental health issues, how much does their family impact their outcome? There’s a lot of research that needs to be done for other diseases.”