Online mindfulness training for older adults during the COVID-19 pandemic: a randomized controlled trial using a multi-method assessment approach.

OBJECTIVES: The COVID-19 pandemic drastically accelerated the need for studies examining the effectiveness of programs to bolster psychological well-being, particularly for at-risk groups, such as older adults (OAs). Mindfulness Training (MT) has been suggested as a well-suited program for this purpose. The present study examined the impact of a 4-week online, trainer-led MT course tailored for OAs during the early months of the COVID-19 pandemic. METHODS: Fifty-three OAs were randomly assigned to either Group A or Group B. Group A received the online MT course during the 4-week interval between the first (T1) and second (T2) testing sessions, while Group B received the same MT course during the interval between T2 and the third testing session (T3). The testing sessions included measures of mindfulness, emotional well-being, psychological health, and cognitive performance. In addition, a very brief survey was sent every week during the T1-T2 and T2-T3 intervals to assess weekly emotional well-being. RESULTS: The findings revealed that MT may improve some, albeit not all, aspects of mindfulness and well-being, while no significant results were noted for outcomes measuring psychological health and cognitive performance. CONCLUSIONS: These findings are discussed in the context of the evolving COVID-19 situation.

Measuring the Frailty Phenotype and its Association with Cognition in Mid-Life and Older Age.

BACKGROUND: Frailty is directly linked to physical robustness and cognitive decline in older age. The Fried Frailty phenotype (FP) is a construct composed of five core symptoms that has been studied predominately in older age. There is little research contrasting the psychometric properties of the FP in mid-life versus older age. OBJECTIVE: We compared the psychometric properties of the FP in mid-life and older age and investigated relationships between the FP and cognition. METHODS: Frailty and neuropsychological assessments were completed on 361 adults, between 45 and 92 years of age, without primary neurological disorders. Confirmatory factor analysis was used to examine FP, indicated by Grip Strength, Gait Speed, Physical Activity, Fatigue, and Weight Loss. Measurement invariance was tested in mid-life (45-64 years) versus older age (≥65 years). Associations were examined between FP and language, executive functions, memory, processing speed, and visuospatial domains as well as a Generalized Cognition factor. Age was tested as a moderator of these associations. RESULTS: Weight Loss was a poor indicator of FP. Factor loadings were comparable across age groups; however, Fatigue was disproportionately higher among those in mid-life. FP was negatively associated with all cognitive domains and remained invariant across age groups. CONCLUSION: Results support the construct validity of the FP and document its stable associations with poorer cognition in middle and older life. Future research investigating central features of frailty earlier in life may offer avenues for developing targeted prevention measures and better characterization of individuals with elevated dementia risk.

Does mindfulness training help working memory 'work' better?

There has been a proliferation of mindfulness training (MT) programs offered across a multitude of settings, including military, business, sports, education, and medicine. As such, ascertaining training effectiveness and determining best practices for program delivery are of the utmost importance. MT is often introduced to promote an array of desired effects from better mood, better leadership and management skills, to improved workplace or academic performance. Despite the diversity of factors motivating adoption of MTs, it can be argued from a cognitive training perspective that there should be uniformity in the core cognitive processes strengthened via repeated and systematic engagement in MT exercises. Herein, we explore the hypothesis that MT promotes salutary changes in the brain's working memory (WM) system. We review prior research and highlight aspects of MT programs that may be critical for achieving beneficial WM effects. Further, we suggest that given the centrality of WM in core processes such as emotion regulation, problem solving, and learning, MT programs capable of achieving WM benefits may be best positioned to promote other desired outcomes (e.g. reductions in negative mood). For these reasons, we recommend that more studies include WM metrics in their evaluation of MT programs.

Revisiting eligibility for deep brain stimulation: Do preoperative mood symptoms predict outcomes in Parkinson's disease patients?

INTRODUCTION: Anxiety and depression are common in PD, occurring in an estimated 30%-40% of PD patients. However, the extent to which these emotional symptoms interfere with Deep Brain Stimulation (DBS) outcomes is not well established. This study examined the association between pre-operative emotional well-being and postsurgical cognitive, emotional, and motor performance in PD. METHODS: Forty-nine PD patients underwent neurological, neuropsychological (global cognition, processing speed, language, visuospatial, memory), and emotional assessments pre- and post-DBS. Fifteen patients were administered the UPDRS. Patients were divided into Anxious (Anx; n = 21), Comorbid Anxious and Depressed (Anx + Dep; n = 15), and Emotionally Asymptomatic (EA; n = 13) based on BAI and BDI-II cutoffs, and compared on pre-post changes in neurocognitive, mood, and motor scores using analyses of covariance (ANCOVA), controlling for education, ethnicity, and disease duration. RESULTS: Pre-DBS, there were no significant differences between the three groups on any neuropsychological measure. Overall change from pre-to post-DBS revealed declines on multiple cognitive measures and lower symptom endorsement on the BAI among all participants. No group differences were observed on neurocognitive measures, mood, or UPDRS. CONCLUSIONS: PD patients with mild-moderate anxiety or comorbid anxiety/depression pre-DBS do not show greater cognitive, emotional, and motor changes post-DBS compared to emotionally asymptomatic patients. These data emphasize the importance of discussing potential DBS outcomes, while keeping in mind that psychiatric comorbidity should not necessarily exclude patients from DBS. The notion that premorbid mood symptoms could disqualify a candidate for surgery would be a disservice, as this group performs comparably to asymptomatic peers.

Benefits of mindfulness training for patients with progressive cognitive decline and their caregivers.

New strategies are needed to help people cope with the repercussions of neurodegenerative disorders such as Alzheimer's disease. Patients and caregivers face different challenges, but here we investigated an intervention tailored for this combined population. The program focused on training skills such as attending to the present moment nonjudgmentally, which may help reduce maladaptive emotional responses. Patients participated together with caregivers in weekly group sessions over 8 weeks. An assessment battery was individually administered before and after the program. Pre-post analyses revealed several benefits, including increased quality-of-life ratings, fewer depressive symptoms, and better subjective sleep quality. In addition, participants indicated that they were grateful for the opportunity to learn to apply mindfulness skills and that they would recommend the program to others. In conclusion, mindfulness training can be beneficial for patients and their caregivers, it can be delivered at low cost to combined groups, and it is worthy of further investigation.