Estimulación basada en mindfulness para personas mayores con enfermedad de alzheimer u otras demencias / Mindfulness based stimulation for elderly people with alzheimer's disease or other types of dementia

Los tratamientos psicológicos son una práctica habitual en el contexto sociosanitario de atención a personas mayores dependientes. En los últimos años se está introduciendo la práctica de mindfulness para personas mayores. Sin embargo, estas prácticas presentan dificultades para su aplicación en residencias y centros de día por el deterioro cognitivo que presentan los usuarios de estos servicios. En este artículo se muestra cómo se desarrollo un programa de estimulación basado en mindfulness en el entrenamiento de las actividades de vida diaria (AVD). Esta intervención se fundamenta en el entrenamiento del personal auxiliar y/o cuidador de forma simultánea con los usuarios de los servicios para, posteriormente en la rutina del centro, realizar un entrenamiento de la presencia consciente en la acción durante las AVD. El objetivo final de esta intervención es potenciar la coherencia funcional y la integración personal mediante prácticas de mindfulness en acción en actividades básicas, instrumentales o avanzadas

Psychological treatments are a common practice in health care centres for elderly dependent people. Recently, mindfulness practice is being introduced in these settings. However, it is difficult to carry out mindfulness practice in residential or daily care centres due to the cognitive impairment of the elderly users. This paper shows how a mindfulness based stimulation program for daily life activities (DLA) has been developed. This intervention aims to train assistants to the elderly along with the elderly themselves so that afterwards, within the routine at the centre, daily life activities can be done with conscious presence. The ultimate purpose of this intervention is to strengthen functional coherence and personal integration through the practice of mindfulness in action with basic, instrumental or advanced activities

Estimulación basada en mindfulness en la enfermedad de Alzheimer avanzada: ensayo clínico piloto comparativo de equivalencia / Mindfulness-based stimulation in advanced Alzheimer's disease: a comparative, non-inferiority, clinical pilot study

Introducción. Se llevó a cabo un estudio longitudinal para analizar la viabilidad, la seguridad y los efectos de la práctica de mindfulness, relajación y estimulación cognitiva en la evolución clínica de la enfermedad de Alzheimer (EA) con el objetivo de analizar la equivalencia de estos tratamientos. Material y métodos. En el estudio participaron 168 personas con EA probable en tratamiento con donepezilo. En este artículo se muestra a los 21 participantes en estadio grave que completaron el seguimiento de 24 meses. Se agrupó a los sujetos en 3 grupos experimentales (estimulación cognitiva, relajación y mindfulness) y uno control. Cada grupo desarrolló 3 sesiones semanales con medidas semestrales de seguimiento (cognición: CAMCOG y MMSE; funcionalidad: RDRS-2; psicopatología: NPI). Se realizaron análisis no paramétricos. Resultados. Las puntuaciones de la función cognitiva y la funcionalidad indicaron que no existían diferencias significativas entre los diferentes grupos. No obstante, los grupos de mindfulness y estimulación cognitiva no perdieron puntuación en la capacidad cognitiva en el análisis intragrupo. En el NPI se produjeron diferencias entre el grupo de mindfulness y el control al final del estudio (p < 0,017). Conclusión. Los datos muestran que el tratamiento de donepezilo con mindfulness o estimulación cognitiva presenta una mejor evolución clínica que el tratamiento farmacológico solo o combinado con relajación. Estos datos indican que se debe seguir trabajando en nuevas alternativas terapéuticas para la EA avanzada y que los tratamientos no farmacológicos deben ser recomendados en la práctica clínica para el control evolutivo de la enfermedad a largo plazo. Ensayos con un mayor número de participantes son necesarios para confirmar los resultados informados en este estudio (AU)

Introduction. A longitudinal study was conducted in order to analyze the feasibility, safety, and effects of the practice of mindfulness, relaxation and cognitive stimulation on the evolution of Alzheimer's disease, with the aim of testing the equivalence of these interventions. Material and methods. There were a total of 168 participants with probable Alzheimer's disease (AD) treated with donepezil. In the present article, the 21 participants with advanced AD who completed a follow-up period of 24 months are presented. The participants were grouped into three experimental groups (mindfulness, relaxation, and cognitive stimulation) and one control group. Each group carried out three weekly sessions with bi-annual follow-up measurements (cognition: CAMCOG and MMSE; functionality: RDRS; psychopathology: NPI). Non-parametric analyses were performed. Results. The cognitive function and functionality scores showed no significant differences between the groups. However, the scores in cognitive function of the mindfulness group and the cognitive stimulation group did not decrease in an intra-group analysis. In NPI, there were significant differences between the mindfulness group and the control group by the end of the study (P<.017). Conclusion. The data showed that the treatment with donepezil in combination with mindfulness or cognitive stimulation presented a better clinical evolution than the pharmacological treatment alone or combined with relaxation. These data suggest that these therapeutic alternatives should be investigated further, and that the non-pharmacological treatments should be recommended in clinical practice in order to control the evolution of AD in the long term. In order to confirm these findings, a larger study is necessary (AU)

[Mindfulness-based stimulation in advanced Alzheimer's disease: A comparative, non-inferiority, clinical pilot study]. / Estimulación basada en mindfulness en la enfermedad de Alzheimer avanzada: ensayo clínico piloto comparativo de equivalencia.

INTRODUCTION: A longitudinal study was conducted in order to analyze the feasibility, safety, and effects of the practice of mindfulness, relaxation and cognitive stimulation on the evolution of Alzheimer's disease, with the aim of testing the equivalence of these interventions. MATERIAL AND METHODS: There were a total of 168 participants with probable Alzheimer's disease (AD) treated with donepezil. In the present article, the 21 participants with advanced AD who completed a follow-up period of 24 months are presented. The participants were grouped into three experimental groups (mindfulness, relaxation, and cognitive stimulation) and one control group. Each group carried out three weekly sessions with bi-annual follow-up measurements (cognition: CAMCOG and MMSE; functionality: RDRS; psychopathology: NPI). Non-parametric analyses were performed. RESULTS: The cognitive function and functionality scores showed no significant differences between the groups. However, the scores in cognitive function of the mindfulness group and the cognitive stimulation group did not decrease in an intra-group analysis. In NPI, there were significant differences between the mindfulness group and the control group by the end of the study (P<.017). CONCLUSION: The data showed that the treatment with donepezil in combination with mindfulness or cognitive stimulation presented a better clinical evolution than the pharmacological treatment alone or combined with relaxation. These data suggest that these therapeutic alternatives should be investigated further, and that the non-pharmacological treatments should be recommended in clinical practice in order to control the evolution of AD in the long term. In order to confirm these findings, a larger study is necessary.

Efectos de un programa de intervención neuropsicológica basado en mindfulness sobre la enfermedad de Alzheimer: ensayo clínico aleatorizado a doble ciego / Effects of a neuropsychology program based on mindfulness on Alzheimer's disease: randomized double-blind clinical study

Introducción. Evaluar los efectos de un programa de intervención neuropsicológica basado en mindfulness en la evolución clínica de la enfermedad de Alzheimer. Material y método. Se realizó un ensayo clínico aleatorizado de dos años de duración a doble ciego. En el estudio participaron 127 personas mayores con enfermedad de Alzheimer probable según criterios de la NINCDS-ADRDA. Se agruparon los enfermos en tres grupos experimentales (estimulación cognitiva, relajación muscular progresiva y mindfulness) y un grupo control. Todos los enfermos estaban en tratamiento con donepezilo. Se evaluaron las capacidades cognitivas con el CAMCOG y MMSE, el área funcional con el RDRS-2 y el área psicopatológica con el NPI. Se desarrollaron tres sesiones a la semana durante 2 años con medidas semestrales de seguimiento. Resultados. Las mediciones de la función cognitiva global, la funcionalidad y los trastornos de conducta asociados a la demencia indicaron que los enfermos del grupo experimental basado en mindfulness se han mantenido estables durante los dos años, mientras que los controles y el resto de los grupos experimentales muestran un leve pero significativo empeoramiento de sus capacidades mentales. Conclusión. El programa de intervención neuropsicológica basado en mindfulness se ha asociado con la estabilidad cognitiva y funcional y mejoras significativas en la situación psicopatológica de los enfermos de Alzheimer en fase leve y moderada. Estos resultados apoyan la idea de que la intervención basada en mindfulness puede producir un beneficio clínicamente relevante en el tratamiento de la demencia. Se debe seguir trabajando en esta línea para confirmar estos datos (AU)

Introduction. The purpose of this research was to assess effects of a mindfulness based neuropsychological intervention on the clinical course of Alzheimer's disease. Material and method. A two year randomized and double blind clinical trial was conducted on 127 probable Alzheimer's disease patients, according to NINCDS-ADRDA scale. Patients were grouped into three experimental groups (cognitive stimulation, progressive muscular relaxation, and mindfulness) plus a control group. All participants were receiving donepezil. Cognitive skills were assessed with CAMCOG and MMSE, functional area with RDRS-2, and NPI was used for psychopathology screening. Three treatment sessions per week were carried out for two years, and follow up measurements were taken every six months. Results. The global cognitive function, functionality and behavioral disorders measurements indicated that patients from the experimental group based on mindfulness were stable during the two years, while patients from the control group, as well as the other experimental groups, showed a mild but significant worsening of their mental capacities. Conclusion. The mindfulness based neuropsychological program showed better cognitive and functional stability, as well as significant improvement in the psychopathological condition of mild to moderate Alzheimer’ patients. These results support the idea that a mindfulness based intervention can produce a clinically relevant improvement in the treatment of dementia. More research is needed to confirm these data (AU)

[Effects of a neuropsychology program based on mindfulness on Alzheimer's disease: randomized double-blind clinical study]. / Efectos de un programa de intervención neuropsicológica basado en mindfulness sobre la enfermedad de Alzheimer: ensayo clínico aleatorizado a doble ciego.

INTRODUCTION: The purpose of this research was to assess effects of a mindfulness based neuropsychological intervention on the clinical course of Alzheimer's disease. MATERIAL AND METHOD: A two year randomized and double blind clinical trial was conducted on 127 probable Alzheimer's disease patients, according to NINCDS-ADRDA scale. Patients were grouped into three experimental groups (cognitive stimulation, progressive muscular relaxation, and mindfulness) plus a control group. All participants were receiving donepezil. Cognitive skills were assessed with CAMCOG and MMSE, functional area with RDRS-2, and NPI was used for psychopathology screening. Three treatment sessions per week were carried out for two years, and follow up measurements were taken every six months. RESULTS: The global cognitive function, functionality and behavioral disorders measurements indicated that patients from the experimental group based on mindfulness were stable during the two years, while patients from the control group, as well as the other experimental groups, showed a mild but significant worsening of their mental capacities. CONCLUSION: The mindfulness based neuropsychological program showed better cognitive and functional stability, as well as significant improvement in the psychopathological condition of mild to moderate Alzheimer' patients. These results support the idea that a mindfulness based intervention can produce a clinically relevant improvement in the treatment of dementia. More research is needed to confirm these data.