Mindfulness-Based Training Does Not Improve Neuropsychological Outcomes in Mild Cognitive Impairment More Than Spontaneous Reversion Rates: A Randomized Controlled Trial.

Abstract

BACKGROUND\nCurrent pharmacological and behavioral treatment options for mild cognitive impairment (MCI) are limited, motivating a search for alternative therapies that might slow the progression of cognitive decline.\n\n\nOBJECTIVE\nWe investigated the effectiveness of a cognition-focused mindfulness-based intervention.\n\n\nMETHODS\nAn open-label, three arm randomized controlled trial was conducted at a public tertiary medical center. Older persons (ages 45-75; N\u200a=\u200a76) diagnosed with MCI were recruited and randomized into either Mindfulness-based training (MBT), cognitive rehabilitation therapy (CRT), or treatment as usual (TAU). Participants in the intervention arms received 8 weekly 2-h sessions delivered in a group setting and engaged in home practice. Primary outcomes measures included changes in index scores for attention, immediate memory, and delayed memory as measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Depression was a secondary outcome.\n\n\nRESULTS\nUsing intent-to-treat analysis, we found that participants receiving MBT showed significant improvements in global cognition (d\u200a=\u200a0.26; [95%CI 0.03-0.56]) and delayed memory (d\u200a=\u200a0.36; [95%CI 0.17-0.57]), with significantly greater improvements in delayed memory than CRT (ηp2\u200a=\u200a0.10). However, there was no benefit of MBT over TAU. No change in depression was observed in the MBT group. Reductions in depression were associated with improvements in cognitive functioning in the MBT group only.\n\n\nCONCLUSION\nOur results suggest that a cognition-focused MBT did not improve cognitive functioning in MCI patients substantially more than spontaneous reversion rates, possibly as mood symptoms were not significantly alleviated in this group.