Beneficial Effects of Mindfulness-based Training on Neuropsychological Outcomes in Mild Cognitive Impairment
Condition: Mild Cognitive Impairment
MeSH terms: Cognitive Dysfunction
Study type: Interventional

Summary: 
      This study evaluates the effects of Mindfulness-based Interventions (MBI) on the
      neuropsychological profile of individuals with mild cognitive impairment (MCI). It will also
      investigate changes in fMRI activity, such as resting-state functional connectivity networks
      and changes in activity in attention networks in task-related fMRI using graph theory
      analysis after Mindfulness-based Interventions. Participants will be randomly assigned to
      receive either the Mindfulness-Based Intervention, Cognitive Rehabilitation Training or
      Treatment as Usual as the passive control group comparison.
    

Detailed description: 
      As the population of Singapore ages rapidly, cognitive decline associated with both normal
      aging and disease is becoming a frequently encountered health challenge. In our proposed
      study, we will investigate the effects of mindfulness-based interventions (MBI), which have
      shown significant promise in halting and even reversing age-related cognitive impairment. MBI
      enhances the quality and frequency of mindfulness, defined as a mental state achieved by
      focusing one's attention and awareness on the present moment, while calmly acknowledging and
      accepting one's feelings, thoughts, and bodily sensations. In this study, we will administer
      a standardized MBI program or Cognitive Rehabilitation Therapy to a group of 60 patients
      diagnosed with mild cognitive impairment (MCI), a condition marked by deficits in language,
      memory and attention that often leads to dementia; an additional 30 patients will be assigned
      to the control group. There will be 3 runs with 30 persons per run; each group will have 10
      randomly assigned participants. By comparing the 3 groups across the 3 runs, we seek to test
      the following hypotheses: 1) MBI will result in significantly greater improvements in
      neuropsychological testing outcomes across multiple cognitive domains, including attention,
      memory, language and processing speed, 2) MBI will strengthen cortical connectivity as
      measured by functional magnetic resonance imaging (fMRI), and 3) MBI will lead to changes in
      fMRI activation on a test of facets of attention. Neuropsychological testing will take place
      in SGH, while fMRI and EEG scanning will take place in the Center for Cognitive Neuroscience
      at Duke-NUS. Both the MBI and CRT will be facilitated by trained personnel. Our proposed
      experiment comprises one of the most comprehensive interrogations of the effects of MBT on
      patients to date, and if successful, could rapidly translate into a program with both
      clinical and economic impact.
    

Intervention name(s): Mindfulness Based Training (MBT) Program; Cognitive Rehabilitation Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants in the MBT program will meet weekly for 8 weeks. Each session will last one-and-a-half hours. Mindfulness, defined as caring moment-to-moment awareness, will be cultivated through the teaching and formal practice of sitting and walking meditation, body scan, and mindful movement (e.g. yoga). Participants will also be taught how to practice mindfulness informally when eating, engaging in pleasurable activities and through interactions with others. Participants will be encouraged to practice approximately 30 minutes a day, and will be provided handouts as well as guided audio recordings of formal practices taught in session to aid their practice at home.; Participants in the CRT program will meet weekly for 8 weeks. Each session will last one-and-a-half hours. The 8 week-program will consist of the following components: (i) identifying and working on at least one personal rehabilitation goal related to everyday life that is associated with cognitive difficulties; (ii) reviewing and building on the use of practical memory strategies, and or introducing and teaching the use of a new strategy or memory aid; (iii) introducing techniques for learning new information and associations, identifying the preferred strategy, and encouraging the application of this strategy in daily life; (iv) providing practice in maintaining attention and concentration; and (v) exploring current ways of coping with stress and anxiety as well as providing relaxation techniques to help aid with coping (Clare, 2007). Participants will be provided with instructional hand-outs as well as logs to record, monitor and evaluate their progress.
Other intervention name(s): MBT; CRT
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: Participants will be randomly assigned to receive either the treatment intervention, Mindfulness-Based Intervention, compared against an active control, the Cognitive Rehabilitation Training in parallel and both groups will also be compared against a passive control group, the Treatment as Usual, where no intervention takes place.
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Mindfulness; Cognitive Rehabilitation