Mindfulness Research Program: Designed to Enhance Wellbeing in People Living With Dementia and Their Spouses
Condition: Dementia
MeSH terms: Dementia
Study type: Interventional

Summary: 
      People with dementia forget things and have trouble concentrating. In addition, they and
      their caregivers can become depressed. This project will show whether Mindfulness-Based
      Cognitive Therapy (MBCT) can lessen depression, increase attention spans and improve quality
      of life for those affected by the disease and their caregivers.

      MBCT combines intensive training in mindfulness meditation with Cognitive Behavioural
      Therapy. Studies show the meditation component creates changes in areas of the brain
      associated with our ability to pay attention. This form of meditation can help those impacted
      by dementia become more aware of their depressive thinking, leading to improved ways of
      coping.

      The investigators predict that individuals in the early stages of dementia and their spousal
      caregivers will report fewer depression symptoms following the 8-week Mindfulness-Based
      Cognitive Therapy (MBCT) Program, as well as experience improvements in quality of life and
      daily mindfulness.

      If successful, MBCT could improve the quality of life in individuals with dementia and their
      caregivers, as well as may take pressure off the health care system by delaying
      institutionalization.
    

Detailed description: 
      The overall objective of the proposed study is to investigate the efficacy of
      Mindfulness-Based Cognitive Therapy (MBCT) to alleviate depression symptoms, increase
      attention abilities, and improve quality of life in individuals with dementia and their
      caregivers. MBCT works to help individuals increase concentration and increase awareness of
      depressive thinking to ultimately provide a better means of coping and emotional regulation.

      While dementia is non-reversible and progressive in nature, supportive interventions,
      especially at the early stage of the disease, can make life more manageable for both dementia
      individuals and their caregivers. Along with the initial signs of forgetfulness and
      concentration difficulties, it is common for both individuals with dementia and their primary
      caregivers to also experience depression symptoms. For dementia individuals, depression
      symptoms are common early on as they still have insight into their disease. This increase in
      depression has been shown to be related to apathy, overall poorer quality of life and
      cognitive decline. Caregivers not only witness a significant change in daily functioning of
      someone they love and know well, they are also faced with new responsibilities associated
      with managing the disease, while simultaneously trying to juggling their own day-to-day
      tasks. These drastic changes and increased responsibilities have been shown to increase
      feelings of depression and burden, resulting in coping-related problems in caregivers.

      Counseling intervention in early stages of dementia has been shown to delay and even decrease
      patient admittance into long-term facilities, ultimately relieving stress placed on the
      healthcare system. MBCT is a specific program designed to, and proven successful at, treating
      various populations with recurrent depression. With its unique therapeutic approach of
      integrating intensive training in mindfulness meditation with Cognitive Behavioural Therapy,
      MBCT helps individuals pay greater attention, increase concentration, increase awareness of
      depressive thinking and learn to apply more skillful means of coping. In addition to treating
      depression, the meditation component of MBCT has also been shown to improve various aspects
      of attention and result in changes in neural networks implicated in attention processes. The
      investigators predict that MBCT will alleviate depression symptoms and increase quality of
      life in both patients and caregivers. The investigators also expect that individuals will
      experience improvements in attention and memory abilities.

      If successful, MBCT could improve overall quality of life in dementia individuals and
      caregivers, as well as benefit our healthcare system by delaying institutionalization. From a
      research perspective, success of this program may lead to a larger clinical controlled trial
      to further investigate the efficacy of MBCT in individuals affected by dementia.
    

Intervention name(s): Mindfulness-Based Cognitive Therapy
Intervention type(s): Behavioral
Intervention description(s): In the experimental condition, individuals with dementia (n = 15) and their spouses (n = 15) will partake in one MBCT session per week for 8 weeks. The partners will attend separate MBCT sessions (different day of the week). In the control condition, individuals with dementia (n = 15) and their spouses (n= 15) will go through an 8-week waitlist control period.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Dementia; Spouse Caregiver; Depression; Mind Body Therapy; Cognitive Therapy; Quality of Life; Attention; Memory