Can mindfulness-based interventions benefit people with dementia? Drawing on the evidence from a systematic review in populations with cognitive impairments

ABSTRACT

Introduction

Non-pharmacological interventions that promote quality of life in people with dementia are urgently needed. To accelerate development, evidence-based psychotherapies used in other populations can be considered. Mindfulness-based interventions with standardized protocols, namely mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR), may be effective in people with dementia, although tailoring for cognitive impairment may be needed. Evidence from other cognitive disorders can inform research.

Areas covered

The authors reviewed 12 studies of MBCT/MBSR conducted in people with cognitive impairments, including 10 in stroke, traumatic brain injury, and mild cognitive impairment; and two in dementia. Protocol modifications, outcomes, and evidence quality were analyzed. Common themes to address cognitive difficulties included: shortened session duration, use of memory aids, increase in repetition, simplified language, and omitted retreat sessions.

Expert opinion

MBCT and MBSR can be applied without drastic modifications in people with cognitive impairment. Their effectiveness in people with dementia remains unknown: empirical studies using/adapting evidence-based MBCT/MBSR protocols in this population is seriously lacking. Studies used a diverse range of outcome measures, which made direct comparison difficult. Further research with high methodological quality, sufficient power, and longer follow-up is urgently needed. Development of manuals would enhance the replicability of future studies.

KEYWORDS:

• Dementia
• mild cognitive impairment
• mindfulness-based cognitive therapy
• mindfulness-based stress reduction
• intervention modification

Article highlights

• Both mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) appear feasible in people with cognitive impairments.

• Minor modifications were mainly observed in delivery format such as duration, without having to tailor the intervention content according to cognitive ability such as abstract thinking.

• Anecdotal evidence suggests mindfulness-based intervention may be effective even in later stages of dementia.

• Empirical studies of mindfulness-based intervention using/adapting evidence-based protocols of MBCT or MBSR in people with dementia are seriously lacking.

• Future studies need to also include measures of mindfulness to inform the theoretical basis of applying mindfulness-based interventions in people living with dementia.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.