Mindfulness in the Maintenance of Cognitive Capacities in Alzheimer's Disease: A Randomized Clinical Trial

Abstract

Background: The Canary Islands longitudinal study on non-pharmacological treatments showed the overall effectiveness of mindfulness in Alzheimer's disease (AD). However, no specific data on the maintenance of cognitive capacities were presented.

Objective: To determine whether the practice of mindfulness modifies the course of cognitive impairment in AD.

Design: Longitudinal, non-inferiority and equivalence, randomized clinical trial, repeated-measures design, with three experimental groups and one control group.

Participants: Patients with AD who voluntarily attended the Lidia García Foundation (n = 502). Only those who were treated with donepezil and MMSE ≥18 were included (n = 120).

Intervention: Over a two-year period, each group carried out three weekly sessions of stimulation based on mindfulness, cognitive stimulation therapy, and progressive muscle relaxation.

Measures: Cognitive assessment CAMDEX-R (MMSE and CAMCOG).

Statistical analysis: Repeated-measures ANOVA (p < 0.05) and the effect size Cohen's d were performed.

Results: The mindfulness group showed significant scores compared with the control and muscle relaxation groups (p < 0.05), while mindfulness and cognitive stimulation therapy were equivalent (p≥0.05). Group cognitive stimulation evolved better than the control (p < 0.05) group but not better than the muscle relaxation group (p≥0.05). The effect size compared over two years was large for the mindfulness group (p≥0.80), moderate for the relaxation group (p≥0.50), and low for the cognitive stimulation group (p≥0.20).

Conclusion: The practice of mindfulness maintained cognitive function over a period of two years. This longitudinal study suggests that mindfulness can be used as a non-pharmacological treatment to slow cognitive impairment in AD.

Keywords: Alzheimer’s disease; cognitive impairment; cognitive stimulation therapy; mindfulness; non-pharmacological treatments; progressive muscle relaxation.