Mindfulness-Based Stress Reduction (MBSR) is a mind-body technique that incorporates mindfulness meditation, yoga, and cognitive reappraisal with the goal of self-managing the psychological and physical distress resulting from stress, as well as pain, cancer and other illnesses. Although MBSR has been in existence for 20 years and has been incorporated into numerous clinical settings, few randomized clinical trials (RCTs) have evaluated its effects on stress reduction, or the physiological mechanism by which MBSR reduces stress. Caregivers to persons with Alzheimer's Disease (AD) experience high levels of stress, depressive symptoms, and adverse physical health outcomes, likely as a result of chronic stress. However, psycho-educational interventions for AD caregivers have shown only modest benefits on self-reported stress, probably because they teach techniques to deal with current caregiving problems which become less useful as the care recipient's disease progresses. In contrast, MBSR presents a conceptually effective stress reduction method for AD caregivers because of its generic approach to stress management and adaptability to various stressful situations. ? This revised proposed R21 study is guided by psychoneuoimmunology (PNI) theory.
It aims to design and pilot-test an RCT of an 8-week MBSR intervention for older adult AD caregivers to reduce perceived stress, depressive symptoms, and improve two biological markers of PNI mechanisms: dihydroepiandrosterone-sulfate (DHEA-S) and interleukin-6 (IL-6). This study has two phases. The first phase is a development phase in which a team of MBSR experts will design the curriculum and training materials for an 8-week MBSR program adapted for elderly caregivers, and an 8-week social contact program to be used for comparison purposes. The second phase will be a pilot test of an RCT comparing this MBSR program to a social contact control group on short-term (pre-post intervention) and 6-month change in perceived stress, depressive symptoms, and biological markers among 72 elderly AD caregivers, recruited from the Boston University (BU) Alzheimer's Disease Center. Data collection will take place at the BU General Clinical Research Center. The results will provide information on rates of eligibility, participation, compliance and attrition; respondents' willingness to provide biological specimens; and the overall protocol for the future RCT. Mixed effects models will be used to test hypotheses comparing the MBSR group to the control group on changes in perceived stress, depressive symptoms, and DHEA-S and IL-6. The results will guide the design of a larger RCT of the effects of MBSR on reducing stress, and will provide insight into the physiological mechanisms of MBSR. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Center for Complementary & Alternative Medicine (NCCAM)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AT002959-01A2
Application #
7208470
Study Section
Special Emphasis Panel (ZAT1-JH (16))
Program Officer
Stoney, Catherine
Project Start
2007-03-01
Project End
2010-02-28
Budget Start
2007-03-01
Budget End
2008-02-29
Support Year
1
Fiscal Year
2007
Total Cost
$203,125
Indirect Cost
Name
Boston University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
604483045
City
Boston
State
MA
Country
United States
Zip Code
02118
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Bertrand, Rosanna M; Saczynski, Jane S; Mezzacappa, Catherine et al. (2012) Caregiving and cognitive function in older women: evidence for the healthy caregiver hypothesis. J Aging Health 24:48-66