Mindfulness-based intervention significantly reduced depressive symptoms and increased perceived social support among informal caregivers of people with dementia.
According to their recent study published in JAMA Network Open, researchers examined the effects of five psychosocial intervention components and their interactions, and provided evidence for optimizing caregiver support programs.
The trial included 250 informal caregivers in Hong Kong, who were a mean age of 48.9 years and primarily female (68.4%). Participants were randomized into 16 experimental conditions for which they received a core psychoeducation component alongside varying combinations of self-care skills (SC), behavioral problem management (BPM), behavioral activation (BA), mindfulness-based intervention (MBI), and social support group (SG) participation. Researchers assessed changes in depressive symptoms, caregiver burden, anxiety, stress, and social support over 12 months.
MBI yielded significant improvements in reduction of depressive symptoms (β = −2.13 [95% confidence interval [CI] −2.85 to −1.38]; P < .001), increased mindfulness (β = 4.23 [95% CI = 2.27-6.36]; P < .001), perceived social support (β = 4.76 [95% CI = 1.28-8.15]; P = .007), and active dementia care management (β = 3.70 [95% CI = 1.80-5.66]; P < .001) at 12 months. SG participation also improved perceived social support (β = 4.63 [95% CI = 1.32-7.85]; P = .006). BPM had mixed effects: it initially increased caregiver anxiety (β = 1.43 [95% CI = 0.43-2.42]; P = .005) and self-care risk (β = −1.12 [95% CI = −1.82 to −0.43]; P = .002) at 6 months but improved psychological well-being (β = 3.52 [95% CI = 0.92-6.08]; P = .008) at 12 months.
Researchers then observed interaction effects between MBI and other components. They found that MBI enhanced the benefits of SC (β = −1.70 [95% CI = −3.05 to −0.35]; P = .01) and BPM (β = −1.40 [95% CI = −2.76 to −0.05]; P = .04) on depression. Additionally, "the mindfulness and support group components synergistically improved perceived social support," wrote Jojo Yan Yan Kwok, MPH, PhD, of the School of Nursing, Li Ka Shing Faculty of Medicine at the University of Hong Kong, with colleagues.
The researchers suggested that integrating MBI with SC, SG, or BPM may be an effective approach to enhancing caregiver well-being. "We recommend conducting a well-designed [randomized clinical trial] to definitively test the efficacy of integrated intervention components, explore underlying mechanisms behind observed interactive effects, assess generalizability, and investigate methods to mitigate potential adverse effects on anxiety reduction when combining group support and mindfulness-based components," they concluded.
No conflicts of interest were reported.
