HONOLULU – Twenty minutes per day of either meditation or relaxation improved depression scores in family caregivers of people with dementia, but meditation seemed to provide additional benefits in a randomized, controlled pilot study in 39 caregivers.
Mental functioning and cognition scores improved significantly in the meditation group, compared with the relaxation group, Dr. Helen Lavretsky and Dr. Michael Irwin reported in a poster presentation at the annual meeting of the American Psychiatric Association. Both are professors of psychiatry and biobehavioral sciences at the University of California, Los Angeles.
Dr. Helen Lavretsky
The 23 caregivers in the meditation group averaged 61 years of age and the 16 caregivers in the relaxation group averaged 61 years of age. They had been caring for a family member with dementia for 5 years and 4 years, respectively. Participants in the relaxation group spent significantly more time per week in caregiving, averaging 63 hours vs. 48 in the meditation group. Hamilton Rating Scale–Depression (HAM-D) scores at baseline were 11.8 in the meditation group and 11.4 in the relaxation group.
Participants in the meditation group were trained in a yoga practice of meditation called Kirtan Kriya that involves chanting, breath work, and finger poses. Participants in the control group were asked to rest quietly while listening to relaxation recordings. Each group devoted 20 minutes per day to the activity for 8 weeks.
In both groups, devoting time each day to self-care was new to participants, all but two of whom were women, Dr. Lavretsky said in an interview.
HAM-D scores improved by 7 points in the meditation group and by 5 points in the relaxation group, a difference that was not statistically significant. The perceived burden of care improved in both groups, too.
In the meditation group, however, 52% showed at least a 50% improvement on the 36-item short form health survey (SF-36) global mental health score, compared with 19% in the relaxation group, which was a significant difference between groups.
Measures of cognition also improved significantly in the meditation group, compared with the control group. Mini-Mental Status Examination scores increased by 0.2 points in the meditation group and decreased by 0.9 points in the relaxation group. Times to complete the Trail Making Test (Part B), a measure of executive function, decreased by 11.2 seconds in the meditation group but increased by 9.9 seconds in the relaxation group.
Preliminary data from several other measures in the study suggest biological differences in outcomes, Dr. Lavretsky said. Intranuclear staining and flow cytometry showed that a significantly lower proportion of lymphocytes was positive for nuclear transcription factor–kappa beta (a protein complex that has been linked to chronic stress and inflammatory responses) in the meditation practitioners, compared with the control group. The meditation group also showed increased telomerase activity, compared with the relaxation group. Telomere length and telomerase activity are markers of biological age linking stress and disease, she said.
PET scan results suggested that improvements in cognition were associated with changes in regional brain metabolism in areas relevant for executive dysfunction and global cognition.
This and other studies suggest that meditation, tai chi, or other mind-body techniques seem to be helpful stress-reducing therapies for family caregivers of people with dementia, Dr. Lavretsky said.
A larger study is planned that also will compare the Kirtan Kriya form of meditation with aerobic exercise in stressed family caregivers of people with dementia, she said.
The Alzheimer’s Research and Prevention Foundation funded the study. Dr. Lavretsky is a certified yoga instructor who has practices the Kirtan Kriya form of meditation.