Effects of Mindfulness-Based Cognitive Therapy on Peripheral Markers of Stress and Inflammation in Older-Adults With Depression and Anxiety: A Parallel Analysis of a Randomized Controlled Trial.

Background: Depression and anxiety are prevalent in older-adults and often difficult to treat: up to 55% of patients are unresponsive to pharmacotherapy. Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment, however, its biological mechanisms remain unknown in older-adults. Methods: We examined if, in older-adults, decreased depression and anxiety symptoms after MBCT are associated with changes in the expression levels of C-reactive protein, Interleukin-1ß, Monocyte chemoattractant protein-1 and mineralocorticoid receptor compared to treatment as usual (TAU). Older-adults (age ≥60) with depression and anxiety were randomized to MBCT or treatment as usual. Gene expression levels from blood samples were measured using quantitative polymerase chain reaction (n = 37) at baseline and after 8-weeks of MBCT or TAU. Results: As previously published, we found a significant reduction in symptoms of depression F (1, 35) = 10.68, p = 0.002, partial η2 = 0.23 and anxiety F (1, 35) = 9.36, p = 0.004, partial η2 = 0.21 in geriatric participants following MBCT compared to TAU. However, the expression levels of measured genes were not significantly different between groups and were not associated with changes in depression and anxiety symptoms. Conclusion: Our results suggest that the symptom reduction following MBCT in older-adults may not be accompanied by changes in the stress-response and inflammatory pathways. Future research should address other potential biological alterations associated to MBCT that may be responsible for the reduction of symptoms.

Continuation Sessions of Mindfulness-Based Cognitive Therapy (MBCT-C) vs. Treatment as Usual in Late-Life Depression and Anxiety: An Open-Label Extension Study.

OBJECTIVES: Mindfulness-based cognitive therapy (MBCT) is a novel treatment for depression. Our published randomized controlled trial shows that MBCT improves symptoms of late-life depression (LLD) and anxiety (LLA). We now examine whether continuation sessions of MBCT (MBCT-C) can prevent LLD/LLA symptom recurrence. METHODS/DESIGN: Following an 8-week MBCT intervention, we compared patients who attended open-label weekly 1-hour MBCT-C for another 26 weeks (n = 10) vs those who did not (n = 17) for change in depressive and anxiety symptoms. RESULTS: While there were no significant differences between groups on depressive or anxiety symptom severities between 8- and 34- weeks (Cohen's d = 0.045), we observed a small clinical effect of MBCT-C on symptoms of anxiety (d = 0.29). CONCLUSIONS: These preliminary results suggest that MBCT-C may be somewhat beneficial for symptoms of LLA, but not for LLD. Healthcare providers should consider what is clinically feasible before investing time and resources into MBCT-C in older adults with depression and/or anxiety.

Selective familiarity deficits in otherwise cognitively intact aging individuals with genetic risk for Alzheimer's disease.

INTRODUCTION: Familiarity has been associated with integrity of the rhinal cortex. Thus, impairment in familiarity is expected in very early stages of Alzheimer's disease (AD). The apolipoprotein E (APOE) ε4 allele is a major risk factor for AD. Here, we investigated the effect of the APOE ε4 status on familiarity in cognitively normal aging individuals. METHODS: Eighty-one individuals aged between 55 and 80 years, 21 carriers and 60 noncarriers, were used in these analyses. A cognitive evaluation was performed on all participants to document the absence of objective cognitive deficits. The effect of APOE ε4 status on familiarity was tested using independent sample t test and an analysis of covariance controlling for age, gender, and education. RESULTS: The groups did not differ in term of age, education, and male/female ratio. APOE ε4 carriers showed a significant reduction in familiarity. No other cognitive deficit was observed in the group of ε4 carriers, relative to noncarriers. DISCUSSION: APOE ε4 is associated with a reduction in familiarity in the absence of other cognitive deficits. These results suggest that performance in familiarity could represent an early cognitive marker for individuals at risk of AD.