Mindfulness-based stress reduction for older adults with worry symptoms and co-occurring cognitive dysfunction
Open accessAbstract
Background: Mindfulness‐based stress reduction (MBSR) has the potential to reduce worry and improve cognitive functioning. Objectives: In this treatment development project, we examined MBSR in older adults with worry symptoms and co‐occurring cognitive dysfunction. We examined (i) acceptability of MBSR, (ii) whether MBSR needs to be lengthened providing more repetition, (iii) MBSR's benefits for worry reduction and cognitive improvements, and (iv) continued use of MBSR techniques during follow‐up. Methods: Two sites (St. Louis and San Diego) enrolled individuals aged 65 years or older with significant anxiety‐related distress plus subjective cognitive dysfunction, into traditional 8‐session MBSR groups and 12‐session groups that had the same content but more repetition of topics and techniques. We examined measures of mindfulness, worry, and a neuropsychological battery focused on memory and executive function before and after the MBSR program, and we followed up participants for 6 months after the completion of MBSR regarding their continued use of its techniques. Results: Participants ( N = 34) showed improvements in worry severity, increases in mindfulness, and improvements in memory as measured by paragraph learning and recall after a delay, all with a large effect size. Most participants continued to use MBSR techniques for 6 months post‐instruction and found them helpful in stressful situations. There was no evidence that the extended 12‐week MBSR produced superior cognitive or clinical outcomes, greater satisfaction, or greater continuation of MBSR techniques than 8‐week MBSR. Conclusions: These preliminary findings are promising for the further testing and use of MBSR in older adults suffering from clinical worry symptoms and co‐occurring cognitive dysfunction. These are common problems in a broad range of older adults, many of whom have anxiety and mood disorders; therefore, stress reduction intervention for them may have great public health value. Copyright © 2014 John Wiley & Sons, Ltd.
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Only a few studies have examined other psychological interventions such as acceptance and commitment therapy and mindfulness-based stress reduction for generalised anxiety disorder in older people.
“Only a few have examined other psychological interventions such as acceptance and commitment therapy (ACT) and mindfulness-based stress reduction.27,28”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [28]
The Methods (Sample; page unavailable) show that this paper examined mindfulness-based stress reduction in adults aged 65 or older with significant worry and cognitive complaints. The Results (page unavailable) report that 12 of 34 participants had generalized anxiety disorder, but the study did not require that diagnosis. It therefore supports the mindfulness-based stress reduction example, not a study specifically of older people with generalized anxiety disorder; it also does not establish how few such studies existed. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMBSR was effective in anxious older adults; patients experienced decreased worry severity and improved memory.
“The study showed that MBSR was effective in anxious older adults; the patients experienced positive developments such as decreased worry severity and improved memory.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Abstract Results and Results sections report decreased worry severity and improved memory after MBSR. However, the Discussion calls the findings preliminary and says the study had no control group, so it does not establish that MBSR was effective rather than that participants improved during the study. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMBSR is efficacious for treating anxiety, depression, and worry in older adults and veterans.
“The studies show the efficacy of MBSR for treating anxiety, depression, and worry in older adults and veterans, even reducing patients' suicidal ideation.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Discussion reports improved worry severity in older adults and calls the findings preliminary because the small treatment-development study had no control group. The paper does not establish efficacy for treating anxiety or depression in this population, and it does not report results in veterans. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMBSR was effective in anxious older adults.
“The study showed that MBSR was effective in anxious older adults; the patients experienced positive developments such as decreased worry severity and improved memory.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Discussion reports improvements in worry severity and memory among older adults with high worry symptoms and co-occurring cognitive dysfunction. But it calls efficacy preliminary: this was a small treatment-development study without a control group, so saying MBSR was effective overstates the finding. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPatients experienced decreased worry severity and improved memory.
“The study showed that MBSR was effective in anxious older adults; the patients experienced positive developments such as decreased worry severity and improved memory.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Abstract Results and Results sections report reduced worry severity and improved memory after MBSR. However, the Discussion calls these findings preliminary, notes that the study had no control group, and says a randomized trial is needed to demonstrate efficacy. The claim that MBSR was effective is therefore stronger than the paper supports. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Mindfulness decreases worry, negative thoughts and feelings, and ameliorates cognitive dysfunction in older adults.
“Anxiety disorders are centered on excessive worrying about future events and negative thoughts, and the practice of mindfulness helps individuals focus on the present moment, helping to decrease worry, negative thoughts and feelings, and to ameliorate cognitive dysfunction in older adults.[14][15][16]19”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Results (Clinical outcomes; Cognitive outcomes, page unavailable) report reduced worry and improved memory after mindfulness-based stress reduction in older adults. The Introduction describes mindfulness as attention to the present rather than dwelling on the future. But the paper does not establish a reduction in negative thoughts and feelings, and the Discussion calls the cognitive findings preliminary because the small study had no control group; the claim presents these effects more definitively than the source does. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAnxiety disorders are centered on excessive worrying about future events and negative thoughts.
“Anxiety disorders are centered on excessive worrying about future events and negative thoughts, and the practice of mindfulness helps individuals focus on the present moment, helping to decrease worry, negative thoughts and feelings, and to ameliorate cognitive dysfunction in older adults.[14][15][16]19”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Introduction links excessive worry to late-life anxiety disorders and describes worrying as dwelling on the future. It does not say that anxiety disorders generally are centered on worry and negative thoughts; the study focuses on older adults with worry symptoms. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOnly a few studies have examined other psychological interventions such as acceptance and commitment therapy and mindfulness-based stress reduction for GAD in older people.
“Only a few have examined other psychological interventions such as acceptance and commitment therapy (ACT) and mindfulness-based stress reduction.27,28”
From Acceptance and commitment therapy for older people with treatment-resistant generalised anxiety disorder: The FACTOID feasibility study (2021) · cites this paper as [28]
Lenze et al. (2014) found that the MAAS does not account for increases in mindfulness due to the effects of MBSR, attributing this shortcoming to possible difficulty some older adults may have in understanding items on this measure.
“Lenze et al. (2014) found that the MAAS does not account for increases in mindfulness due to the effects of MBSR, attributing this shortcoming to the possible difficulty some older adults may have in understanding items on this measure.”
From Anxiety Sensitivity, Experiential Avoidance, and Mindfulness Among Younger and Older Adults: Age Differences in Risk Factors for Anxiety Symptoms (2015) · cites this paper as Lenze et al. (2014)
The data did not show a significant difference in cognitive or clinical performance due to MBSR techniques in the 12-week MBSR program compared to the 8-week MBSR program.
“The data did not show a significant difference in cognitive or clinical performance due to MBSR techniques in the 12-week MBSR program compared to the 8-week MBSR program.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
Mindfulness helps individuals focus on the present moment.
“Anxiety disorders are centered on excessive worrying about future events and negative thoughts, and the practice of mindfulness helps individuals focus on the present moment, helping to decrease worry, negative thoughts and feelings, and to ameliorate cognitive dysfunction in older adults.[14][15][16]19”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
MBSR reduces suicidal ideation in older adults and veterans.
“even reducing patients' suicidal ideation.”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Discussion reports preliminary improvements in worry severity, memory, and executive function among older adults, but does not address suicidal ideation. Searches for suicidal ideation, suicide, and veterans found no relevant passage in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measuredStudy limitations include failure to provide details from medical records on veterans' characteristics that could have influenced treatment effect.
“Study limitations include failure to not provide details from medical records on veterans'”
From Mindfulness in mood and anxiety disorders: A review of the literature (2017) · cites this paper as [14]
The Methods (Sample) describe older adults recruited from the community and outpatient clinics, and the Results describe their baseline characteristics. Searches for veterans, medical records, and missing patient characteristics found no passage stating the claimed limitation or linking such characteristics to treatment effects. (LLM, conf=0.76)
Experimental — accuracy not yet measuredOne pilot study included 34 older adults with SCD and showed improved worry severity.
“One pilot study included 34 older adults with SCD and showed improved worry severity (Lenze et al., 2014).”
From Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions (2018) · cites this paper as Lenze et al., 2014
Lenze et al. (2014) found significant improvement post-intervention in list learning, delayed recall, paragraph immediate recall, paragraph delayed recall, verbal fluency, color-word interference, worry reduction (PSWQ-A), and mindfulness (measured by CAMS-R, but not MAAS).
“Sign. improvement post-intervention List, delayed recall, Paragraph immediate recall, Paragraph delayed recall, Verbal Fluency Color-word interference, worry reduction (PSWQ-A), mindfulness (measured by CAMS-R, but not MAAS),”
From Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions (2018) · cites this paper as Lenze et al., 2014
A 12-week MBSR and an 8-week MBSR did not differ in effects in older adults with worry symptoms and subjective cognitive dysfunction.
“However, one study compared an extended 12-week MBSR to an 8-week MBSR in older adults with worry symptoms and subjective cognitive dysfunction, and they found no difference in effects for the different duration of the MBSR (Lenze et al., 2014).”
From Mindfulness Training for People With Dementia and Their Caregivers: Rationale, Current Research, and Future Directions (2018) · cites this paper as Lenze et al., 2014
Behavioral treatments can improve executive dysfunction and traits linked to neuroticism in older people.
“increasing evidence suggests executive dysfunction and constructs associated with neuroticism respond to behavioral interventions in older adults15–17.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [17]
Clinical research indicates that cognitive training, mindfulness meditation, and aerobic exercise reduce depressive symptoms and improve executive dysfunction or neuroticism in late-life depression.
“clinical studies suggest cognitive training, mindfulness meditation, and aerobic exercise improve depression symptoms and executive dysfunction or neuroticism in LLD 17, 40, 41.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [17]
In 34 older adults, 73% with generalized anxiety disorder or a depressive disorder, mindfulness meditation training produced six-month improvements in worry severity, executive function, and memory.
“The authors initially demonstrated the treatment efficacy of MMT in 34 older adults, 73% of whom met criteria for a diagnosis of generalized anxiety disorder or a depressive disorder (i.e., both LLD and minor depressive symptoms)17. MMT resulted in six-month improvements in worry severity and executive functioning and memory.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [17]
Mindfulness meditation training improves cognitive problems and psychiatric symptoms in older adults.
“MMT improves cognitive dysfunction and psychopathology in older adults.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [17]
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Effects of Complementary Therapy on Health in a National U.S. Sample of Older Adults
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Escitalopram for Older Adults With Generalized Anxiety Disorder: A Randomized Controlled Trial
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Self-citation
Flagged first, then by citations
Research works printed but not linked: 1
- FIRST M SPITZER R GIBBON M WILLIAMS J Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) 1997 American Psychiatric Press Washington, D.C.
Cited by
Sorted by citations
Moore, R. C., Depp, C. A., Wetherell, J. L., & Lenze, E. J. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.01.011 · Cited by 274 · see citing works
Self-citationGeiger, P. J., Boggero, I. A., Brake, C. A., Caldera, C. A., Combs, H. L., Peters, J. R., & Baer, R. A. (2016) · Mindfulness · doi:10.1007/s12671-015-0444-1 · Cited by 205 · see citing works
Parmentier, F. B. R., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.00506 · Cited by 172 · see citing works
Li, S. Y. H., & Bressington, D. (2019) · International Journal of Mental Health Nursing · doi:10.1111/inm.12568 · Cited by 142 · see citing works
Hazlett-Stevens, H., Singer, J., & Chong, A. (2019) · Clinical Gerontologist · doi:10.1080/07317115.2018.1518282 · Cited by 123 · see citing works
Effects of mindfulness training on cognition and well-being in healthy older adults.
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New Research on Anxiety Disorders in the Elderly and an Update on Evidence-Based Treatments
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“Lenze et al.14 150 min 1x/week 8 weeks 12 weeks Group-based session plus one day-long retreat or 2.5 hour retreat 3 months 6 moths MAAS CAMS-R The study showed that MBSR was effective in anxious older adults; the patients experienced positive developments such as decreased worry severity and…”
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An adapted mindfulness intervention for people with dementia in care homes: feasibility pilot study
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Mind-Body Therapies for Late-Life Mental and Cognitive Health
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Marchant, N. L., Barnhofer, T., Coueron, R., Wirth, M., Lutz, A., Arenaza-Urquijo, E. M., Collette, F., Poisnel, G., Demnitz-King, H., Schild, A.-K., et al. (2021) · Psychotherapy and Psychosomatics · doi:10.1159/000515669 · Cited by 40 · see citing works
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Cognitive and Affective Mindfulness Scale-Revised (CAMS-R)
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“Most importantly, a significant interaction was found between time and group, yielding a moderate effect size, F(1,21) = 4.”
BackgroundMethodInfluentialAging Mindfully to Minimize Cognitive Decline
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Self-citationPsychotherapeutic Treatment Approaches of Anxiety Disorders in the Elderly
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Bryant, C. (2016) · Mental Health and Illness Worldwide · doi:10.1007/978-981-10-0370-7_21-1 · Cited by 1 · see citing works
- Authors
- Lenze, E. J., Hickman, S., Hershey, T., Wendleton, L., Ly, K., Dixon, D., Doré, P., & Wetherell, J. L.
- Affiliations
- Washington University in St. Louis (US)
- University of California San Diego (US)
- Corresponding author
- Lenze, Eric J.
- ORCID
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2014-02-18
- Volume
- 29
- Issue
- 10
- Pages
- 991-1000
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- PMC
- PMC4136987
- OpenAlex
- W1484996231
- Semantic Scholar
- 694c6a55c7995f0407c32abefad044cad1311c66
- Cited by
- 207
- References
- 63
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 16 · 2023: 16 · 2022: 34 · 2021: 31 · 2020: 15 · 2019: 15 · 2018: 20 · 2017: 16 · 2016: 11 · 2015: 9 · 2014: 2
- FWCI
- 14.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Center for Complementary and Alternative Medicine (R34 AT007064)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- mindfulness-based stress reduction, older adults, worry, cognitive impairment, anxiety, memory, executive function, treatment acceptability, program duration, stress reduction intervention
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Anxiety Disorders, Cognition Disorders, Depressive Disorder, Feasibility Studies, Female, Humans, Male, Stress, Psychological, Yoga, Exercise, Meditation, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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