Mindfulness-Based Stress Reduction for Symptom Management in Older Individuals with HIV-Associated Neurocognitive Disorder.
Judith T Moskowitz, Brijesh Sharma, Shireen Javandel, Patricia Moran, Robert Paul, Victor De Gruttola, Dimitre Tomov, Haleem Azmy, Rodrigo Sandoval, Madeline Hillis, Karen P Chen, Torie Tsuei, Elizabeth L Addington, Peter D Cummings, Joanna Hellmuth, Isabel Elaine Allen, Beau M Ances, Victor Valcour, Benedetta Milanini
AIDS and behavior June 1, 2024 DOI: 10.1007/s10461-024-04295-1
Summary
Mindfulness-Based Stress Reduction (MBSR) significantly improved depression symptoms and perceived quality of life in older adults with HIV-associated neurocognitive disorder (HAND). In a study involving 180 participants aged 55 and older, those who underwent an 8-week MBSR program experienced notable reductions in depression levels compared to a waitlist control group. While these benefits were not maintained at 16 weeks, improvements in quality of life persisted. Cognitive performance remained unchanged, highlighting MBSR's potential for enhancing emotional well-being among this vulnerable population.
Abstract
The growing number of people aging with HIV represents a group vulnerable to the symptom burdens of HIV-associated neurocognitive disorder (HAND). Among younger groups, Mindfulness-Based Stress Reduction (MBSR) has been shown to help people living with HIV manage HIV-related and other life stress, and although there is some theoretical and empirical evidence that it may be effective among those with cognitive deficits, the approach has not been studied in older populations with HAND. Participants (n = 180) 55 years or older with HIV and cognitive impairment were randomly assigned to either an 8-week MBSR arm or a waitlist control. We assessed the impact of MBSR compared to a waitlist control on psychological outcomes [stress, anxiety, depression, and quality of life (QOL)] and cognitive metrics (e.g., speed of information processing, working memory, attention, impulsivity) measured at baseline, immediately post intervention (8 weeks) and one month later (16 weeks). Intent to treat analyses showed significant improvement in the MBSR group compared to control on symptoms of depression from baseline to 8 weeks, however, the difference was not sustained at 16 weeks. The MBSR group also showed improvement in perceived QOL from baseline to 16 weeks compared to the waitlist control group. Cognitive performance did not differ between the two treatment arms. MBSR shows promise as a tool to help alleviate the symptom burden of depression and low QOL in older individuals living with HAND and future work should address methods to better sustain the beneficial impact on depression and QOL.