Mindfulness Meditation Reduces Loneliness in Older Adults

Mindfulness Meditation Training Also Lowers Inflammation Levels and Alters Gene Expression

For older adults, loneliness is a major risk factor for health problems — such as cardiovascular disease and Alzheimer's — and death. Attempts to diminish loneliness with social networking programs like creating community centers to encourage new relationships have not been effective.

However, a new study led by Carnegie Mellon University's J. David Creswell offers the first evidence that mindfulness meditation reduces loneliness in older adults. Published in "Brain, Behavior & Immunity," the researchers also found that mindfulness meditation — a 2,500-year-old practice dating back to Buddha that focuses on creating an attentive awareness of the present moment — lowered inflammation levels, which is thought to promote the development and progression of many diseases. These findings provide valuable insights into how mindfulness meditation training can be used as a novel approach for reducing loneliness and the risk of disease in older adults.

"We always tell people to quit smoking for health reasons, but rarely do we think about loneliness in the same way," said Creswell, assistant professor of psychology within CMU's Dietrich College of Humanities and Social Sciences. "We know that loneliness is a major risk factor for health problems and mortality in older adults. This research suggests that mindfulness meditation training is a promising intervention for improving the health of older adults."

For the study, the research team recruited 40 healthy adults aged 55-85 who indicated an interest in learning mindfulness meditation techniques. Each person was assessed at the beginning and end of the study using an established loneliness scale. Blood samples also were collected.

The participants were randomly assigned to receive either the eight-week Mindfulness-Based Stress Reduction (MBSR) program or no treatment. The MBSR program consisted of weekly two-hour meetings in which participants learned body awareness techniques — noticing sensations and working on breathing — and worked their way toward understanding how to mindfully attend to their emotions and daily life practices. They also were asked to practice mindfulness meditation exercises for 30 minutes each day at home and attended a daylong retreat.

The researchers found that eight weeks of the mindfulness meditation training decreased the participants' loneliness. Using the blood samples collected, they found that the older adult sample had elevated pro-inflammatory gene expression in their immune cells at the beginning of the study, and that the training reduced this pro-inflammatory gene expression, as well as a measure of C-Reactive Protein (CRP). These findings suggest that mindfulness meditation training may reduce older adults' inflammatory disease risk.

"Reductions in the expression of inflammation-related genes were particularly significant because inflammation contributes to a wide variety of the health threats including cancer, cardiovascular diseases and neurodegenerative diseases," said study collaborator Steven Cole, professor of medicine and psychiatry and biobehavioral sciences at the UCLA School of Medicine.

While the health effects of the observed gene expression changes were not directly measured in the study, Cole noted that "these results provide some of the first indications that immune cell gene expression profiles can be modulated by a psychological intervention."

Creswell added that while this research suggests a promising new approach for treating loneliness and inflammatory disease risk in older adults, more work needs to be done. "If you're interested in using mindfulness meditation, find an instructor in your city," he said. "It's important to train your mind like you train your biceps in the gym

Yoga reduces stress; now it's known why

Six months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer's and dementia. Now they know why.

As previously reported, practicing a certain form of chanting yogic meditation for just 12 minutes daily for eight weeks led to a reduction in the biological mechanisms responsible for an increase in the immune system's inflammation response. Inflammation, if constantly activated, can contribute to a multitude of chronic health problems.

Reporting in the current online edition of the journal Psychoneuroendocrinology, Dr. Helen Lavretsky, senior author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues found in their work with 45 family dementia caregivers that 68 of their genes responded differently after Kirtan Kriya Meditation (KKM), resulting in reduced inflammation.

Caregivers are the unsung heroes for their yeoman's work in taking care of loved ones that have been stricken with Alzheimer's and other forms of dementia, said Lavretsky, who also directs UCLA's Late-Life Depression, Stress and Wellness Research Program. But caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general. Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.

As the U.S. population continues to age over the next two decades, Lavretsky noted, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia.

"We know that chronic stress places caregivers at a higher risk for developing depression," she said "On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress." What's more, many caregivers tend to be older themselves, leading to what Lavretsky calls an "impaired resilience" to stress and an increased rate of cardiovascular disease and mortality.

Research has suggested for some time that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.

In the study, the participants were randomized into two groups. The meditation group was taught the 12-minute yogic practice that included Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes daily for eight weeks. Blood samples were taken at the beginning of the study and again at the end of the eight weeks.

"The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression," said Lavretsky. "Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.

"This is encouraging news. Caregivers often don't have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too."

Lavretsky is a member of UCLA's recently launched Alzheimer's and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

Group yoga improves motor function and balance long after stroke

Group yoga can improve motor function and balance in stroke survivors, even if they don't begin yoga until six months or more after the stroke, according to "Post-Stroke Balance Improves With Yoga: A Pilot Study," published online July 26 in the journal Stroke.

Forty-seven older adults, three-quarters of whom were male, participated in the study. They were divided into three sections: One section engaged in twice-weekly group yoga for eight weeks; the second section met twice weekly for group yoga and was provided with a relaxation audio recording to use at least three times weekly; and the third section received usual medical care that included no rehabilitation.

The yoga classes, taught by a registered yoga therapist, included modified yoga postures, relaxation and meditation. Classes grew more challenging each week.

Improvement in balance was statistically significant and clinically meaningful. It was also greater than previously found by other post-stroke exercise trials. Study participants reported they increasingly attempted new activities in different, more challenging environments and, while aware of potential fall risk, grew confident in maintaining their balance.

"For patients, like those in our study, natural recovery and acute rehabilitation therapy typically ends after six or, less frequently, 12 months," said Regenstrief Institute investigator Arlene Schmid, Ph.D., OTR, a rehabilitation research scientist with the Center of Excellence on Implementing Evidence-Based Practice at the Richard Roudebush VA Medical Center and assistant professor of occupational therapy at Indiana University-Purdue University Indianapolis, who led the study. "We found that yoga exercises significantly extended rehabilitation beyond the first year after stroke."

Yoga may be more therapeutic than traditional exercise because the combination of postures, breathing and meditation may produce different effects than simple exercise, according to Dr. Schmid, who plans to further study the effectiveness of group yoga to improve balance, quality of life and participation in everyday activities. She notes that yoga's mind-body connection may be what makes it more powerful and engaging than other strengthening exercise.

Reflexology Proves Beneficial For Non-Cardiology Patients

In a study examining the effects of reflexology in healthy patients and patients with heart disease, researchers have found that applying pressure to the upper the heart reflex point on the left foot had an effect on the hearts of healthy patients but not on those with cardiac disease.

The study, conducted by researchers at the University of Stirling, found that massage to the heart reflex point had a small effect on heart function in healthy patients but not in the hearts of cardiology patients. In addition, they found that when pressure was applied to areas of the feet not related to the heart there was not change in heart function.

According to reflexologists, each part of the hands and feet are connected with specific organs in the body. Applying pressure with specific thumb, finger, and hand techniques to specific organ reflex points is believed to increased blood flow to the organ.

In this study, the team focused on the upper left ball of the sole which is said to 'map' to the heart and compared this area to other areas of both feet.

Jenny Jones, Ph.D., from the School of Nursing, Midwifery & Health, explained:

"Reflexology is unique because it makes quite specific claims that it increases blood flow and this is something you can scientifically test. In our experiment with healthy people there was an inexplicable change in the heart function which occurred only when the heart reflex point area was massaged. We have no idea what caused this change se we have applied for funding to investigate this further."

Jones continued:

"Cardiology patients have problems with coronary blood flow so we wanted to find out if there was any impact on their heart function whilst receiving reflexology too. Interestingly, there was no effect on the hearts of cardiology patients; however all the patients found the treatment to be really relaxing, so it seems to be a safe and useful relaxation tool for cardiac patients to use.

We want to investigate further why the hearts of cardiology patients are not affected in the same way as the healthy volunteers, with medication being a possible cause. We also want to research and better understand why this one area of the foot - the upper left ball of the sole - had an effect on the heart."

Professor Steve Leslie, a cardiologist from the Cardiac Unit at Raigmore Hospital, said:

"Most patients responded well to conventional medicine but for some patients symptoms of cardiac disease persist despite best medical treatments. For these patients we wished to test if reflexology was safe. The results of this study, demonstrated that reflexology did not affect cardiac function, heart rate or blood pressure and therefore it would appear safe for patients, even those with significant cardiac disease to undergo reflexology. Whether reflexology can improve cardiac symptoms requires further research."

According to Jones, the complementary therapies market in the UK is huge and shows that there is a great deal of public interest in the topic.

Jones explained: "There are limitations of what we can do with clinical medicine but there has not been much scientific research available on complementary therapies such as reflexology to help people decide if they work or not.

However, if people are choosing to pay to have these complementary therapy treatments to treat symptoms when we have a health care service which is free, you need to ask what it is that these therapies offer that is missing in conventional healthcare."

The researchers plan to conduct further studies in order to determine whether the effect observed in this study is repeated in patients with various gradations of heart disease and other patients groups.

Health Benefits of 'Mindfulness-Based Practices'

Practices Derived from Buddhist Meditation Show Real Effectiveness for Certain Health Problems, Reports Journal of Psychiatric Practice

Specific types of "mindfulness practices" including Zen meditation have research-proven benefits for patients with certain physical and mental health problems, according to a report in the July Journal of Psychiatric Practice. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"An extensive review of therapies that include meditation as a key component—referred to as mindfulness-based practices—shows convincing evidence that such interventions are effective in the treatment of psychiatric symptoms and pain, when used in combination with more conventional therapies," according to Dr William R. Marchand of the George E. Wahlen Veterans Affairs Medical Center and the University of Utah in Salt Lake City.

Mindfulness Techniques Show Health Benefits_Dr Marchand reviewed published studies evaluating the health benefits of mindfulness-based practices. Mindfulness has been described as "the practice of learning to focus attention on moment-by-moment experience with an attitude of curiosity, openness, and acceptance." Put another way, "Practicing mindfulness is simply experiencing the present moment, without trying to change anything."

The review focused on three techniques:_• Zen meditation, a Buddhist spiritual practice that involves the practice of developing mindfulness by meditation, typically focusing on awareness of breathing patterns._• Mindfulness-based stress reduction (MBSR), a secular method of using Buddhist mindfulness, combining meditation with elements of yoga and education about stress and coping strategies._• Mindfulness-based cognitive therapy (MBCT), which combines MBSR with principles of cognitive therapy (for example, recognizing and disengaging from negative thoughts) to prevent relapse of depression.

Dr Marchand found evidence that MBSR and MBCT have "broad-spectrum" effects against depression and anxiety and can also decrease general psychological distress. Based on the evidence, MBCT can be "strongly recommended" as an addition to conventional treatments (adjunctive treatment) for unipolar depression. Both MBSR and MBCT were effective adjunctive treatments for anxiety.

Research data also supported the effectiveness of MBSR to help reduce stress and promote general psychological health in patients with various medical and/or psychiatric illnesses. On its own, MBSR was helpful in managing stress and promoting general psychological health in healthy people. There was also evidence that Zen meditation and MBSR were useful adjunctive treatments for pain management.

How do these practices work to affect mental and physical health? Dr Marchand discusses recent research showing the impact of mindfulness practices on brain function and structure, which may in part account for their psychological benefits. "These mindfulness practices show considerable promise and the available evidence indicates their use is currently warranted in a variety of clinical situations," he concludes.

The article includes some proposed evidence-based guidelines for incorporating mindfulness-based practices into health care. So far there's little evidence on which patients are most likely to benefit, but Dr Marchand suggests that patient preferences and enthusiasm are a good guide. He comments, "The most important considerations may be desire to try a mindfulness-based practice and willingness to engage in the regular practice of seated meditation."

Finding right meditation technique key to user satisfaction

A new study published online July 7 in EXPLORE: The Journal of Science and Healing highlights the importance of ensuring that new meditators select methods with which they are most comfortable, rather than those that are most popular.

If they do, they are likely to stick with it, says Adam Burke, the author of the study. If not, there is a higher chance they may abandon meditation altogether, losing out on its myriad personal and medical benefits. Burke is a professor of Health Education at SF State and the director of SF State's Institute for Holistic Health Studies.

"Because of the increase in both general and clinical use of meditation, you want to make sure you're finding the right method for each person," he said. Although meditation has become significantly more popular in the U.S., Burke said, there have been very few studies comparing multiple methods head to head to examine individual preference or specific clinical benefits.

To better understand user preference, Burke compared four popular meditation methods -- Mantra, Mindfulness, Zen and Qigong Visualization -- to see if novice meditation practitioners favored one over the others. The study's 247 participants were taught each method and asked to practice at home and, at the end of the study, evaluate which they preferred. The two simpler methods, Mantra and Mindfulness, were preferred by 31 percent of study participants. Zen and Qigong had smaller but still sizable contingents of adherents, with 22 percent and 14.8 percent of participants preferring them, respectively.

The results show the value of providing new practitioners a simpler, more accessible method of meditation. But they also emphasize that no one technique is best for everyone, and even less common methods are preferred by certain people. Older participants, who grew up when Zen was becoming one of the first meditation techniques to gain attention in the U.S., in particular were more likely to prefer that method.

"It was interesting that Mantra and Mindfulness were found to be equally compelling by participants despite the fact that they are fundamentally different techniques," Burke said. Mindfulness is the most recent meditation technique to gain widespread popularity, he added, and is often the only one with which a novice practitioner or health professional is familiar. Not surprisingly, Mindfulness was the method most preferred by the youngest participants.

"If someone is exposed to a particular technique through the media or a healthcare provider, they might assume because it's popular it's the best for everyone," Burke said. "But that's like saying because a pink dress or a blue sport coat is popular this year, it's going to look good on everybody. In truth, different people like different things. One size does not fit all."

If an individual is not comfortable with a specific method for any reason, he said, they may be less likely to continue meditating and would lose out on such benefits as reduced stress, lower blood pressure or even treatment for addiction.

Burke hopes to see more comparative meditation studies, especially to determine if particular methods are better at addressing specific health issues, such as addiction. If that's the case, he said, healthcare professionals would be able to guide patients toward techniques that will be most effective for them. Additional studies are also needed to determine if there is a way to predict which method will be best suited for any particular individual, he said.