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The primary objective of the proposed research is to investigate the promise and underlying mechanisms of mindfulness training as a preventative lifestyle intervention to enhance cognitive health in Latino older adults, thereby mitigating risk of Alzheimer's Disease (AD) in a population that may be particularly vulnerable.
This proposal rigorously examines the feasibility and mechanisms of action of a novel, culturally-sensitive mindfulness training program developed by the PIs, utilizing EEG methods and theoretically-optimized cognitive control tasks to assess neurocognitive effects. Additionally, blood-based assessment of AD biomarkers will be utilized to test whether biomarker status will moderate the effect of training, such that the neurocognitive benefits will be larger Latino older adults with greater evidence of AD-related pathology. Furthermore, the study will also seek to elucidate the subjective effects of mindfulness training on daily-life experiences using ecological momentary assessment (EMA) methods. The study will utilize a mixed between and within-subject design involving longitudinal (pre vs. post-training) assessment and a wait-list control group. 60 Latino older adults will first complete a baseline assessment protocol, followed by randomized assignment to either the mindfulness or wait-list group (N=30 in each group). The mindfulness group will receive 8 weeks of mindfulness training. During this 8-week period participants from both groups will also complete an EMA protocol, consisting of prompts occurring 4x/day on 3 random days per week, assessing subjective mindfulness states, practice experiences, mood, cognition, setting, and activity. Both groups will then return to repeat performance of the same assessment protocol. The assessment protocol involves two testing sessions performed on separate days, each involving completion of the Stroop and AX-CPT task while continuous EEG is recorded. The mindfulness training curriculum utilizes a novel adaptation of the well-validated mindfulness-based stress reduction (MBSR) course, that has been previously validated in focus groups. Participants will meet weekly with an instructor (either in-person or on-line) in classes to receive instructions and practice mindfulness skills. The curriculum embeds core MBSR principles and practices within a culturally-sensitive didactic framework, that includes four key modifications: (1) delivering all instruction in participants native Spanish language; (2) emphasizing/encouraging the connection between mindfulness practices and participants' personal religious beliefs (e.g., "connecting the breath/body to God"), (3) incorporating culturally unique experiences into group activities/exercises (e.g., sharing immigration stories and examining how alterations in perspective can influence meaning and affect), and (4) adding more familial focus to course content (e.g., highlighting how certain skills or practices can benefit the family). In addition to weekly class meetings, participants will also have access to instructional videos and guided audio practices available on their mobile device; on these devices, they will also be periodically prompted to partake in a short mindfulness behavioral task, a 2-minute breath-counting exercise. Finally, all participants will complete a blood draw at the end of the study to determine AD biomarker status. Outcomes will be assessed using EMA measures of daily mindfulness and mood/cognition as well as other qualitative self-report measures assessing the accessibility, utility and feasibility of the mindfulness training curriculum (Aim 1); EEG/ERP measures of state mindfulness and neurocognitive functioning (Aim 2); behavioral metrics of cognitive performance (Aim 2); and moderating role of AD biomarker status (Aim 3).
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| mindfulness | Behavioral | MBSR: Mindfulness Program A novel and culturally-adapted version of the well-validated mindfulness-based stress reduction (MBSR) course will be used for the intervention. The adapted program curriculum embeds core MBSR principles and practices within a culturally responsive didactic framework developed directly from community focus-group feedback. The course will be delivered via a group meeting across 8 weeks, with weekly classes held at a local community center. All classes will be held in hybrid format, with most participants attending in person, but with a live-stream option offered via Zoom. |
| Measure | Description | Time Frame |
|---|---|---|
| EEG brain markers of cognitive functioning | EEG indices of cognitive performances evoked by task stimuli and participant responses. ERP components of attention and cognitive control during task performance, focused on target-related P3 amplitude. | Time-frame: 2 time-points - baseline/pre-intervention, and immediately after the intervention |
| EEG brain markers of cognitive functioning | EEG indices of cognitive performances evoked by task stimuli and participant responses. ERP components of attention and cognitive control during task performance, focused on cue-related Contingent Negative Variation (CNV). | Time-frame: 2 time-points - baseline/pre-intervention, and immediately after the intervention |
| AXCPT behavioral performance (reaction time) | Behavioral performance indices during AXCPT task: AX-CPT - reaction time in milliseconds | Assessed at 2 timepoints: baseline/pre-intervention immediately post-intervention |
| AXCPT behavioral performance score (accuracy) | Behavioral performance indices during AXCPT task: AX-CPT - % accuracy AX-CPT --% accuracy | Assessed at 2 timepoints: baseline/pre-intervention immediately post-intervention |
| Five Facet Mindfulness Questionnaire (FFMQ) score | Five Facet Mindfulness Questionnaire (FFMQ) is a 39-item self-report inventory used to measure five distinct facets of mindfulness. The five facets are observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience, each rated on a 5-point Likert scale. | Performed during the intervention (3x /week for 8 weeks) |
| The Mindful Attention Awareness Scale (MAAS) score |
| Measure | Description | Time Frame |
|---|---|---|
| EEG metrics of mindfulness practice quality | EEG spectral power (alpha, theta bands) evoked during guided mindfulness state induction | Assessed at 2 timepoints: baseline/pre-intervention immediately post-intervention |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Todd S Braver, Ph.D. | Contact | 800-438-0445 | tbraver@wustl.edu | |
| Diana Parra Perez, Ph.D. | Contact | parrad@wustl.edu |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington University | Recruiting | St Louis | Missouri | 63130 | United States |
All of the data collected in will be preserved through deposition in a public access data repository (i.e., Open Science Framework [OSF]). Raw self-report, transcription, and EMA data will be recoded, scored, and wrangled to "long" format to enhance accessibility and ease of use prior to sharing. All shared data will be deidentified.
Data will be made available one year after data collection begins and updated annually until the award period ends. All data, data wrangling procedures, registrations, and analysis scripts associated with published manuscripts will be organized into an easily accessible subfolder and made available no later than the time of publication acceptance. The data will be available for public access indefinitely, or until new guidelines are released regarding data archival duration.
All data that is uploaded to OSF will be publicly available with no controlled access.
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| ID | Term |
|---|---|
| D064866 | Mindfulness |
| ID | Term |
|---|---|
| D015928 | Cognitive Behavioral Therapy |
| D001521 | Behavior Therapy |
| D011613 | Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
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Randomization Description: After the pre-training assessment phase, participants will be randomized to either the Mindfulness Based Program or wait-list groups. The only difference between the two groups is that the wait-list group will not receive the mindfulness intervention until after they complete both pre- and post-assessments during the 4-month study period. Intervention Description: Mindfulness Program A novel and culturally-adapted version of the well-validated mindfulness-based stress reduction (MBSR) course will be used for the intervention. The adapted program curriculum embeds core MBSR principles and practices within a culturally responsive didactic framework developed directly from community focus-group feedback. The course will be delivered via a group meeting across 8 weeks, with weekly classes held at a local community center. All classes will be held in hybrid format, with most participants attending in person, but with a live-stream option offered via Zoom.
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The Mindful Attention Awareness Scale (MAAS) is a 15-item measure of mindfulness that prioritizes assessment of the general tendency to be attentive and aware of experiences in the present moment. It is is rated on a 6-point Likert scale (almost always, very frequently, somewhat frequently, somewhat infrequently, very infrequently, almost never). |
| Performed during the intervention (3x /week for 8 weeks) |
| Cognitive and Affective Mindfulness Scale (CAMS-R) score | Cognitive and Affective Mindfulness Scale (CAMS-R) is used to evaluate symptoms of mindfulness as EMA (ecological momentary assessment) questions. It will be measured in a Likert scale (Not at all, Somewhat, Quite a bit, Almost completely) | Performed during the intervention (3x /week for 8 weeks) |
| Patient-Reported Outcomes Measurement Information System (Promis) score | PROMIS (Patient-Reported Outcomes Measurement Information System) are item banks that measure common health outcomes across the domains of physical, mental, and social health. | Performed during the intervention (3x /week for 8 weeks) |
| National Institutes of Health Toolbox Emotion Battery (NIH-TOOLBOX-EB) score | National Institutes of Health Toolbox Emotion Battery for English- and Spanish-speaking adults (NIH-TOOLBOX-EB): National Institutes of Health Toolbox Emotion Battery for English- and Spanish-speaking adults (NIH-TOOLBOX-EB) A series of scales that will be rated on a 5-point Likert scale which include:
| baseline (pre-intervention) & immediately post-intervention |