OHSU Study Examines Meditation's Effect On Stress In Alzheimer's Caregivers

01/20/11  Portland, Ore.

Caring for a loved one with Alzheimer's disease can be a highly stressful endeavor. Oregon Health & Science University researchers want to know if meditation reduces this stress and the declining physical health that often results.

A study expected to be funded by the National Center for Complementary and Alternative Medicine (NCCAM), National Institutes of Health, will examine older adults who serve as primary caregivers for people with Alzheimer's and other forms of dementia. It will compare a group using a meditation program called mindfulness-based cognitive therapy with groups using education and respite only to relieve stress.

"The question is whether meditation or education will be better than respite only," said study leader Barry Oken, M.D., professor of neurology and behavioral neuroscience, and associate professor of physiology and pharmacology, OHSU School of Medicine. "And I'm interested in the physical benefits of stress reduction."

Medical professionals have grown concerned about declining health among the more than 2 million people – many of them family members – who care for the estimated 4 million people with dementia. And the problem is only expected to get worse as Baby Boomers flood the country's health system in the coming decade.

Oken, who directs OHSU's Oregon Center for Complementary and Alternative Medicine in Neurological Disorders, said the mortality rate among caregivers rivals that of the people they're looking after.

"I do know they have more disease," he said. "Besides depression, they have a whole slew of other problems. We have a list of diseases they're more prone to. Caregiving takes its toll."

The high stress of caregiving can even have negative effects on genes. Caregivers "have changes in their DNA," Oken said, pointing to results from research on mothers of disabled children and, more recently, on dementia caregivers.

Oken said stressors come from everywhere in the caregiver's world. "It's 24/7, so it's never being able to put it down. Spouses are following you around everywhere you go. It's just literally having somebody always there, always needing your assistance. It's just this constant attention that's required. It's just wearing. It cuts down on people's ability to do things that are helpful to themselves."

To curb stress, many people have turned to mind-body therapies such as relaxation techniques, meditation, hypnosis, biofeedback, yoga, tai-chi, and music, art and dance therapy. In 2002, about 17 percent of the adult U.S. population used these methods, according to the NCCAM.

Meditation, one of the most common and most studied of the mind-body interventions, originates from Eastern religious or spiritual traditions and is intended to focus or control attention. Most meditation techniques are divided into concentration meditation, which includes transcendental meditation, and mindfulness meditation.

A key facet of mindfulness meditation, the type being used in the caregiver study, involves attending to the present moment in a non-judgmental way. Oken said it was chosen because of its easy adaptability to how a person experiences everyday life situations. Plus, it's already been formally studied and applied in a variety of clinical conditions.

"There are two aspects of mindfulness meditation: Bringing the mind to the current moment, not dwelling on past events; and letting things occur without being overly judgmental about what the event is," Oken said. "For example, if your husband (with dementia) screamed at you, it's not the end of the world. You don't have to necessarily respond on an emotional level. These are two aspects we think might be beneficial to stress reduction."

The study will track 108 generally healthy seniors ages 50 to 85 who are caregivers of a spouse or close relative with dementia. They will be divided into three groups: One using mindfulness-based cognitive therapy for eight weeks; one using educational lectures offering self-care techniques, such as reducing personal stress and changing negative self-talk for eight weeks; and one having breaks with respite care provided once per week for two hours over eight weeks .

All subjects will be assessed at baseline, immediately after, and then 12 weeks after their respective interventions. They will be given a self-rated measure of caregiver stress. The researchers also will look at secondary outcome measures representing biological markers of stress, including concentrations of the steroid hormone cortisol in saliva, respiration, heart rate variability, and even markers of immune function that have been related to caregiver changes or stress.

If such markers can be lowered with meditation, "that'll be the most exciting," Oken said.

Others participating in the study include faculty in OHSU's Schools of Nursing and at Western States Chiropractic College, National College of Natural Medicine, and Pacific University.  

For more information about the study, contact the Oregon Center for Complementary and Alternative Medicine in Neurological Disorders at (503) 494-5650 or orcamind@ohsu.edu.