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An SCD-Well clinical trial participant has her blood tested at the Spanish trial centre - IDIBAPS - in Barcelona.
An SCD-Well clinical trial participant has her blood tested at the Spanish trial centre - IDIBAPS - in Barcelona.

Press release -

Mental health improves after lifestyle changes in later life, new scientific study finds


Study published today finds lasting mental health improvements in older adults with Subjective Cognitive Decline (SCD)

Making lifestyle changes, such as taking up mindfulness or health self-management courses, can help improve the mental health of older adults who are already experiencing memory problems, according to a new scientific study published today.

This EU-funded research is part of the €7million H2020 Silver Santé Study coordinated by Inserm (French national institute of health and medical research). It has studied the impact of an eight-week mindfulness or health self-management course on anxiety, which is associated with increased risk of dementia.

The volunteers, all with subjective cognitive decline (self-perceived memory problems that cannot be verified by testing), had anxiety levels measured before, directly after the courses and again six months later. The results showed that anxiety levels had reduced directly after the course and the reduction was maintained at six months. No difference in reduction of anxiety was found between the groups.

Published today in Psychotherapy and Psychosomatics (https://www.karger.com/Article/FullText/515669), the SCD-Well trial included 147 participants from memory clinics in France, Spain, Germany and the UK, with blood tests, cognitive assessments, and questionnaires used to assess the impact of the interventions.

Dr Natalie Marchant, of University College London, UK, who led the trial, says: “With incidence of worldwide dementia estimated to triple by 2050, there is a growing need to target modifiable risk factors in individuals as early as possible, while their cognitive decline is still limited.

“Although we expected mindfulness meditation to have more of an impact on mental health, the results of our trial show that small but significant improvements in mental health can be observed after a short course of mindfulness or health self-management in people who are already experiencing some subjective cognitive decline, and the effects last for at least six months.”

Effective treatments for the underlying illnesses that cause dementia are currently lacking, making it all the more important to find ways to prevent them. Research shows that approximately a third of dementia cases worldwide might be attributable to potentially modifiable risk factors.

Patients with SCD often experience mild symptoms of anxiety, and evidence suggests that even mild anxiety is associated with increased risk of dementia,” said Dr Marchant. “What our results offer is an encouraging first step towards providing an intervention that could be used to reduce anxiety and potentially the risk of developing dementia which would benefit both individuals and society as a whole in terms of the associated emotional, health and social care costs of poor mental health.

“However, as our study did not include a passive control group (where participants do not take part in any intervention) we do not know for sure whether the reductions in anxiety were specifically due to the lifestyle changes promoted by the interventions.

“We must allow for the fact that people with anxiety tend to benefit from the social interaction that taking part in a group provides, nevertheless these results are encouraging and will help inform strategies aimed at improving mental health in older adults.”

Jenny Cleary, of Loughton, Essex, who took part in the London trial, was referred to a memory clinic after experiencing problems with forgetfulness. The 61-year-old customer service assistant underwent tests but was told her memory problems were most likely caused by stress and was offered the chance to take part in the SCD-Well trial.

Jenny says: “We had a mindfulness class once a week and then we had to do it four or five times a week on our own at home. It was definitely a bit harder to do it at home– you have to be more disciplined – but you get used to it after a while.

“I’ve definitely benefitted from meditation and I think it has improved my memory. I tend to do it every night when I get into bed as I find the breathing calms my brain down and helps me sleep. I also recommend it to other people I meet too as I know it’s helped me,” she adds.

The SCD-Well trial is part of the 5-year EU-funded Silver Santé Study which is examining whether mental training techniques, like mindfulness, health education, or learning a language, can help improve mental health and well-being in the ageing population. Further results from the SCD Well trial are expected in due course.

In addition to the SCD Well trial, the study is running a second trial called Age-Well which is examining the effects of long-term mindfulness and language-learning interventions on cognitively normal older adults aged 65+ in the Caen area of France, and a group of expert meditators. It is the longest ever study of meditation and language-learning and the first to take into account the emotional aspects of ageing as well as lifestyle factors such as diet, sleep quality and physical exercise.

Silver Santé Study Project Coordinator, Dr Gaël Chételat, of Inserm in France, who is also leading the Age-Well trial, says: “The results of the SCD-Well trial are exciting as they show that behavioural interventions can help improve mental health in patients with some level of cognitive decline.

“We are looking forward to analysing the date from our Age Well trial, which is examining the effects of long-term mindfulness and language-learning on healthy older adults and expert meditators. We hope these studies will help us learn more about techniques that we can all use to help safeguard our mental health & well-being in later life.”

Age-Well participants have been randomly assigned to one of three groups – mindfulness, English language learning or a control group in which the participants have made no change to their lifestyles. The effects of the 18-month interventions are being assessed through both behavioural and biological measures. These include blood sample analyses, questionnaires, cognitive tests, sleep assessment, neuroimaging data and lifestyle factors. Changes are measured between baseline readings and those at 18 and 21 months. The results of this trial are due to be released in 2022.

For further information about the Silver Santé Study visit the project website at www.silversantestudy.euor watch the project’s 3-minute film at http://ow.ly/Lhle30lUZqp


ENDS/ Case Studies, Contacts & Notes follow


SCD-Well case studies/photos/videos


Mindfulness intervention

The Caring Mindfulness-based Approach for Seniors (CMBAS) followed the general format of a mindfulness-based stress reduction programme (MBSR), consisting of a pre-class interview, eight weekly group-based sessions of 2 hours duration, and a half-day of meditation practice in the 6thweek of the programme.

It was specifically tailored to the needs of older adults together with a focus on compassion and loving-kindness mindfulness. The psycho-educational components were customised for individuals with SCD to help them more adaptively manage concerns about cognitive functioning and tendencies to worry.

Participants were asked to engage in home practice for approximately one hour per day, 6 days per week, which consisted of formal guided mindfulness and informal practices aimed to help generalise mindfulness skills to daily life.

Jack Forsey, from Essex – mindfulness participant

Retired postal worker Jack Forsey was told that he had deterioration in parts of his brain after suffering three mini-strokes.

Jack, from Buckhurst Hill in Essex, was then referred to a memory clinic where tests showed he had mild cognitive impairment. It was here that he first heard about the Silver Santé Study’s clinical trials and after agreeing to take part, was randomly assigned to an eight-week mindfulness course.

The 76-year-old says: “If people benefit in the future because I’ve taken part in something, then I’m all for it, but it’s hard to say whether it’s done me any good.

“When you sit back and shut your eyes and the instructor starts talking, my mind would quite often wander but I was told that was all part of it. We had quite a lot of homework and I did it a few times at home but I would drift off while I was doing it!”

“One time the teacher had us walking around in the park and thinking about what our brains were doing, listening to the sound of the trees and thinking about the way we were walking. I’m surprised we weren’t arrested as people must have wondered what we were up to but I understand what she was trying to do!”

As well as taking part in this and other clinical trials, Jack volunteers for the Alzheimer’s Society’s Singing for the Brain service and helps teenagers who have been excluded from school.

He says: “I do use sometimes use mindfulness so what the instructor taught us has gone in. I’m more aware of the things around me so it has made me think more about that.

“At the memory clinic they told me I would eventually get more memory loss but at my last visit, two years later, they said there was no deterioration, so mindfulness possibly did help.”


Caption: SCD-Well trial mindfulness participant, Jack Forsey.

Jenny Cleary – mindfulness participant

Since taking a course in mindfulness as part of the Silver Santé Study’s SCD-Well trial, 61-year-old Jenny Cleary has practised mindfulness nearly every day.

Before taking the eight-week course, which started in January 2018, Jenny had been experiencing forgetfulness and was referred to a memory clinic where she was asked if she wanted to take part in the Silver Santé Study’s clinical trial.

Jenny, a part-time customer service assistant, says: “My mum was diagnosed with Alzheimer’s at a young age and I went to the doctor’s because I started getting problems with my memory.

“I was referred to the memory clinic, and they did lots of tests but couldn’t find anything wrong and, in the end, they said they thought the memory problems were caused by stress as my life was very stressful at that time.”

Jenny, who lives with her husband Gerard and two sons in Loughton, Essex, says: “They asked me if I would be willing to get involved in the Silver Santé Study’s research so I agreed and was put in a group that was doing a mindfulness course.

“I’d never done mindfulness before, even though my husband used to do a lot of meditation and tai-chi, but I found it really calming. My mind has always been all over the place so I didn’t think I’d be able to do it but I find it helps me stay calm so I do it every day now.”

As well as learning breathing meditation, Jenny learned about compassion and kindness meditation and mindful eating. She says: “I remember doing one exercise where the teacher got us to put a raisin in our mouths and then we had to think about the texture of the raisin and how it felt and it really makes you think about things in a different way.

“We had a mindfulness class once a week and then we had to do it four or five times on our own at home. It was definitely a bit harder to do it at home– you have to be more disciplined – but you get used to it after a while.

“I’ve definitely benefitted from mindfulness and I think it has improved my memory. I tend to do it every night when I get into bed as I find the breathing calms my brain down and helps me sleep. I also recommend it to other people I meet too as I know it’s helped me,” Jenny adds.


Caption: SCD-Well trial mindfulness participant, Jenny Cleary, with her husband, Gerard.



Health self-management intervention

The health self-management intervention followed the same format and structure as the mindfulness programme in administration, frequency, and duration. More specifically, it consisted of a pre-class meeting with the facilitator, eight weekly group-based sessions of 2 to 2½ hours duration, a half-day of practice after the sixth session of the program (9 sessions in total), and home practices.

The treatment was based on a published manual [24], with every session of the program covering different subjects, including self-management; problem-solving; sleep; stress; exercise; managing medicines and memory; communicating with family, friends, and health care professionals; eating; weight management; and planning for the future.

Participants were provided with information about these subjects and engaged in group exercises and discussions about them. They were given a workbook and asked to actively engage in activities described in the workbook to improve health and well-being on 6 days each week, matching home assignments in the mindfulness programme. The workbook summarizes the most important points of each session, and participants are asked to record engagement in health-related activities on protocol sheets in the workbook.

Ray Brock – health self-management participant


Caption: SCD-Well trial health education participant, Ray Brock, with his wife, Lea.

Taking part in one of the Silver Santé Study’s clinical trials has helped 73-year-old Ray Brock to travel the world.

Ray, from Nazeing in Essex, attended an eight-week health self-management course as part of the Study’s SCD-Well trial and it was during the course that he learned about setting and achieving goals. Ray’s chosen goal was to pursue his interest in unicycling and one of the steps he identified was to go online to explore his hobby and it was taking this step that connected him to people all over the world who shared the same interest. Since then he has travelled the world to meet up with new friends and attend events relating to electric unicycling as far afield as China, Singapore and Malaysia.

Before taking part in the trial, Ray had experienced problems with his memory, particularly in relation to people’s names. He says: “I could remember the people and the detail of every conversation we’d had and I would know the first letter of their name but I just couldn’t recall the name itself.

“I’ve always had a bad memory but I decided to go to the doctor to see if they could help and they suggested that I go on this course.

“I don’t think the course made any real difference to me but my wife, Lea, thinks it did,” says Ray, who looks after maintenance at ten different properties. “I’ve always been active and when I get a call about a property I have to get up and go no matter what, so I don’t think the course was really right for someone like me as the other people on the course weren’t very active.”

However, Ray’s wife, Lea, thinks Ray has benefitted from taking part in the trial, particularly with regard to learning new skills. She says: “Before taking part, his memory did seem to be getting a lot worse. He wasn’t interacting with other people very well and wasn’t making the effort to go out and see other people.

“One of the things he’s never been very good at is planning, so I’ve always done it for him, but on this course he learned how to set a goal and to plan the steps needed to achieve it. He’s an electric unicyclist and what he learned on this course made him go online, find other people who are doing it, find an event abroad and organise the whole trip himself. In that way he’s grown a lot.”

Lea has noticed other changes in Ray, too. She says: “He never used to have a phone before but now he’s got one now and has learnt how to use it. He can fly through it and he’s even better at it than me.

“If he hadn’t been on that course, he wouldn’t be doing these things now. He’s certainly benefitted and has now got a circle of friends who share a similar hobby that he’s been half way round the world with, including China, Singapore, and Malaysia.”

David McLean – health self-management participant

After noticing problems with his memory, retired architect David McLean decided to visit his doctor.

The 83-year-old, from Billericay in Essex, says: “What prompted me to go to the doctor was that I was having trouble remembering where I had parked my car. I would be in the town and, after 30 or 40 minutes in the supermarket, have to concentrate very hard trying to remember where I had parked and could spend up to 15 minutes doing so. This bothered me because two elderly men friends who died of Alzheimer’s disease had experienced similar problems in the early stages of their illness.”

David’s GP referred him to a memory clinic. Two nurses visited him at home and conducted a series of memory tests. He scored 96% and his visitors seemed content to leave it at that. At this point he asked if there were any trials in which he could take part with a view to at least slowing what he felt might be a progressive degeneration in his memory.

David, who was widowed in 2016, was then contacted by a researcher at Epping Hospital and, following a further two rounds of memory tests, was invited to join an eight-week health education course as part of the Silver Santé Study’s SCD-Well trial which covered healthy lifestyles as well as setting goals and planning how to achieve them.

When asked about his experience of taking part, he says: “I was very happy to take part but I must confess I had been hoping that there might be a drug trial I could take part in rather than a programme about lifestyles. The course was easy to follow and the other half dozen participants were interesting people.

“I lead a fairly busy life, including work as a volunteer in various schools and community-oriented projects, so I have to admit that practical application of the course got rather swamped,” David continues. “I did, however, commit to make better use of the cultural wealth which proximity to London affords. Although I did go to London a couple of times early on, I found it hard to keep that going.

“This was mainly because I’ve spent the past year doing a foundation course in counselling which really stretched and pre-occupied me. I cannot offer concrete evidence of it, but my feeling is that the course was helping my memory. Taking in and retaining information was a huge challenge, but the experience confirmed in me the conviction that serious study is good for the brain and is most certainly to be encouraged,” concludes David.


Caption: SCD-Well trial healthy education participant, David McLean.

Contacts:

Media contact: Rhonda Smith / Charlotte Reid at Minerva +44 (0)1264-326427 or +44 (0)7887-714957. rhonda@minervacomms.net or charlotte@minervacomms.net

Editor’s notes:

  1. The call under which Medit-Ageing has been successfully funded is H2020-PHC-22: Promoting mental well-being in the ageing population
  2. The project receives €7million funding and runs for 5 years from Jan 2016 - 2020. The project has been extended for a further six months, to the end of June 2021, due to delays caused by the Covid pandemic.
  3. http://ec.europa.eu/programmes/horizon2020/en/h2020-section/societal-challenges
  4. The partners in Medit-Ageing are:
  5. There are nine work packages in the study:

Partner organisation name

Short name

Country

Contact

Institut national de la santé et de la recherche médicale

Inserm

France

Dr Gaël Chételat

Project co-ordinator

Dr Antoine Lutz

Dr Hélène Esperou

Dr Géraldine Poisnel

University of Liege (GIGA-CRC-In Vivo Imaging; Psychology and Neuroscience of Cognition Research Unit)

ULG

Belgium

Dr Fabienne Collette

Professor Eric Salmon

University of Geneva (Swiss Centre for Affective Sciences, Campus Biotech)

UNIGE

Switzerland

Dr Olga Klimecki

Professor Patrik Vuilleumier

University College London,

UCL

UK

Dr Natalie Marchant

University of Exeter

UNEXE

UK

Dr Thorsten Barnhofer

University of Cologne

UKK

Germany

Professor Frank Jessen

Hospices Civils de Lyon (Clinical and Research Memory Centre of Lyon)

HCL

France

Professor Pierre Krolak-Salmon

Consorci Institut d’Investigacions biomèdiques August Pi I Sunyer (Alzheimer’s disease and other cognitive disorders Unit; Hospital Clinic; Neurodegenerative diseases: Clinical and experimental research)

IDIBAPS

Spain

Dr Jose Luis Molinuevo

European Clinical Research Infrastructures Network

ECRIN

EU

Amélie Michon

Inserm Transfert SA

IT

France

Delphine Smagghe

Minerva Health & Care Communications UK Ltd

Minerva

UK

Rhonda Smith, Director

Work Package

Lead partner

Institution & Country

1

Meditation

Dr Antoine Lutz

Inserm, France

2

Lifestyle

Dr Julie Gonneaud

Inserm, France

3

Attention

Dr Fabienne Collette

University of Liege, Belgium

4

Emotion

Dr Olga Klimecki

University of Geneva, Switzerland

5

Cognition & Well-being

Dr Natalie Marchant

University College London, UK

6

Biomarkers

Dr Gaël Chételat

Inserm, France

7

Coordination & Management

Dr Géraldine Poisnel

Inserm, France

8

Communication

Rhonda Smith

Minerva Communications UK Ltd

9

Clinical Trial

Dr Hélène Esperou

Inserm, France

Notes/End

Subjects

Categories


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