Advances in Mind/Body Therapies: Concept, Data and Delivery

Abstract

Mind/body therapies, such as yoga, mindfulness, and guided imagery, are often touted in media reports as ways to slow cognitive decline, improve brain health, and ameliorate negative psychological symptoms such as stress and depression. However, the clinical and neurobiological evidence base for these uses in older adults is limited. Moreover, many older adults, particularly during the COVID-19 pandemic, have difficulty accessing these therapies due to the in-person, group formats in which they are often delivered. A major difficulty in understanding the objective benefits of mind/body therapies for subjective cognitive and psychological symptoms is infrequent measurement during clinical trials using retrospective questionnaires. Thus, increased clinical efficacy research, neurobiological research, and methodological research to identify new ways to deliver and measure the effects of mind/body therapies is urgently needed.In this general session, three presenters will discuss recent advances in mind/body therapies, including new evidence from large-scale trials, and methodological innovations enabling remote therapy delivery and the assessment of behavioral outcomes.First, Dr. Felipe Jain will discuss smartphone delivery of mind/body therapies and new technologies that use passive smartphone sensors to enable continuous measurement of behavior. The development of digital phenotypes of psychological symptoms from these fine-grained behavioral assessments will be discussed. Dr. Jain's presentation will describe a smartphone application which delivers mind/body tools, mentalizing imagery therapy (MIT), and caregiver skills, to older adult family caregivers of persons living with dementia. His talk will elucidate simultaneous capture of usage data and passive smartphone sensor data in a subset of participants in a clinical trial using the application. Statistical methods to derive individual behavioral phenotypes for symptom tracking of psychological stress and sleep will be presented.Second, Dr. Eric Lenze will share clinical and neuroimaging results of a large trial of mindfulness-based stress reduction (MBSR) with and without exercise aimed at improving cognitive function and brain health in older adults. His talk will include clinical effects of intervention on episodic memory and executive function, and structural brain markers including hippocampal volume and dorsolateral prefrontal cortex thickness and surface area. Finally, he will focus on sensitive analyses of functional brain connectivity from before to after treatment.Finally, Dr. Helen Lavretsky will discuss the recent trends in the methodology of conducting mind-body efficacy and effectiveness trials. She will also discuss the results of a recently completed trial of Kundalini yoga for prevention of cognitive decline in women with subjective memory complaints and at risk for AD. This will also cover clinical outcomes and the role of neural and peripheral biomarkers of response.The panel discussion will outline future research directions in mind-body therapies for treatment and prevention in older adults, with a focus on diversity and inclusion of underrepresented populations.