The Effectiveness of a Mindfulness Intervention in Improving the Psychological Wellbeing, Motor Symptoms and Cognition of People with Parkinson’s disease

Abstract

Parkinson's disease (PD) is a chronic and progressive neurological disorder characterised by both motor and non-motor symptoms. The motor symptoms include tremors, postural and gait instability, rigidity and slowness in movement. Non-motor symptoms include neuropsychiatric disturbances such as anxiety and depression, sleep disturbances, cognitive decline, and other physiological symptoms such as sensory and gastro-intestinal difficulties. Given the complexities of the disease, individuals with PD experience a reduced quality of life and psychological wellbeing. Other than medication, there is a paucity of research in non-pharmacological psychological intervention in managing PD symptoms. The primary aim of this study was to examine the effectiveness of an 8-week group mindfulness intervention program adapted from Kabat-Zinn’s Mindfulness Based Stress Reduction Therapy (1990) in improving psychological outcomes in PD, with trait mindfulness as the mechanism of change. Given that this study is exploratory, the secondary aim of this study was to explore the impact of mindfulness on other PD symptoms including cognitive symptoms, motor symptoms, and quality of life. The study also sought to obtain participants’ expectations, experience, feedback and suggestion of the program, to inform future research and implementation. A total of 14 participants with mild to none cognitive impairment completed the intervention. Results were promising, with significant improvement in depression and symptom distress at post intervention, with increase in trait mindfulness scores preceding psychological distress scores. Further, linear regression analyses revealed that increases mindfulness scores were predictive of improvement in psychological distress scores. However, improvement in depression and symptom distress was not sustained at a 6-month follow up, indicating short term effects of the intervention. Secondary exploratory analyses revealed significant improvement in postural instability and gait dysfunction, as well as cognitive functioning at post intervention. Except for cognitive functioning (specifically working memory), these findings were however, not sustained at 6-month follow-up. Due to methodological limitations, including a small sample size, the findings of this study should be interpreted with caution. Limitations of the study along with clinical implications of these findings and recommendations are discussed.