Mindfulness Meditation Training in Lonely Older Adults

 描述(由申请人提供)：建议的项目是一名早期调查员为家长R01提交的新申请(资助机会公告PA-13-302)。 这项研究的广泛目的是评估正念冥想训练是否可以减少孤独，改善社会关系功能，并改善孤独老年人的炎症生物标志物。孤独的老年人(65-93岁)在美国是一个人口规模相对于其他人口部分正在增加的群体，他们的健康风险显著增加(例如，炎症、心血管疾病、抑郁症和过早死亡)。可以减少孤独感的干预措施在减少这一不断增长但未得到充分研究的患者群体中的高发病率和过早死亡方面具有重大潜力。之前的RCT研究试图减少老年人的孤独感，但收效甚微。在一项初步研究中，我们发现，为期8周的基于正念的压力减轻(MBSR)计划减少了孤独老年人的孤独感和炎症(Creswell等人，2012年)。这项建议描述了在孤独的老年人(N=188)中进行MBSR的创新和良好控制的RCT，将MBSR与结构上相同的8周健康教育计划(HEP)进行了比较。参与者将完成问卷调查，每日体验采样(使用预先编程的智能手机)，并在基线、治疗后和3个月随访时提供血样。这项拟议的研究将测试由一个新的概念模型指导的三个具体目标：(1)正念冥想训练减少孤独感；(2)正念冥想训练对孤独的影响通过减少日常生活互动中的关系痛苦来解释；(3)正念冥想训练降低炎症性疾病风险的生物标记物，这些标记物在孤独的老年人中升高(促炎基因表达、C反应蛋白和白细胞介素6)。这项研究提供的信息有可能：(A)确定一种治疗老年人孤独的新方法；(B)揭示这种效应的社会心理机制(即减少日常生活中的关系痛苦)；以及(C)描述这种治疗对这一高危患者群体中炎症性疾病风险的健康保护后果。

 DESCRIPTION (provided by applicant): The proposed project is a new submission by an Early Stage Investigator for a Parent R01 (Funding Opportunity Announcement PA-13-302). The broad aim of this research is to evaluate whether mindfulness meditation training reduces loneliness, improves social relationship functioning, and improves biomarkers of inflammation in lonely older adults. Lonely older adults (aged 65-93 years) are a population that is increasing in size in the United States relative to other segments of the population and they have significantly elevated health risks (e.g., increased inflammation, cardiovascular disease, depression, and premature mortality). Interventions that can reduce loneliness have significant potential to reduce the elevated morbidity and premature mortality in this growing but understudied patient population. Previous RCT studies that have attempted to reduce loneliness in older adults have had limited success. In a pilot study, we found that an 8-week Mindfulness-Based Stress Reduction (MBSR) program reduced loneliness and inflammation in lonely older adults (Creswell et al., 2012). This proposal describes an innovative and well-controlled RCT of MBSR in lonely older adults (N=188), comparing MBSR to a structurally equivalent 8-week Health Education Program (HEP). Participants will complete questionnaires, daily experience sampling (using pre-programmed smartphones), and provide blood samples at baseline, post-treatment, and 3-month follow-up. This proposed study will test three specific aims that are guided by a novel conceptual model: (1) mindfulness meditation training reduces loneliness; (2) the effects of mindfulness meditation training on loneliness are explained by reductions in relational distress in daily life interactions; and (3) mindfulness meditation training reduces biomarkers of inflammatory disease risk that are elevated in lonely older adults (pro-inflammatory gene expression, C Reactive Protein, and Interleukin-6). The information provided by this study has the potential to: (a) identify a novel treatment for loneliness in older adults; (b) reveal a social psychological mechanism for this effect (i.e., reductions in daily life relational distress); and to (c) describe the health protective consequences of this treatment on inflammatory disease risk in this at-risk patient population.