Mindfulness Meditation Training in Lonely Older Adults

 描述（由申请人提供）：拟议的项目是一个新的提交由早期研究者为父母R 01（资助机会公告PA-13-302）。 这项研究的主要目的是评估正念冥想训练是否会减少孤独感，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）是美国相对于其他人群规模不断增加的人群，他们的健康风险显著升高（例如，增加的炎症、心血管疾病、抑郁和过早死亡）。可以减少孤独感的干预措施具有显著的潜力，可以降低这一不断增长但研究不足的患者人群的发病率和过早死亡率。以前的RCT研究试图减少老年人的孤独感，但成功有限。在一项试点研究中，我们发现，为期8周的正念减压（MBSR）计划减少了孤独老年人的孤独感和炎症（Creswell et al.，2012年）。这项提案描述了一个创新的和良好的控制随机对照试验的MBSR孤独的老年人（N=188），比较MBSR结构等效的8周健康教育计划（HEP）。参与者将完成问卷调查，日常经验采样（使用预编程的智能手机），并在基线，治疗后和3个月随访时提供血液样本。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感的影响可以通过减少日常生活互动中的关系困扰来解释;（3）正念冥想训练降低了孤独老年人中炎症性疾病风险的生物标志物（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）确定老年人孤独的新治疗方法;（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困扰）;和（c）描述这种治疗对该高危患者人群中炎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.