Mindfulness-based cognitive therapy vs. a health enhancement program for the treatment of late-life depression: Study protocol for a multi-site randomized controlled trial

Magnus Bein, Myriam Lesage, Elena Dikaios, Mallar Chakravarty, Zindel Segal, Isabelle Royal, Mark Speechley, Alessandra Schiavetto, Daniel Blumberger, Matthew D Sacchet, Joseph Therriault, Johanna Gruber, Valerie Tourjman, Stephane Richard-Devantoy, Vasavan Nair, Marie-Andrée Bruneau, Soham Rej, Michael Lifshitz, Harmehr Sekhon, Magnus Bein, Myriam Lesage, Elena Dikaios, Mallar Chakravarty, Zindel Segal, Isabelle Royal, Mark Speechley, Alessandra Schiavetto, Daniel Blumberger, Matthew D Sacchet, Joseph Therriault, Johanna Gruber, Valerie Tourjman, Stephane Richard-Devantoy, Vasavan Nair, Marie-Andrée Bruneau, Soham Rej, Michael Lifshitz, Harmehr Sekhon

Abstract

Background: Late-life depression (LLD) affects up to 18% of older adults and has been linked to elevated dementia risk. Mindfulness-based cognitive therapy (MBCT) holds promise for treating symptoms of depression and ameliorating cognitive deficits in older adults. While preliminary findings are promising, a definitive RCT investigating its effects on late life depression and cognition have not yet been conducted. We present a protocol describing a multi-site blinded randomized controlled trial, comparing the effects of MBCT and of an active control, a Health Enhancement Program (HEP), on depressive symptoms, executive functioning, and brain biomarkers of LLD, among several other exploratory outcomes.

Methods: Two-hundred and thirteen (n = 213) patients with LLD will be recruited at various centers in Montreal, QC, Canada. Participants will undergo stratified randomization to either MBCT or HEP intervention groups. We will assess changes in (1) depression severity using the Hamilton Depression Rating Scale (HAM-D17), (2) processing speed and executive functioning, (3) brain biomarkers of LLD (hippocampal volume, default network resting-state functional connectivity and executive network resting-state functional connectivity), and (4) other exploratory physiological and mood-based measures, at baseline (0 weeks), post intervention (8 weeks), and 26 weeks after baseline.

Discussion: The proposed study will assess the clinical potential of MBCT to improve symptoms of depression, as well as examine its impact on cognitive impairments and neurobiological markers, and thus inform its use as a promising adjunct in the treatment of LLD.

Clinical trial registration: www.ClinicalTrials.gov, identifier: NCT05366088.

Keywords: behavioral activation; cognitive function; executive function; late-life depression; memory; mindfulness; processing speed.

Conflict of interest statement

SR receives a salary award from the Fonds de Recherche de Québec Santé FRQS, is a consultant for AbbVie, and is a shareholder of Aifred Health. HS has a CIHR fellowship award, MITACS fellowship award, and AGE-WELL award. ZS is a cofounder of Mindful Noggin and receives royalties from Guilford Press. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2022 Bein, Lesage, Dikaios, Chakravarty, Segal, Royal, Speechley, Schiavetto, Blumberger, Sacchet, Therriault, Gruber, Tourjman, Richard-Devantoy, Nair, Bruneau, Rej, Lifshitz and Sekhon.

Figures

Figure 1
Figure 1
Participant Allocation Flowchart.

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