Introduction: Older adults experiencing subjective cognitive decline (SCD) have a heightened risk of developing dementia and frequently experience subclinical anxiety, which is itself associated with dementia risk. Objective: To understand whether subclinical anxiety symptoms in SCD can be reduced through behavioral interventions. Methods: SCD-Well is a randomized controlled trial designed to determine whether an 8-week mindfulness-based intervention (caring mindfulness-based approach for seniors; CMBAS) is superior to a structurally matched health self-management program (HSMP) in reducing subclinical anxiety. Participants were recruited from memory clinics at 4 European sites. The primary outcome was change in anxiety symptoms (trait subscale of the State-Trait Anxiety Inventory; trait-STAI) from pre- to postintervention. Secondary outcomes included a change in state anxiety and depression symptoms postintervention and 6 months postrandomization (follow-up). Results: One hundred forty-seven participants (mean [SD] age: 72.7 [6.9] years; 64.6% women; CMBAS, n = 73; HSMP, n = 74) were included in the intention-to-treat analysis. There was no difference in trait-STAI between groups postintervention (adjusted change difference: –1.25 points; 95% CI –4.76 to 2.25) or at follow-up (adjusted change difference: –0.43 points; 95% CI –2.92 to 2.07). Trait-STAI decreased postintervention in both groups (CMBAS: –3.43 points; 95% CI –5.27 to –1.59; HSMP: –2.29 points; 95% CI –4.14 to –0.44) and reductions were maintained at follow-up. No between-group differences were observed for change in state anxiety or depression symptoms. Conclusions: A time-limited mindfulness intervention is not superior to health self-management in reducing subclinical anxiety symptoms in SCD. The sustained reduction observed across both groups suggests that subclinical anxiety symptoms in SCD are modifiable. ClinicalTrials.gov identifier: NCT03005652.
Psychother Psychosom

中文翻译：

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基于正念的干预与健康自我管理对主观认知衰退老年人亚临床焦虑的影响：SCD-Well 随机优势试验

简介：经历主观认知能力下降 (SCD) 的老年人患痴呆症的风险更高，并且经常经历亚临床焦虑，而亚临床焦虑本身与痴呆风险有关。目的：了解是否可以通过行为干预减少 SCD 的亚临床焦虑症状。方法：SCD-Well 是一项随机对照试验，旨在确定为期 8 周的基于正念的干预（针对老年人的基于正念的关怀方法；CMBAS）在减少亚临床焦虑方面是否优于结构匹配的健康自我管理计划 (HSMP)。参与者是从 4 个欧洲站点的记忆诊所招募的。主要结果是焦虑症状（状态-特质焦虑量表的特质分量表；特质-STAI）从干预前到干预后的变化。次要结果包括干预后和随机化后 6 个月（随访）状态焦虑和抑郁症状的变化。结果： 147 名参与者（平均 [SD] 年龄：72.7 [6.9] 岁；64.6% 为女性；CMBAS，n = 73；HSMP，n= 74) 被纳入意向治疗分析。干预后（调整后的变化差异：–1.25 分；95% CI –4.76 至 2.25）或随访时（调整后的变化差异：–0.43 分；95% CI –2.92 至 2.07）组间的特质 STAI 没有差异. 两组的 Trait-STAI 均在干预后降低（CMBAS：–3.43 分；95% CI –5.27 至 –1.59；HSMP：–2.29 分；95% CI –4.14 至 –0.44）并且在随访时保持降低。在状态焦虑或抑郁症状的变化方面没有观察到组间差异。结论：限时正念干预在减少 SCD 的亚临床焦虑症状方面并不优于健康自我管理。在两组中观察到的持续减少表明 SCD 中的亚临床焦虑症状是可以改变的。ClinicalTrials.gov 标识符： NCT03005652。
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