Mindfulness-based interventions for older adults with late-life anxiety

Abstract

Anxiety in older adults can be debilitating and affect every aspect of daily life including cognitive function, sleep, and stress management. Although the presentation of anxiety can vary, common symptoms reported to primary care providers are insomnia, agitation, and irritation. The prevalence of anxiety in Canada is reported at 6.4% affecting about 2.5 million people across the lifespan. In 2012, anxiety costed the Canadian healthcare system an estimated $119.8 million per 100,000 people, and this cost is expected to increase with the rapidly aging population. The use of pharmacotherapy for the first line treatment of anxiety in older adults is common, has limited effectiveness and produce side effects such as increased risk of falls leading to hospitalization. Older adults have expressed interest in receiving mindfulness-based interventions for anxiety as an alternative or complementary treatment. The overall purpose of this dissertation was to expand knowledge related to mindfulness-based group treatments for late-life anxiety. Two studies were conducted as part of this dissertation. The first was a systematic review of existing mindfulness-based interventions for late-life anxiety. The second study was a randomized control trial to test the feasibility and acceptability of Emotion-Focused Mindfulness Therapy (EFMT), a mindfulness-based intervention, in older adult populations with anxiety. The key findings indicated the feasibility and acceptability of EFMT delivered through video conferencing for older adults with anxiety. Although the trial was not planned to be powered to examine clinical changes, statistically significant reductions to anxiety were observed in the intervention group post intervention compared to the control group. There was also a statistically significant reduction in the use of memory strategies post-intervention. The findings from this thesis will inform further development and evaluation of mindfulness-based interventions to meaningfully impact the mental health care of older adults with late-life anxiety. Thus, the present dissertation contributes to an emerging body of international research and clinical practice supporting alternative interventions for late-life anxiety in primary care, and also contributes to laying the groundwork for future larger scale studies of EFMT.