Automatic self-transcending meditation improves heart rate variability in late-life depression

Arena A, Maldeniya P, Ionson E, Newman R, Burhan A, Wetmore S, & Vasudev A

Abstract:

Late-life depression (LLD) typically affects adults 60 years of age or older, many of whom experience their first major depressive episode later in life (i.e. after 50 years of age). Current estimates of the prevalence of this mental health disease have been found to be as high as 16% and are expected to increase further as we face a more aged population. It is widely accepted that LLD differs in aetiology and clinical presentation from depression in the general adult population as it has been found to be strongly associated with heart-related diseases. Specifically, evidence has shown that LLD is associated with a three-fold increased risk of cardiovascular disease. This relationship may be mediated by autonomic dysfunction and is further complicated by the adverse effects some antidepressants have been found to have on autonomic tone. Given the prevalence and severity of these illnesses, there is scope to explore the utility of non-pharmacological mind-body therapies in ameliorating physiological symptoms of depression. Therefore, the aim of this study is to assess the cardiovascular benefits of a category of meditation referred to as automatic self-transcending meditation (ASTM) in LLD. We present preliminary results (n=20) from an ongoing single-centre, single-blind, longitudinal RCT assessing the effects of a 12-week augmentation program of ASTM vs. treatment as usual (TAU) on heart rate variability (HRV), an autonomic parameter. Participants between 60-85 years of age with an Axis I diagnosis of mild to moderate LLD were randomized to the ASTM (n=9) or TAU (n=11) study arms. ASTM training was administered on four consecutive days (2hrs/day), followed by weekly 1hr follow up sessions for 11 subsequent weeks. ECGs were completed at baseline (week 0) and post-intervention (week 12). Thus far, the findings are promising; although only approaching significance at the current sample size, paired t-tests identify improvements in low frequency- HRV with ASTM training (p = .06) as compared to TAU (p = .6). These preliminary results suggest that ASTM may improve autonomic tone in LLD. The study is ongoing (target n=96) and will require further analysis; if the results continue to show the effectiveness of ASTM in improving autonomic parameters, such a treatment could be readily adapted into routine clinical care.