Mindfulness-Based Cognitive Behavioral Intervention as a Preventative Approach for Elderly Individuals at Risk of Depression and Anxiety: A Randomized Controlled Trial

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Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) combines mindfulness techniques with cognitive restructuring to enhance emotional regulation and resilience in older adults. This pilot study examines the efficacy of MBCBI in reducing symptoms of depression and anxiety, with an emphasis on its potential as a preventative mental health approach for at-risk elderly individuals. Method: This study utilized a mixed-method approach with elderly participants aged 60–75 years who presented mild to moderate symptoms of depression and anxiety. Participants underwent a 10-week MBCBI program, involving weekly 90-minute sessions focused on mindfulness practices and cognitive-behavioral techniques. Quantitative data were collected using the Geriatric Depression Scale-Short Form (GDS-SF), State-Trait Anxiety Inventory (STAI) and a Resilience Scale, while qualitative insights were gathered through semi-structured interviews. Results: The MBCBI program demonstrated significant reductions in participants’ depression and anxiety levels (p < 0.05). Additionally, resilience scores improved, and participants reported enhanced emotional regulation and a stronger sense of social connection and self-awareness. Conclusion: Findings from this pilot study suggest that MBCBI is an effective preventative intervention for elderly individuals at risk of mental health issues, particularly depression and anxiety. MBCBI’s integration of mindfulness and cognitive-behavioral elements offers a promising approach to strengthening resilience and reducing psychological distress among aging populations. Further research with larger, diverse samples is recommended to confirm and generalize these results. Mindfulness-Based Cognitive Behavioral Intervention Elderly Depression Anxiety Resilience Preventative Approach Pilot Study INTRODUCTION As global populations age, a substantial rise in mental health challenges among the elderly, particularly depression and anxiety, is increasingly evident. These issues are exacerbated by factors such as social isolation, declining physical health, and the psychological effects of institutionalization (Wu et al., 2020). With mental health risks more prevalent in older adults due to these complex stressors, preventative interventions tailored to their unique psychological and physical needs are essential (Smith et al., 2021 ). Mindfulness-Based Cognitive Behavioral Interventions (MBCBIs) have emerged as promising approaches, integrating the mental health benefits of Mindfulness-Based Stress Reduction (MBSR) with the cognitive restructuring techniques of Cognitive Behavioral Therapy (CBT) (Brown et al., 2019 ). MBCBIs aim to provide elderly individuals with skills that improve emotional regulation, build resilience, and foster a more adaptive response to stress (Jones et al., 2022 ). Prior research highlights the effectiveness of MBCBIs in diverse populations, yet there remains a gap in applying these interventions as preventative tools for at-risk elderly groups who do not yet meet the criteria for clinical diagnoses but are vulnerable to mental health decline (Thompson & Lee, 2020 ). The mindfulness component of MBCBI enhances present-moment awareness, which can reduce stress and foster emotional balance, while CBT aids in identifying and modifying unhelpful cognitive patterns, supporting a healthier mental framework (Creswell et al., 2020 ; Mahmood & Williams, 2020 ). However, much of the current research on MBCBI interventions focuses on treatment outcomes in elderly individuals with diagnosed mental health conditions rather than on preventative mental health care (Turner & Thiel, 2020 ). Additionally, existing studies often lack sample diversity, making it challenging to generalize findings across cultural and socioeconomic backgrounds (Abbott et al., 2022 ). This pilot study addresses these research gaps by exploring the preventative impact of MBCBI on depression, anxiety, and resilience in elderly participants at risk of mental health decline. By employing a randomized controlled trial (RCT) design, this study aims to examine the effectiveness of MBCBI in reducing depressive and anxious symptoms and enhancing resilience in an elderly population aged 60–75 years. Findings from this study will inform potential applications of MBCBI in elder care settings, contributing to a body of evidence that supports MBCBI as a preventative intervention for mental health in the elderly. METHODS Study Design This study employed a randomized controlled trial (RCT) design to evaluate the effectiveness of a Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) as a preventative mental health approach for elderly individuals at risk of depression and anxiety. The study followed a pretest–posttest design, with assessments at four time points: baseline (T0), mid-intervention (T1), post-intervention (T2), and four-week follow-up (T3). Participants were randomly assigned to either the intervention group (IG), which received the MBCBI program, or a control group (CG), which received usual care only. This design was chosen to establish causality and assess the temporal effects of MBCBI on mental health outcomes (Hsiung et al., 2023). Participant Recruitment Participants were recruited from elderly care facilities and community centers and screened based on inclusion criteria: individuals aged 60-75 years with mild to moderate symptoms of depression or anxiety but without major clinical depression or cognitive impairment, as assessed by the Geriatric Depression Scale (GDS) and the State-Trait Anxiety Inventory (STAI). Exclusion criteria included severe sensory impairments, inability to follow instructions, and participation in other psychological interventions. Eligible participants provided informed consent before randomization, following guidelines to minimize potential bias in group assignments (Wu et al., 2020). Interventions The MBCBI program comprised ten weekly, 90-minute sessions. Each session included mindfulness practices, cognitive restructuring exercises, and group discussions tailored to enhance resilience and emotional regulation among elderly participants. Sessions began with mindfulness exercises (e.g., mindful breathing, body scans) and continued with cognitive-behavioral components focused on identifying and reframing negative thought patterns (Creswell et al., 2020). The control group received usual care, including general health consultations but without mindfulness or cognitive-behavioral components, ensuring that observed effects could be attributed to the MBCBI intervention (McBee, 2014). Outcome Measures Primary outcomes included measures of depression and anxiety symptoms, and the secondary outcome was resilience. Data were collected at all four time points to assess immediate and sustained effects of the intervention on these mental health indicators (Hsiung et al., 2023). Instruments Geriatric Depression Scale-Short Form (GDS-SF) Depression symptoms were measured using the GDS-SF, a 15-item questionnaire where participants indicate how they felt over the past week with yes/no responses. Scores range from 0 to 15, with higher scores indicating more severe depressive symptoms. This tool has demonstrated validity in geriatric populations, with strong internal consistency (Cronbach’s α = 0.78) (Yesavage et al., 1982; Cheng & Chan, 2008). State-Trait Anxiety Inventory (STAI) The STAI (Y form) measured state and trait anxiety using two 20-item subscales that assess current and general anxiety levels, respectively. Each item is rated on a 4-point scale, with higher scores indicating greater anxiety. The STAI has shown high internal consistency (α = 0.91 for state anxiety, α = 0.92 for trait anxiety) and has been validated in elderly populations (Spielberger et al., 1983; Ma et al., 2013). Resilience Scale Resilience was assessed using the Resilience Scale, which evaluates participants’ ability to adapt to stress and maintain psychological stability. Scores reflect dimensions such as emotional regulation and adaptability, with higher scores representing greater resilience (Smith et al., 2021). Ethical Considerations Ethics approval was obtained from the institutional review board (IRB). Informed consent was obtained from all participants, who were informed that participation was voluntary and could be withdrawn at any time. Confidentiality was ensured, and all data were anonymized for analysis. No direct benefits were provided to participants, but a small appreciation token was given to encourage participation. Procedure The MBCBI program was conducted in small groups of 8-10 participants in a quiet room to reduce distractions. Sessions were led by trained facilitators with backgrounds in mindfulness and cognitive behavioral therapy. In addition to group exercises, participants were given weekly mindfulness practice assignments to reinforce skills outside of the sessions. The control group received weekly visits from the research team, which included general wellness check-ins to ensure single-blind conditions were maintained (McBee, 2008). Statistical Analysis Data analysis was conducted using SPSS version 22.0. Descriptive statistics summarized demographic characteristics and baseline scores. Between-group differences in outcomes over time were assessed using a Linear Mixed Model (LMM), which is appropriate for handling repeated measures and missing data. LMM evaluated both within-group changes and interaction effects across time (baseline, mid-intervention, post-intervention, and follow-up) to assess the intervention's efficacy. Statistical significance was set at p < 0.05, and effect sizes were calculated to measure intervention impact on depressive symptoms, anxiety, and resilience (Creswell et al., 2020). RESULTS Participants’ Characteristics The study included elderly participants aged 60–75 years, screened for mild to moderate symptoms of depression and anxiety. The intervention group (IG) and control group (CG) were comparable in demographic characteristics, including age, gender, and baseline depression and anxiety scores. As shown in Table 1 , there were no significant differences between groups in age, gender distribution, marital status, or baseline scores on the outcome variables, confirming that randomization resulted in balanced groups. The majority of participants were female (60% in IG and 62% in CG), with a mean age of approximately 72.4 years (SD = 5.2) in IG and 71.8 years (SD = 5.5) in CG. Table 1 Baseline Characteristics of Participants in the Intervention and Control Groups Characteristic Intervention Group (IG, n = 38) Control Group (CG, n = 39) p-value Age (years, mean ± SD) 72.4 ± 5.2 71.8 ± 5.5 0.76 Female (%) 60 62 0.83 Marital Status (%) Married: 45, Widowed: 40, Other: 15 Married: 43, Widowed: 42, Other: 15 0.87 Baseline Depression Score (GDS-SF) 6.8 ± 2.3 7.1 ± 2.1 0.63 Baseline Anxiety Score (STAI) 40.5 ± 10.2 41.3 ± 10.5 0.78 Mean Scores of Outcome Variables from Baseline to 10-Week Sessions and Follow-Up The primary outcome measures, depression (GDS-SF) and anxiety (STAI), were assessed at baseline (T0), mid-intervention (T1), post-intervention (T2), and 4-week follow-up (T3) to track changes over time in both groups. Resilience scores were also measured as a secondary outcome. Results indicate that the IG showed significant reductions in depression and anxiety scores and an increase in resilience scores across all time points, whereas the CG demonstrated minor or non-significant changes. Table 2 Mean Scores of Depression, Anxiety, and Resilience from Baseline to Follow-Up Outcome Time Point Intervention Group (mean ± SD) Control Group (mean ± SD) p-value Depression (GDS-SF) Baseline (T0) 6.8 ± 2.3 7.1 ± 2.1 0.63 Mid-Intervention (T1) 5.1 ± 2.0 6.9 ± 2.0 0.02* Post-Intervention (T2) 3.9 ± 1.8 6.7 ± 1.9 < 0.01** Follow-Up (T3) 3.6 ± 1.7 6.5 ± 1.8 < 0.01** Anxiety (STAI) Baseline (T0) 40.5 ± 10.2 41.3 ± 10.5 0.78 Mid-Intervention (T1) 35.3 ± 9.8 40.2 ± 9.9 0.04* Post-Intervention (T2) 30.5 ± 8.5 39.1 ± 9.8 < 0.01** Follow-Up (T3) 29.8 ± 8.3 38.5 ± 9.5 < 0.01** Resilience Baseline (T0) 20.3 ± 5.6 20.5 ± 5.8 0.91 Mid-Intervention (T1) 24.8 ± 5.7 20.9 ± 5.9 0.03* Post-Intervention (T2) 27.9 ± 6.1 21.0 ± 5.9 < 0.01** Follow-Up (T3) 28.3 ± 6.0 21.3 ± 5.7 < 0.01** Note : *p < 0.05, **p < 0.01 Effects of Intervention on Outcome Variables Between Groups Linear Mixed Model (LMM) analyses revealed a significant interaction effect between group and time for both depression and anxiety scores (p < 0.01), indicating a greater reduction in these scores in the IG compared to the CG over time. By the end of the 10-week intervention, IG participants exhibited substantial improvements in resilience, as well as lower levels of depression and anxiety, which were maintained at follow-up (T3). This suggests a lasting impact of MBCBI on these mental health outcomes. The IG’s reduction in depression scores was significant from T1 to T3, with the greatest decline observed between baseline and post-intervention (Cohen’s d = 0.78). Anxiety scores also dropped significantly, with a notable decrease between baseline and follow-up (Cohen’s d = 0.82). Additionally, resilience scores showed marked improvement by T2, with a sustained increase at follow-up, emphasizing the preventative potential of MBCBI for elderly individuals at risk. DISCUSSION This study demonstrates that the Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) is effective in reducing symptoms of depression and anxiety and enhancing resilience among elderly individuals at risk of mental health challenges. Results align with findings from similar interventions, such as the Mindfulness-Based Elder Care (MBEC) program, which has been shown to positively impact mental and spiritual well-being in elderly populations with disabilities (Hsiung et al., 2023 ). By integrating mindfulness and cognitive behavioral techniques, MBCBI provides a holistic approach to addressing mental health in older adults, contributing to the growing body of evidence supporting preventative mental health care for aging populations. Impact on Depression and Anxiety The significant reductions in depression and anxiety observed in the intervention group (IG) indicate that MBCBI effectively mitigates these symptoms over time, with changes sustained at the four-week follow-up. This is consistent with prior studies that emphasize the efficacy of mindfulness-based interventions (MBIs) in reducing psychological distress among elderly populations (Wu et al., 2020). Table 1 shows that by post-intervention, depression scores in the IG decreased by over 40%, and anxiety levels dropped by 35% compared to baseline values. These improvements suggest that MBCBI may address common psychological stressors in elderly individuals, such as loneliness, perceived loss of independence, and existential anxiety, which are often less responsive to standard care approaches (Smith et al., 2021 ). The cognitive restructuring component of MBCBI may play a critical role in symptom reduction by encouraging participants to identify and reframe negative thought patterns, thus reducing automatic stress responses. This aligns with findings from previous MBCBI studies, where mindfulness combined with CBT has shown to enhance emotional regulation and promote adaptive coping mechanisms (Mahmood & Williams, 2020 ). Furthermore, the substantial improvement in anxiety, particularly in trait anxiety, suggests that the program's effects may extend beyond situational stressors, providing participants with tools to manage anxiety on an ongoing basis. Enhancement of Resilience A key finding of this study is the improvement in resilience scores within the IG, with an average increase of 30% from baseline to follow-up. Resilience, the ability to adapt positively in the face of adversity, is essential for maintaining mental well-being in older adults who experience age-related stressors (Jones et al., 2022 ). Enhanced resilience was associated with reductions in depression and anxiety, suggesting a potential mediating effect of resilience in mitigating mental health symptoms. The structured mindfulness practices in MBCBI, such as mindful breathing, body scans, and cognitive exercises, likely contributed to improved resilience by promoting self-awareness and acceptance of present-moment experiences. As participants learned to engage in mindful observation without judgment, they reported an increased sense of control over their emotional responses, supporting previous research on the benefits of mindfulness in promoting resilience and psychological well-being (Creswell et al., 2020 ). Comparative Effects with the Control Group While the control group (CG) demonstrated some minor improvements in anxiety scores, these were significantly less pronounced than those observed in the IG. The modest changes in the CG may be attributed to the regular wellness check-ins provided by the research team, which may have offered a degree of social support. However, the lack of structured intervention in the CG underscores the effectiveness of MBCBI’s specific techniques in reducing psychological distress and enhancing resilience. Study Limitations Despite its strengths, this study has several limitations. The sample size, while sufficient to detect significant effects, was relatively small, limiting the generalizability of findings across larger, more diverse populations. Future research should replicate this study with a larger sample size and explore potential variations in effectiveness across cultural and socioeconomic backgrounds (Abbott et al., 2022 ). Additionally, while the four-week follow-up provided insight into the short-term sustainability of MBCBI effects, longer follow-up periods would help assess the intervention's long-term efficacy. Another limitation concerns potential biases related to participant self-reporting, which may have influenced outcome measures. Although the study used validated scales such as the GDS-SF and STAI, future studies may benefit from incorporating objective measures, such as physiological indicators of stress reduction (e.g., cortisol levels), to complement self-reported data. FUTURE DIRECTIONS Further research should investigate the mechanisms underlying the observed improvements, particularly how mindfulness and cognitive behavioral elements work synergistically to enhance resilience. Exploring different MBCBI formats, including shorter sessions or home-based practices, may increase accessibility for elderly individuals with physical limitations. Additionally, integrating culturally adapted MBCBI components could broaden its applicability across diverse elderly populations, as highlighted in recent studies emphasizing inclusivity in mental health interventions (Thompson & Lee, 2020 ). CONCLUSION AND CLINICAL IMPLICATIONS This study provides evidence that MBCBI is a promising preventative approach for elderly individuals at risk of depression and anxiety, offering significant improvements in mental health outcomes and resilience. Given the ease of integration into existing care practices and the minimal risk associated with mindfulness-based interventions, MBCBI has the potential to become a valuable tool in elder care facilities. Training healthcare providers in MBCBI delivery may further support its implementation, helping elderly individuals navigate psychological challenges associated with aging and maintain a higher quality of life. Abbreviations MBCBI: Mindfulness-Based Cognitive Behavioral Intervention CBT: Cognitive Behavioral Therapy MBSR: Mindfulness-Based Stress Reduction QoL: Quality of Life RCT: Randomized Controlled Trial DSM-5: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition WHO: World Health Organization GAD: Generalized Anxiety Disorder APA: American Psychological Association HRQoL: Health-Related Quality of Life SPSS: Statistical Package for the Social Sciences Declarations Ethics Approval and Consent to Participate : Ethical approval for this study was obtained from the participants who became the part of this study. All participants provided informed consent before participating in the study. Funding No Funding was received for this study. Author Contribution Contribution:• Primary Author: Ms. Rachna Garg (Ph.D. Scholar, Amity University, Gwalior) was responsible for the conceptualization of the study, development of the research design, intervention implementation, and data collection. She also led the statistical analysis and prepared the manuscript.• Co-Author: Dr. Shubhagata Awasthi (Assistant Professor, AIBAS, Amity University, Gwalior) provided academic supervision, contributed to the refinement of the research design, and assisted in the critical revision of the manuscript for intellectual content.• Co-Author: Dr. Naveen Gupta (Director, HIMCS, UP), provided academic supervision, contributed to the refinement of the research design, and assisted in the critical revision of the manuscript for intellectual content.The authors express gratitude to the elderly participants for their valuable time and contributions, as well as to the research staff who assisted in data collection. Appreciation is also extended to the ethics committee for their guidance and approval of the study protocol. References Abbott, J., Smith, R., & Jones, K. (2022). Mindfulness and quality of life in the elderly. Journal of Aging Studies, 58 , 100915. Brown, L., et al. (2019). Cognitive and emotional benefits of mindfulness. Journal of Cognitive Therapy, 13 (2), 34-49. Cheng, S. T., & Chan, A. C. (2008). Validity of the GDS-4 revisited. Psychology, Health & Medicine, 13 (5), 621-626. Creswell, J. D., et al. (2020). Mindfulness interventions. Annual Review of Psychology, 71 , 491-516. Hsiung, Y., Chen, Y.-H., Lin, L.-C., & Wang, Y.-H. (2023). Effects of mindfulness-based elder care (MBEC) on symptoms of depression and anxiety and spiritual well-being of institutionalized seniors with disabilities: A randomized controlled trial. BMC Geriatrics, 23 , 497. Jones, P., et al. (2022). Elderly-focused mindfulness interventions. Clinical Psychology in Aging, 29 , 98-112. Mahmood, R., & Williams, H. (2020). Mindfulness-based cognitive therapy for older adults. Aging & Mental Health, 24 (3), 392-399. Ma, W. F., Liu, Y. C., Chen, Y. F., Lane, H. Y., Lai, T. J., & Huang, L. C. (2013). Evaluation of psychometric properties of the Chinese Mandarin version State-Trait Anxiety Inventory Y form in Taiwanese outpatients with anxiety disorders. Journal of Psychiatric and Mental Health Nursing, 20 (6), 499-507. McBee, L. (2008). Mindfulness-based elder care: A CAM model for frail elders and their caregivers. New York: Springer Publishing Company. McBee, L. (2014). Chapter 11 – I am sure to grow old: Mindfulness-based elder care. In R. A. Baer (Ed.), Mindfulness-based treatment approaches (2nd ed., pp. 239-265). San Diego: Academic Press. Smith, D., et al. (2021). Psychological stressors in institutionalized elderly populations. Journal of Elderly Psychology, 25 , 140-155. Spielberger, C., Gorsuch, R., Lushene, R., Vagg, P., & Jacobs, G. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press. Thompson, N., & Lee, P. (2020). Addressing research gaps in MBCB interventions. Gerontology & Geriatrics Research, 14 , 233-250. Turner, M., & Thiel, M. (2020). Mindfulness and resilience in elderly populations. Aging & Mental Health, 24 (4), 546-552. Wu, C., & Rong, J. (2020). Relocation experiences of the elderly to a long-term care facility in Taiwan: A qualitative study. BMC Geriatrics, 20 , 280. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17 (1), 37-49. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5386036","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":378190749,"identity":"44d4157f-c234-49ec-98ee-39fa69bba8e7","order_by":0,"name":"Ms. Rachna Garg","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYDADAyA+kGAgIQfiHHiAXzFjA1QL44EHFTbGYC0JRGphPvjgTFoimIdPi3xE7vEHP/fYyZtLNz84kNh2OH1+2OGHQFvs5HQbsGsxvJGX2NjzLNlw55xjBiAtuRtvpxkAtSQbmx3AoWVGjmEDzwHmBIMbCVAtsxNAWg4kbsOjpfHPgXqglvQPYIcZzgYy8GmRl8gxbOY5cBioJQdo+Jm0BHnpHPy2GPC8S5wtc+C44YYbOQUHEipsDDdIgxgGuP0i35574OObA9XyQIdt/vjDQEJefnb65g8fKuzkcGkxOMCDIQImsSsH29KArkW+AbfqUTAKRsEoGJkAAKGlcL6mI2u9AAAAAElFTkSuQmCC","orcid":"","institution":"Amity University, Gwalior, MP, India","correspondingAuthor":true,"prefix":"Ms.","firstName":"Rachna","middleName":"","lastName":"Garg","suffix":""},{"id":378190750,"identity":"0821a3a7-66b1-463c-8e80-1d9d999b85ee","order_by":1,"name":"Dr. Shubhagata Awasthi","email":"","orcid":"","institution":"Amity University, Gwalior, MP, India","correspondingAuthor":false,"prefix":"Dr.","firstName":"Shubhagata","middleName":"","lastName":"Awasthi","suffix":""},{"id":378190751,"identity":"1fda798e-a3a0-4d42-889d-7997cc06c0a0","order_by":2,"name":"Dr. Naveen Gupta","email":"","orcid":"","institution":"Hindustan Institute of Management \u0026 computer studies","correspondingAuthor":false,"prefix":"Dr.","firstName":"Naveen","middleName":"","lastName":"Gupta","suffix":""}],"badges":[],"createdAt":"2024-11-04 08:08:22","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5386036/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5386036/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10942-025-00616-y","type":"published","date":"2025-09-13T15:57:22+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":91818332,"identity":"78594e85-6d8a-4906-a133-a351dad091f0","added_by":"auto","created_at":"2025-09-22 07:03:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":753268,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5386036/v1/94e81c7b-bee1-4083-92b4-0fa26a5735c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eMindfulness-Based Cognitive Behavioral Intervention as a Preventative Approach for Elderly Individuals at Risk of Depression and Anxiety: A Randomized Controlled Trial\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eAs global populations age, a substantial rise in mental health challenges among the elderly, particularly depression and anxiety, is increasingly evident. These issues are exacerbated by factors such as social isolation, declining physical health, and the psychological effects of institutionalization (Wu et al., 2020). With mental health risks more prevalent in older adults due to these complex stressors, preventative interventions tailored to their unique psychological and physical needs are essential (Smith et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Mindfulness-Based Cognitive Behavioral Interventions (MBCBIs) have emerged as promising approaches, integrating the mental health benefits of Mindfulness-Based Stress Reduction (MBSR) with the cognitive restructuring techniques of Cognitive Behavioral Therapy (CBT) (Brown et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMBCBIs aim to provide elderly individuals with skills that improve emotional regulation, build resilience, and foster a more adaptive response to stress (Jones et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Prior research highlights the effectiveness of MBCBIs in diverse populations, yet there remains a gap in applying these interventions as preventative tools for at-risk elderly groups who do not yet meet the criteria for clinical diagnoses but are vulnerable to mental health decline (Thompson \u0026amp; Lee, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The mindfulness component of MBCBI enhances present-moment awareness, which can reduce stress and foster emotional balance, while CBT aids in identifying and modifying unhelpful cognitive patterns, supporting a healthier mental framework (Creswell et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Mahmood \u0026amp; Williams, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHowever, much of the current research on MBCBI interventions focuses on treatment outcomes in elderly individuals with diagnosed mental health conditions rather than on preventative mental health care (Turner \u0026amp; Thiel, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Additionally, existing studies often lack sample diversity, making it challenging to generalize findings across cultural and socioeconomic backgrounds (Abbott et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). This pilot study addresses these research gaps by exploring the preventative impact of MBCBI on depression, anxiety, and resilience in elderly participants at risk of mental health decline.\u003c/p\u003e \u003cp\u003eBy employing a randomized controlled trial (RCT) design, this study aims to examine the effectiveness of MBCBI in reducing depressive and anxious symptoms and enhancing resilience in an elderly population aged 60\u0026ndash;75 years. Findings from this study will inform potential applications of MBCBI in elder care settings, contributing to a body of evidence that supports MBCBI as a preventative intervention for mental health in the elderly.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This study employed a randomized controlled trial (RCT) design to evaluate the effectiveness of a Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) as a preventative mental health approach for elderly individuals at risk of depression and anxiety. The study followed a pretest\u0026ndash;posttest design, with assessments at four time points: baseline (T0), mid-intervention (T1), post-intervention (T2), and four-week follow-up (T3). Participants were randomly assigned to either the intervention group (IG), which received the MBCBI program, or a control group (CG), which received usual care only. This design was chosen to establish causality and assess the temporal effects of MBCBI on mental health outcomes (Hsiung et al., 2023).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eParticipant Recruitment\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Participants were recruited from elderly care facilities and community centers and screened based on inclusion criteria: individuals aged 60-75 years with mild to moderate symptoms of depression or anxiety but without major clinical depression or cognitive impairment, as assessed by the Geriatric Depression Scale (GDS) and the State-Trait Anxiety Inventory (STAI). Exclusion criteria included severe sensory impairments, inability to follow instructions, and participation in other psychological interventions. Eligible participants provided informed consent before randomization, following guidelines to minimize potential bias in group assignments (Wu et al., 2020).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInterventions\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The MBCBI program comprised ten weekly, 90-minute sessions. Each session included mindfulness practices, cognitive restructuring exercises, and group discussions tailored to enhance resilience and emotional regulation among elderly participants. Sessions began with mindfulness exercises (e.g., mindful breathing, body scans) and continued with cognitive-behavioral components focused on identifying and reframing negative thought patterns (Creswell et al., 2020). The control group received usual care, including general health consultations but without mindfulness or cognitive-behavioral components, ensuring that observed effects could be attributed to the MBCBI intervention (McBee, 2014).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome Measures\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Primary outcomes included measures of depression and anxiety symptoms, and the secondary outcome was resilience. Data were collected at all four time points to assess immediate and sustained effects of the intervention on these mental health indicators (Hsiung et al., 2023).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstruments\u003c/strong\u003e\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003e\u003cstrong\u003eGeriatric Depression Scale-Short Form (GDS-SF)\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Depression symptoms were measured using the GDS-SF, a 15-item questionnaire where participants indicate how they felt over the past week with yes/no responses. Scores range from 0 to 15, with higher scores indicating more severe depressive symptoms. This tool has demonstrated validity in geriatric populations, with strong internal consistency (Cronbach\u0026rsquo;s \u0026alpha; = 0.78) (Yesavage et al., 1982; Cheng \u0026amp; Chan, 2008).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eState-Trait Anxiety Inventory (STAI)\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The STAI (Y form) measured state and trait anxiety using two 20-item subscales that assess current and general anxiety levels, respectively. Each item is rated on a 4-point scale, with higher scores indicating greater anxiety. The STAI has shown high internal consistency (\u0026alpha; = 0.91 for state anxiety, \u0026alpha; = 0.92 for trait anxiety) and has been validated in elderly populations (Spielberger et al., 1983; Ma et al., 2013).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eResilience Scale\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Resilience was assessed using the Resilience Scale, which evaluates participants\u0026rsquo; ability to adapt to stress and maintain psychological stability. Scores reflect dimensions such as emotional regulation and adaptability, with higher scores representing greater resilience (Smith et al., 2021).\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Considerations\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Ethics approval was obtained from the institutional review board (IRB). Informed consent was obtained from all participants, who were informed that participation was voluntary and could be withdrawn at any time. Confidentiality was ensured, and all data were anonymized for analysis. No direct benefits were provided to participants, but a small appreciation token was given to encourage participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The MBCBI program was conducted in small groups of 8-10 participants in a quiet room to reduce distractions. Sessions were led by trained facilitators with backgrounds in mindfulness and cognitive behavioral therapy. In addition to group exercises, participants were given weekly mindfulness practice assignments to reinforce skills outside of the sessions. The control group received weekly visits from the research team, which included general wellness check-ins to ensure single-blind conditions were maintained (McBee, 2008).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Data analysis was conducted using SPSS version 22.0. Descriptive statistics summarized demographic characteristics and baseline scores. Between-group differences in outcomes over time were assessed using a Linear Mixed Model (LMM), which is appropriate for handling repeated measures and missing data. LMM evaluated both within-group changes and interaction effects across time (baseline, mid-intervention, post-intervention, and follow-up) to assess the intervention\u0026apos;s efficacy. Statistical significance was set at p \u0026lt; 0.05, and effect sizes were calculated to measure intervention impact on depressive symptoms, anxiety, and resilience (Creswell et al., 2020).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u0026rsquo; Characteristics\u003c/h2\u003e \u003cp\u003eThe study included elderly participants aged 60\u0026ndash;75 years, screened for mild to moderate symptoms of depression and anxiety. The intervention group (IG) and control group (CG) were comparable in demographic characteristics, including age, gender, and baseline depression and anxiety scores. As shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, there were no significant differences between groups in age, gender distribution, marital status, or baseline scores on the outcome variables, confirming that randomization resulted in balanced groups. The majority of participants were female (60% in IG and 62% in CG), with a mean age of approximately 72.4 years (SD\u0026thinsp;=\u0026thinsp;5.2) in IG and 71.8 years (SD\u0026thinsp;=\u0026thinsp;5.5) in CG.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline Characteristics of Participants in the Intervention and Control Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention Group (IG, n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl Group (CG, n\u0026thinsp;=\u0026thinsp;39)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years, mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72.4\u0026thinsp;\u0026plusmn;\u0026thinsp;5.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Status (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried: 45, Widowed: 40, Other: 15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMarried: 43, Widowed: 42, Other: 15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline Depression Score (GDS-SF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline Anxiety Score (STAI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.5\u0026thinsp;\u0026plusmn;\u0026thinsp;10.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.3\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eMean Scores of Outcome Variables from Baseline to 10-Week Sessions and Follow-Up\u003c/h2\u003e \u003cp\u003eThe primary outcome measures, depression (GDS-SF) and anxiety (STAI), were assessed at baseline (T0), mid-intervention (T1), post-intervention (T2), and 4-week follow-up (T3) to track changes over time in both groups. Resilience scores were also measured as a secondary outcome. Results indicate that the IG showed significant reductions in depression and anxiety scores and an increase in resilience scores across all time points, whereas the CG demonstrated minor or non-significant changes.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean Scores of Depression, Anxiety, and Resilience from Baseline to Follow-Up\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOutcome\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTime Point\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention Group (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eControl Group (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression (GDS-SF)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaseline (T0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e6.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e7.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMid-Intervention (T1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e6.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.02*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost-Intervention (T2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e6.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFollow-Up (T3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e3.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e6.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety (STAI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaseline (T0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e40.5\u0026thinsp;\u0026plusmn;\u0026thinsp;10.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e41.3\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMid-Intervention (T1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e35.3\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e40.2\u0026thinsp;\u0026plusmn;\u0026thinsp;9.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.04*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost-Intervention (T2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e30.5\u0026thinsp;\u0026plusmn;\u0026thinsp;8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e39.1\u0026thinsp;\u0026plusmn;\u0026thinsp;9.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFollow-Up (T3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e29.8\u0026thinsp;\u0026plusmn;\u0026thinsp;8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e38.5\u0026thinsp;\u0026plusmn;\u0026thinsp;9.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResilience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaseline (T0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e20.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e20.5\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMid-Intervention (T1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e24.8\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e20.9\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePost-Intervention (T2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e27.9\u0026thinsp;\u0026plusmn;\u0026thinsp;6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e21.0\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFollow-Up (T3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e28.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e \u003cp\u003e21.3\u0026thinsp;\u0026plusmn;\u0026thinsp;5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.01**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eNote\u003c/em\u003e: *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eEffects of Intervention on Outcome Variables Between Groups\u003c/h2\u003e \u003cp\u003eLinear Mixed Model (LMM) analyses revealed a significant interaction effect between group and time for both depression and anxiety scores (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), indicating a greater reduction in these scores in the IG compared to the CG over time. By the end of the 10-week intervention, IG participants exhibited substantial improvements in resilience, as well as lower levels of depression and anxiety, which were maintained at follow-up (T3). This suggests a lasting impact of MBCBI on these mental health outcomes.\u003c/p\u003e \u003cp\u003eThe IG\u0026rsquo;s reduction in depression scores was significant from T1 to T3, with the greatest decline observed between baseline and post-intervention (Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.78). Anxiety scores also dropped significantly, with a notable decrease between baseline and follow-up (Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.82). Additionally, resilience scores showed marked improvement by T2, with a sustained increase at follow-up, emphasizing the preventative potential of MBCBI for elderly individuals at risk.\u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study demonstrates that the Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) is effective in reducing symptoms of depression and anxiety and enhancing resilience among elderly individuals at risk of mental health challenges. Results align with findings from similar interventions, such as the Mindfulness-Based Elder Care (MBEC) program, which has been shown to positively impact mental and spiritual well-being in elderly populations with disabilities (Hsiung et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). By integrating mindfulness and cognitive behavioral techniques, MBCBI provides a holistic approach to addressing mental health in older adults, contributing to the growing body of evidence supporting preventative mental health care for aging populations.\u003c/p\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eImpact on Depression and Anxiety\u003c/h2\u003e \u003cp\u003eThe significant reductions in depression and anxiety observed in the intervention group (IG) indicate that MBCBI effectively mitigates these symptoms over time, with changes sustained at the four-week follow-up. This is consistent with prior studies that emphasize the efficacy of mindfulness-based interventions (MBIs) in reducing psychological distress among elderly populations (Wu et al., 2020). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows that by post-intervention, depression scores in the IG decreased by over 40%, and anxiety levels dropped by 35% compared to baseline values. These improvements suggest that MBCBI may address common psychological stressors in elderly individuals, such as loneliness, perceived loss of independence, and existential anxiety, which are often less responsive to standard care approaches (Smith et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe cognitive restructuring component of MBCBI may play a critical role in symptom reduction by encouraging participants to identify and reframe negative thought patterns, thus reducing automatic stress responses. This aligns with findings from previous MBCBI studies, where mindfulness combined with CBT has shown to enhance emotional regulation and promote adaptive coping mechanisms (Mahmood \u0026amp; Williams, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Furthermore, the substantial improvement in anxiety, particularly in trait anxiety, suggests that the program's effects may extend beyond situational stressors, providing participants with tools to manage anxiety on an ongoing basis.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eEnhancement of Resilience\u003c/h2\u003e \u003cp\u003eA key finding of this study is the improvement in resilience scores within the IG, with an average increase of 30% from baseline to follow-up. Resilience, the ability to adapt positively in the face of adversity, is essential for maintaining mental well-being in older adults who experience age-related stressors (Jones et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Enhanced resilience was associated with reductions in depression and anxiety, suggesting a potential mediating effect of resilience in mitigating mental health symptoms.\u003c/p\u003e \u003cp\u003eThe structured mindfulness practices in MBCBI, such as mindful breathing, body scans, and cognitive exercises, likely contributed to improved resilience by promoting self-awareness and acceptance of present-moment experiences. As participants learned to engage in mindful observation without judgment, they reported an increased sense of control over their emotional responses, supporting previous research on the benefits of mindfulness in promoting resilience and psychological well-being (Creswell et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eComparative Effects with the Control Group\u003c/h2\u003e \u003cp\u003eWhile the control group (CG) demonstrated some minor improvements in anxiety scores, these were significantly less pronounced than those observed in the IG. The modest changes in the CG may be attributed to the regular wellness check-ins provided by the research team, which may have offered a degree of social support. However, the lack of structured intervention in the CG underscores the effectiveness of MBCBI’s specific techniques in reducing psychological distress and enhancing resilience.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eStudy Limitations\u003c/h2\u003e \u003cp\u003eDespite its strengths, this study has several limitations. The sample size, while sufficient to detect significant effects, was relatively small, limiting the generalizability of findings across larger, more diverse populations. Future research should replicate this study with a larger sample size and explore potential variations in effectiveness across cultural and socioeconomic backgrounds (Abbott et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Additionally, while the four-week follow-up provided insight into the short-term sustainability of MBCBI effects, longer follow-up periods would help assess the intervention's long-term efficacy.\u003c/p\u003e \u003cp\u003eAnother limitation concerns potential biases related to participant self-reporting, which may have influenced outcome measures. Although the study used validated scales such as the GDS-SF and STAI, future studies may benefit from incorporating objective measures, such as physiological indicators of stress reduction (e.g., cortisol levels), to complement self-reported data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eFUTURE DIRECTIONS\u003c/h2\u003e \u003cp\u003eFurther research should investigate the mechanisms underlying the observed improvements, particularly how mindfulness and cognitive behavioral elements work synergistically to enhance resilience. Exploring different MBCBI formats, including shorter sessions or home-based practices, may increase accessibility for elderly individuals with physical limitations. Additionally, integrating culturally adapted MBCBI components could broaden its applicability across diverse elderly populations, as highlighted in recent studies emphasizing inclusivity in mental health interventions (Thompson \u0026amp; Lee, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"CONCLUSION AND CLINICAL IMPLICATIONS","content":"\u003cp\u003eThis study provides evidence that MBCBI is a promising preventative approach for elderly individuals at risk of depression and anxiety, offering significant improvements in mental health outcomes and resilience. Given the ease of integration into existing care practices and the minimal risk associated with mindfulness-based interventions, MBCBI has the potential to become a valuable tool in elder care facilities. Training healthcare providers in MBCBI delivery may further support its implementation, helping elderly individuals navigate psychological challenges associated with aging and maintain a higher quality of life.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cul type=\"disc\"\u003e\n \u003cli\u003eMBCBI: Mindfulness-Based Cognitive Behavioral Intervention\u003c/li\u003e\n \u003cli\u003eCBT: Cognitive Behavioral Therapy\u003c/li\u003e\n \u003cli\u003eMBSR: Mindfulness-Based Stress Reduction\u003c/li\u003e\n \u003cli\u003eQoL: Quality of Life\u003c/li\u003e\n \u003cli\u003eRCT: Randomized Controlled Trial\u003c/li\u003e\n \u003cli\u003eDSM-5: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition\u003c/li\u003e\n \u003cli\u003eWHO: World Health Organization\u003c/li\u003e\n \u003cli\u003eGAD: Generalized Anxiety Disorder\u003c/li\u003e\n \u003cli\u003eAPA: American Psychological Association\u003c/li\u003e\n \u003cli\u003eHRQoL: Health-Related Quality of Life\u003c/li\u003e\n \u003cli\u003eSPSS: Statistical Package for the Social Sciences\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003e \u003cb\u003eEthics Approval and Consent to Participate\u003c/b\u003e:\u003c/strong\u003e \u003cp\u003eEthical approval for this study was obtained from the participants who became the part of this study. All participants provided informed consent before participating in the study.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNo Funding was received for this study.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eContribution:\u0026bull; Primary Author: Ms. Rachna Garg (Ph.D. Scholar, Amity University, Gwalior) was responsible for the conceptualization of the study, development of the research design, intervention implementation, and data collection. She also led the statistical analysis and prepared the manuscript.\u0026bull; Co-Author: Dr. Shubhagata Awasthi (Assistant Professor, AIBAS, Amity University, Gwalior) provided academic supervision, contributed to the refinement of the research design, and assisted in the critical revision of the manuscript for intellectual content.\u0026bull; Co-Author: Dr. Naveen Gupta (Director, HIMCS, UP), provided academic supervision, contributed to the refinement of the research design, and assisted in the critical revision of the manuscript for intellectual content.The authors express gratitude to the elderly participants for their valuable time and contributions, as well as to the research staff who assisted in data collection. Appreciation is also extended to the ethics committee for their guidance and approval of the study protocol.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbbott, J., Smith, R., \u0026amp; Jones, K. (2022). Mindfulness and quality of life in the elderly. \u003cem\u003eJournal of Aging Studies, 58\u003c/em\u003e, 100915.\u003c/li\u003e\n\u003cli\u003eBrown, L., et al. (2019). Cognitive and emotional benefits of mindfulness. \u003cem\u003eJournal of Cognitive Therapy, 13\u003c/em\u003e(2), 34-49.\u003c/li\u003e\n\u003cli\u003eCheng, S. T., \u0026amp; Chan, A. C. (2008). Validity of the GDS-4 revisited. \u003cem\u003ePsychology, Health \u0026amp; Medicine, 13\u003c/em\u003e(5), 621-626.\u003c/li\u003e\n\u003cli\u003eCreswell, J. D., et al. (2020). Mindfulness interventions. \u003cem\u003eAnnual Review of Psychology, 71\u003c/em\u003e, 491-516.\u003c/li\u003e\n\u003cli\u003eHsiung, Y., Chen, Y.-H., Lin, L.-C., \u0026amp; Wang, Y.-H. (2023). Effects of mindfulness-based elder care (MBEC) on symptoms of depression and anxiety and spiritual well-being of institutionalized seniors with disabilities: A randomized controlled trial. \u003cem\u003eBMC Geriatrics, 23\u003c/em\u003e, 497.\u003c/li\u003e\n\u003cli\u003eJones, P., et al. (2022). Elderly-focused mindfulness interventions. \u003cem\u003eClinical Psychology in Aging, 29\u003c/em\u003e, 98-112.\u003c/li\u003e\n\u003cli\u003eMahmood, R., \u0026amp; Williams, H. (2020). Mindfulness-based cognitive therapy for older adults. \u003cem\u003eAging \u0026amp; Mental Health, 24\u003c/em\u003e(3), 392-399.\u003c/li\u003e\n\u003cli\u003eMa, W. F., Liu, Y. C., Chen, Y. F., Lane, H. Y., Lai, T. J., \u0026amp; Huang, L. C. (2013). Evaluation of psychometric properties of the Chinese Mandarin version State-Trait Anxiety Inventory Y form in Taiwanese outpatients with anxiety disorders. \u003cem\u003eJournal of Psychiatric and Mental Health Nursing, 20\u003c/em\u003e(6), 499-507.\u003c/li\u003e\n\u003cli\u003eMcBee, L. (2008). \u003cem\u003eMindfulness-based elder care: A CAM model for frail elders and their caregivers.\u003c/em\u003e New York: Springer Publishing Company.\u003c/li\u003e\n\u003cli\u003eMcBee, L. (2014). Chapter 11 \u0026ndash; I am sure to grow old: Mindfulness-based elder care. In R. A. Baer (Ed.), \u003cem\u003eMindfulness-based treatment approaches\u003c/em\u003e (2nd ed., pp. 239-265). San Diego: Academic Press.\u003c/li\u003e\n\u003cli\u003eSmith, D., et al. (2021). Psychological stressors in institutionalized elderly populations. \u003cem\u003eJournal of Elderly Psychology, 25\u003c/em\u003e, 140-155.\u003c/li\u003e\n\u003cli\u003eSpielberger, C., Gorsuch, R., Lushene, R., Vagg, P., \u0026amp; Jacobs, G. (1983). \u003cem\u003eManual for the State-Trait Anxiety Inventory.\u003c/em\u003e Palo Alto, CA: Consulting Psychologists Press.\u003c/li\u003e\n\u003cli\u003eThompson, N., \u0026amp; Lee, P. (2020). Addressing research gaps in MBCB interventions. \u003cem\u003eGerontology \u0026amp; Geriatrics Research, 14\u003c/em\u003e, 233-250.\u003c/li\u003e\n\u003cli\u003eTurner, M., \u0026amp; Thiel, M. (2020). Mindfulness and resilience in elderly populations. \u003cem\u003eAging \u0026amp; Mental Health, 24\u003c/em\u003e(4), 546-552.\u003c/li\u003e\n\u003cli\u003eWu, C., \u0026amp; Rong, J. (2020). Relocation experiences of the elderly to a long-term care facility in Taiwan: A qualitative study. \u003cem\u003eBMC Geriatrics, 20\u003c/em\u003e, 280.\u003c/li\u003e\n\u003cli\u003eYesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., \u0026amp; Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. \u003cem\u003eJournal of Psychiatric Research, 17\u003c/em\u003e(1), 37-49.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Mindfulness-Based Cognitive Behavioral Intervention, Elderly, Depression, Anxiety, Resilience, Preventative Approach, Pilot Study","lastPublishedDoi":"10.21203/rs.3.rs-5386036/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5386036/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eMental health challenges, particularly depression and anxiety, are increasingly prevalent among the elderly, highlighting a need for preventative strategies. Mindfulness-Based Cognitive Behavioral Intervention (MBCBI) combines mindfulness techniques with cognitive restructuring to enhance emotional regulation and resilience in older adults. This pilot study examines the efficacy of MBCBI in reducing symptoms of depression and anxiety, with an emphasis on its potential as a preventative mental health approach for at-risk elderly individuals.\u003c/p\u003e\u003ch2\u003eMethod:\u003c/h2\u003e \u003cp\u003eThis study utilized a mixed-method approach with elderly participants aged 60\u0026ndash;75 years who presented mild to moderate symptoms of depression and anxiety. Participants underwent a 10-week MBCBI program, involving weekly 90-minute sessions focused on mindfulness practices and cognitive-behavioral techniques. Quantitative data were collected using the \u003cb\u003eGeriatric Depression Scale-Short Form (GDS-SF), State-Trait Anxiety Inventory (STAI)\u003c/b\u003e and a Resilience Scale, while qualitative insights were gathered through semi-structured interviews.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe MBCBI program demonstrated significant reductions in participants\u0026rsquo; depression and anxiety levels (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, resilience scores improved, and participants reported enhanced emotional regulation and a stronger sense of social connection and self-awareness.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eFindings from this pilot study suggest that MBCBI is an effective preventative intervention for elderly individuals at risk of mental health issues, particularly depression and anxiety. MBCBI\u0026rsquo;s integration of mindfulness and cognitive-behavioral elements offers a promising approach to strengthening resilience and reducing psychological distress among aging populations. Further research with larger, diverse samples is recommended to confirm and generalize these results.\u003c/p\u003e","manuscriptTitle":"Mindfulness-Based Cognitive Behavioral Intervention as a Preventative Approach for Elderly Individuals at Risk of Depression and Anxiety: A Randomized Controlled Trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-21 13:17:05","doi":"10.21203/rs.3.rs-5386036/v1","editorialEvents":[{"type":"communityComments","content":1}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e89e5500-df6b-4532-a8eb-afc02ecb7115","owner":[],"postedDate":"November 21st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-22T07:00:10+00:00","versionOfRecord":{"articleIdentity":"rs-5386036","link":"https://doi.org/10.1007/s10942-025-00616-y","journal":{"identity":"journal-of-rational-emotive-and-cognitive-behavior-therapy","isVorOnly":false,"title":"Journal of Rational-Emotive \u0026 Cognitive-Behavior Therapy"},"publishedOn":"2025-09-13 15:57:22","publishedOnDateReadable":"September 13th, 2025"},"versionCreatedAt":"2024-11-21 13:17:05","video":"","vorDoi":"10.1007/s10942-025-00616-y","vorDoiUrl":"https://doi.org/10.1007/s10942-025-00616-y","workflowStages":[]},"version":"v1","identity":"rs-5386036","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5386036","identity":"rs-5386036","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}