pp 1–11 | Cite as

Meditation on the Soles of the Feet Practice Provides Some Control of Aggression for Individuals with Alzheimer’s Disease

  • Nirbhay N. SinghEmail author
  • Giulio E. Lancioni
  • Oleg N. Medvedev
  • Shubha Sreenivas
  • Rachel E. Myers
  • Yoon-Suk Hwang


Alzheimer’s disease is a progressive neurodegenerative condition that affects cognition, mental and physical health, and functionality of older people. As the disease progresses from the mild to moderate stage, there is a concomitant increase in several behavioral variables, chiefly agitation, anger, and aggression. Currently, there are no evidence-based treatments for these behaviors in this population. Three individuals with moderate Alzheimer’s disease were taught an informal mindfulness practice, meditation on the Soles of the Feet (SoF), as a self-management strategy within a multiple-baseline design across participants. All three were able to learn and use the SoF practice to manage their verbal and physical aggression. Their use of the SoF practice was correlated with decreased perceived psychological stress for their spouses and caregivers, as well as for the participants, but to a much smaller degree. In terms of social validity, the participants, their spouses, and caregivers rated the SoF practice as acceptable, effective, with no unintended effects, and indicated that they would recommend the practice to others. However, they also rated SoF as effortful for the participants because it involves the participants remembering to use the practice with rising anger, a requirement particularly challenging for those with memory problems. The SoF practice may enable individuals in the early stages of dementia to manage their anger and aggression. The data were derived from an internally valid experimental design, suggestive of initial proof-of-concept, but needs to be replicated before any clinical implications can be imputed from this study.


Alzheimer’s disease Memory Aggression Soles of the Feet Stress Social validity 


Author Contributions

NNS, GEL, and REM designed and executed the study and wrote and revised the article for publication. ONM performed the data analyses and contributed to the writing of the results. SS and Y-S Hwang assisted in the drafting and editing of the article.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that no conflict of interest and they do not work for, consult to, own shares in or receive funding from any company or organization that would benefit from this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Psychiatry and Health Behavior, Medical College of GeorgiaAugusta UniversityAugustaUSA
  2. 2.Department of Neuroscience and Sense OrgansUniversity of BariBariItaly
  3. 3.Department of Psychology, Faculty of Health & Environmental SciencesAuckland University of TechnologyAucklandNew Zealand
  4. 4.Wrexham Glyndŵr University, Psychology Department, Faculty of Social and Life SciencesWrexhamUnited Kingdom
  5. 5.WellStar School of NursingKennesaw State UniversityKennesawUSA
  6. 6.Institute for Learning Sciences and Teacher EducationAustralian Catholic UniversityBrisbaneAustralia

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