J Affect Disord. 2020 Feb 15;263:310-317. doi: 10.1016/j.jad.2019.11.124. Epub 2019 Nov 30.
Purpose in life is a robust protective factor of reported cognitive decline among late middle-aged adults: The Emory Healthy Aging Study.
Journal of affective disorders
Aliza P Wingo, Thomas S Wingo, Wen Fan, Sharon Bergquist, Alvaro Alonso, Michele Marcus, Allan I Levey, James J Lah
Affiliations
Affiliations
- Division of Mental Health, Atlanta VA Medical Center, Decatur, GA, USA; Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: [email protected].
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Epidemiology, Rollins School of Public Health, Emory University, GA, USA.
PMID: 31969260
PMCID: PMC6989389 DOI: 10.1016/j.jad.2019.11.124
Abstract
BACKGROUND: Cognitive abilities tend to decline in advanced age. A novel protective factor of cognitive decline in advanced age is purpose-in-life (PiL), a trait-like tendency to derive life meanings and purpose. However, whether PiL protects against cognitive decline in late-middle-age is unclear. Hence, we examined the association between PiL and perceived cognitive decline, one of the earliest detectable cognitive symptoms before the onset of cognitive impairment. Furthermore, we used a machine learning approach to investigate whether PiL is a robust predictor of cognitive decline when considered with the known protective and risk factors for cognition.
METHODS: PiL was assessed with a 10-item questionnaire and perceived cognitive decline with the Cognitive Function Instrument among 5,441 Emory Healthy Aging Study participants, whose mean age was 63 and 51% were employed. Association between PiL and perceived cognitive decline was examined with linear regression adjusting for relevant confounding factors. Elastic Net was performed to identify the most robust predictors of cognitive decline.
RESULTS: Greater PiL was associated with less perceived cognitive decline after adjusting for the relevant factors. Furthermore, Elastic Net modeling suggested that PiL is a robust predictor of cognitive decline when considered simultaneously with known protective (education, exercise, enrichment activities) and risk factors for cognition (depression, anxiety, diagnosed medical, mental health problems, smoking, alcohol use, family history of dementia, and others).
LIMITATION: This is a cross-sectional study.
CONCLUSIONS: PiL is a robust protective factor of perceived cognitive decline observed as early as middle age. Thus, interventions to enhance PiL merit further investigation.
Copyright © 2019. Published by Elsevier B.V.
Conflict of interest statement
Declaration of Competing Interest None
References
- Neurology. 2015 Sep 8;85(10):898-904 - PubMed
- Alzheimers Dement (Amst). 2015 May 02;1(2):194-205 - PubMed
- J Psychosom Res. 2013 May;74(5):427-32 - PubMed
- J Behav Med. 2013 Apr;36(2):124-33 - PubMed
- Health Qual Life Outcomes. 2006 Oct 04;4:76 - PubMed
- Isr J Psychiatry Relat Sci. 2015;52(3):68-70 - PubMed
- Annu Rev Clin Psychol. 2017 May 8;13:369-396 - PubMed
- J Affect Disord. 2009 Apr;114(1-3):163-73 - PubMed
- Arch Intern Med. 2006 May 22;166(10):1092-7 - PubMed
- Palliat Support Care. 2019 Feb;17(1):21-28 - PubMed
- Neurology. 2012 Sep 25;79(13):1332-9 - PubMed
- Ageing Res Rev. 2006 Aug;5(3):354-69 - PubMed
- J Stat Softw. 2010;33(1):1-22 - PubMed
- J Pers Soc Psychol. 1995 Oct;69(4):719-27 - PubMed
- J Aging Health. 2019 Sep;31(8):1398-1422 - PubMed
- Exp Aging Res. 2007 Jan-Mar;33(1):77-93 - PubMed
- J Am Geriatr Soc. 2005 Apr;53(4):616-21 - PubMed
- Soc Indic Res. 2010 Jul;97(3):357-373 - PubMed
- J Am Geriatr Soc. 2017 Dec;65(12):2627-2633 - PubMed
- Alzheimers Dement. 2017 Apr;13(4):406-418 - PubMed
- J Clin Oncol. 2012 Apr 20;30(12):1304-9 - PubMed
- J Subst Abuse Treat. 2011 Mar;40(2):183-8 - PubMed
- J Psychosom Res. 2016 Jun;85:1-8 - PubMed
- J Alzheimers Dis. 2017;60(2):427-437 - PubMed
- Br Med Bull. 2009;92:135-52 - PubMed
- Arch Gen Psychiatry. 2010 Mar;67(3):304-10 - PubMed
- J Affect Disord. 2010 May;122(3):213-7 - PubMed
- Am J Geriatr Psychiatry. 2010 Dec;18(12):1093-102 - PubMed
- Med Care. 2008 Mar;46(3):266-74 - PubMed
- Neurology. 2015 Nov 24;85(21):1852-8 - PubMed
- Psychol Addict Behav. 2015 Sep;29(3):716-24 - PubMed
- Br J Psychol. 1992 Feb;83 ( Pt 1):133-45 - PubMed
- J Affect Disord. 2019 Mar 1;246:731-737 - PubMed
- Lancet. 2016 Jul 30;388(10043):505-17 - PubMed
- JAMA Neurol. 2015 Apr;72(4):446-54 - PubMed
- Psychol Aging. 2002 Jun;17(2):179-93 - PubMed
- Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2017 Nov;24(6):662-671 - PubMed
- Cancer. 2019 Jul 15;125(14):2383-2393 - PubMed
- Br J Psychiatry. 2018 Nov;213(5):654-660 - PubMed
- J Epidemiol Community Health. 2018 Aug;72(8):685-694 - PubMed
- Brain. 2018 Aug 1;141(8):2475-2485 - PubMed
- Brain. 2017 Mar 1;140(3):804-812 - PubMed
- Am J Public Health. 2010 Dec;100(12):2379-84 - PubMed
- Arch Gen Psychiatry. 2012 May;69(5):499-505 - PubMed
- Stroke. 2015 Apr;46(4):1071-6 - PubMed
- Am J Epidemiol. 2019 Apr 1;188(4):664-673 - PubMed
- J Clin Psychol. 1986 Jan;42(1):5-21 - PubMed
- Arch Gen Psychiatry. 2010 Apr;67(4):414-22 - PubMed
- Acta Psychiatr Scand. 2013 Jul;128(1):3-20 - PubMed
MeSH terms
Publication Types
Grant support