Purpose in life is a robust protective factor of reported cognitive decline among late middle-aged adults: The Emory Healthy Aging Study

• Type of Material: Article
• Authors: Aliza Wingo, Emory University; Thomas Wingo, Emory University; Wen Fan, Emory University; Sharon Bergquist, Emory University; Alvaro Alonso, Emory University; Michele Marcus, Emory University; Allan Levey, Emory University; James Lah, Emory University
• Language: English
• Date: 2020-02-15
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jad.2019.11.124
• Title of Journal or Parent Work: Journal of Affective Disorders
• Volume: 263
• Start Page: 310
• End Page: 317
• Grant/Funding Information: None declared
• Keywords: Life Sciences & Biomedicine; Science & Technology; Reduced risk; Dementia; Stress; Complaints; Neurosciences & Neurology; Clinical Neurology; Impairment; Depression; Resilience; Generalized anxiety disorder; Psychiatry; Alzheimer's disease; Diagnosis
• Research Categories: Health Sciences, Mental Health; Biology, Neuroscience; Health Sciences, Epidemiology

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.