Purposeful Engagement, Healthy Aging, and the Brain

An exploration of neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older black adults

OBJECTIVES

While existing research has shown that Black adults have worse cognitive functioning than their White counterparts, the psychosocial correlates of cognitive functioning for Black older adults are understudied. The objective of this study was to investigate the relationships among perceived neighborhood characteristics, psychosocial resilience resources, and cognitive functioning among midlife and older Black adults.

METHODS

Data were from 3,191 Black adults ages 51+ in the 2008-2016 waves of the Health and Retirement Study to examine associations among neighborhood characteristics, psychosocial resilience (sense of purpose, mastery, and social support), and cognitive functioning among Black adults. Multilevel linear regression models assessed direct effects of neighborhood characteristics and psychosocial resources on cognitive functioning. We then tested whether psychosocial resources moderated the association between neighborhood characteristics and cognitive functioning.

RESULTS

Mean levels of cognitive functioning, sense of purpose, social support, and mastery were significantly related to neighborhood disorder and discohesion. Regression results showed that levels of neighborhood disorder and high discohesion were significantly associated with cognitive functioning. Sense of purpose was positively associated with cognitive functioning, net of neighborhood characteristics. However, only social support moderated the association between neighborhood discohesion and cognition.

CONCLUSIONS

These findings demonstrate the importance of examining psychosocial and contextual risk and resilience resources among midlife and older Black adults. This work may inform the development of cognitive behavioral interventions aimed at increasing sense of purpose to promote and enhance cognitive resiliency among Black adults. Altogether, this work may have implications for policy aimed at advancing cognitive health equity.

Purpose in Life and Cognitive Function: Evidence for Momentary Associations in Daily Life

Background and Objectives

Purpose in life is associated with healthier cognitive outcomes in older adulthood. This research examines within-person dynamics between momentary purpose and cognitive function to provide proof of concept that increases in purpose are associated with better cognitive performance.

Research Design and Methods

Participants (N = 303; 54% female; Mage = 51.71, SD = 7.32) completed smartphone-based momentary assessments of purpose and short cognitive tasks 3 times a day for 8 days.

Results

In moments when participants felt more purpose driven than their average, they had faster processing speed (b = -1.240, SE = 0.194; p < .001), independent of person, temporal, and contextual factors and practice effects. Momentary purpose was unrelated to visual working memory performance (b = -0.001, SE = 0.001; p = .475). In contrast to purpose, momentary hedonic affect (e.g., happiness) was unrelated to momentary cognition.

Discussion and Implications

Feeling more momentary purpose may support faster processing speed in daily life. Such evidence provides stage 0 support for a purpose-based intervention for healthier cognition, which may be particularly useful in middle adulthood and the transition to older adulthood before the onset of cognitive impairment.

Building blocks for a happy life: Longitudinal associations between early life income, mentorship and later well-being

Longitudinal data from the Panel Study of Income Dynamics (PSID; N = 2996) were used to test hypotheses about the link between well-being and financial and social developmental resources. Results suggest that higher average family income from birth to age 18, and personal and professional mentoring received between 17 and 30, were positively associated with indicators of positive well-being and negatively related to negative indicators of well-being. Interactions between early life family income and mentoring during emerging adulthood were not significant predictors of any of the well-being outcomes. In all cases, the magnitudes of the coefficients became larger when simultaneously accounting for early life income, emerging adulthood mentoring, and their interactions-suggesting that financial and social resources in earlier life are independently linked to later life well-being. Findings highlight that mentoring received in emerging adulthood benefits downstream hedonic and eudemonic well-being, regardless of financial resources.

Locus coeruleus neuromelanin accumulation and dissipation across the lifespan

The pigment neuromelanin, produced in the locus coeruleus (LC) as a byproduct of catecholamine synthesis, gives the "blue spot" its name, and both identifies LC neurons and is thought to play an important yet complex role in normal and pathological aging. Using neuromelanin-sensitive T1-weighted turbo spin echo MRI scans we characterized volume and neuromelanin signal intensity in the LC of 96 participants between the ages of 19 and 86. Although LC volume did not change significantly throughout the lifespan, LC neuromelanin signal intensity increased from early adulthood, peaked around age 60 and precipitously declined thereafter. Neuromelanin intensity was greater in the caudal relative to rostral extent and in women relative to men. With regard to function, rostral LC neuromelanin intensity was associated with fluid cognition in older adults (60+) only in those above the 50th percentile of cognitive ability for age. The gradual accumulation of LC neuromelanin across the lifespan, its sudden dissipation in later life, and relation to preserved cognitive function, is consistent with its complex role in normal and pathological aging.

Improving Purpose in Life in School Settings

Background and aim: The dimension of purpose in life (PiL) is one of the core features of eudaimonia and plays a crucial role in developmental settings. However, few studies have examined purpose in life in younger generations and verified if it is amenable to improvements following a wellbeing-promoting intervention. The aim of the present investigation is to explore correlates and predictors of purpose in life in school children and to test if it can be ameliorated after school-based wellbeing interventions. Methods: A total of 614 students were recruited in various schools in Northern Italy. Of these, 456 belonged to junior high and high schools and were randomly assigned to receive a protocol of School Well-Being Therapy (WBT) or a psychoeducational intervention (controls). A total of 158 students were enrolled in elementary schools and received a positive narrative intervention based on fairytales or were randomly assigned to controlled conditions. All students were assessed pre- and post- intervention with Ryff scales of eudaimonic wellbeing (short version) and with other self-report measures of anxiety, depression and somatization. Additionally, the Strengths and Difficulties Questionnaire (SDQ) was administered to their schoolteachers as observed-rated evaluation. Results: In both elementary and high schools, purpose in life after the intervention was predicted by initial depressive symptoms and by group assignment (positive interventions vs. controls). In older students, PiL was predicted by female gender and anxiety levels, while no specific strengths identified by teachers were associated with PiL. Conclusions: PiL plays an important and strategic role in developmental settings, where students can develop skills and capacities to set meaningful goals in life. Depressive symptoms and anxiety can be obstacles to developing PiL in students, while positive school-based interventions can promote this core dimension of eudaimonia.

Well-Being and Aging-Related Decline in Financial and Health Literacy in Advanced Age

OBJECTIVES

Emerging evidence suggests that financial and health literacy deteriorates in advanced age. By contrast, well-being promotes health in aging. This study tested the hypothesis that well-being is associated with slower aging-related literacy decline.

METHODS

Participants were 1,099 community-based older adults without dementia at baseline. Financial and health literacy was assessed at baseline and annually thereafter via a 32-item measure. Well-being was assessed at baseline via the 18-item version of Ryff's Scales of Psychological Well-Being.

RESULTS

During up to 12 years of annual follow-up, literacy declined about 1 percentage point per year on average (β = -0.91, standard error [SE] = 0.08, p < .001); however, there was considerable variation in change in literacy between participants (random slopes variance = 1.24, SE = 0.15, p < .001). In a linear mixed-effects model adjusted for age, sex, and education, higher well-being was associated with higher starting level of literacy (β = 2.31, SE = 0.67, p = .001) and, critically, slower literacy decline (β = 0.29, SE = 0.11, p = .01). The association of higher well-being with slower literacy decline persisted in models that additionally adjusted for income, medical conditions, depressive symptoms, and a robust measure of global cognition.

DISCUSSION

This study suggests that well-being helps stave off aging-related literacy decline.

The pursuit of health: A vitality based perspective

The larger number of adults who enter their senior years with a high burden of chronic diseases has led to new metrics designed to promote health pro-activity, such as the calculation of one's "healthspan". These efforts call for re-evaluation as to what is meant by "health". A large body of epidemiologic and clinical investigation identifies that good health is shaped by specific health behaviors (aerobic exercise, resistance training, sleep, and good diet quality) and four psychological determinants (positive emotions, positive mindsets, purposeful living, and social connectivity). In common, each of these determinants produce "vitality", which can be defined as having the pleasing sensation of feeling energetic. Having a strong sense of vitality produces a sense of agency, provides resilience, and serves as a leading indicator of good health. Importantly, vitality can be assessed as a single item "vital sign" in clinical practice and can be promoted by recommending simple steps to patients, such as suggesting that they initiate walking or other aerobic activities. Because health habits and psychological determinants of health are inter-related, such simple steps can initiate a "virtuous cycle" of health improvement. An emphasis on vitality can also encourage patients to become more cognizant of their level of energy and manage it through health-promoting behaviors rather than quick fix behaviors. Finally, vitality assessment and prescription can promote more successful aging. In sum, an updated and more clinically useful definition of health recognizes that it is a dynamic entity that is influenced at any time by one's engagement in physical and psychological practices that promote health. Accordingly, an updated definition of health is proposed: good health is characterized by physical and psychological well-being and is associated with vitality.

Purpose in life promotes resilience to age-related brain burden in middle-aged adults

BACKGROUND

Disease-modifying agents to counteract cognitive impairment in older age remain elusive. Hence, identifying modifiable factors promoting resilience, as the capacity of the brain to maintain cognition and function with aging and disease, is paramount. In Alzheimer's disease (AD), education and occupation are typical cognitive reserve proxies. However, the importance of psychological factors is being increasingly recognized, as their operating biological mechanisms are elucidated. Purpose in life (PiL), one of the pillars of psychological well-being, has previously been found to reduce the deleterious effects of AD-related pathological changes on cognition. However, whether PiL operates as a resilience factor in middle-aged individuals and what are the underlying neural mechanisms remain unknown.

METHODS

Data was obtained from 624 middle-aged adults (mean age 53.71 ± 6.9; 303 women) from the Barcelona Brain Health Initiative cohort. Individuals with lower (LP; N = 146) and higher (HP; N = 100) PiL rates, according to the division of this variable into quintiles, were compared in terms of cognitive status, a measure reflecting brain burden (white matter lesions; WMLs), and resting-state functional connectivity, examining system segregation (SyS) parameters using 14 common brain circuits.

RESULTS

Neuropsychological status and WMLs burden did not differ between the PiL groups. However, in the LP group, greater WMLs entailed a negative impact on executive functions. Subjects in the HP group showed lower SyS of the dorsal default-mode network (dDMN), indicating lesser segregation of this network from other brain circuits. Specifically, HP individuals had greater inter-network connectivity between specific dDMN nodes, including the frontal cortex, the hippocampal formation, the midcingulate region, and the rest of the brain. Greater functional connectivity in some of these nodes positively correlated with cognitive performance.

CONCLUSION

Expanding previous findings on AD pathology and advanced age, the present results suggest that higher rates of PiL may promote resilience against brain changes already observable in middle age. Furthermore, having a purposeful life implies larger functional integration of the dDMN, which may potentially reflect greater brain reserve associated to better cognitive function.

Life Engagement Improvement Following Initiation of Brexpiprazole Treatment in Patients with MDD: A Naturalistic, Retrospective Real-World Study

Purpose

Life engagement encompasses concepts such as life fulfillment, well-being, and participation in meaningful activities, encompassing cognitive, physical, social, and emotional dimensions. Patients with MDD experience impaired functioning across multiple domains of life engagement and have ranked concepts related to life engagement and fulfillment as important predictors of treatment success. Post-hoc analyses of three clinical trials of patients with MDD treated adjunctively with brexpiprazole have reported a significantly greater improvement in life engagement. This study investigated improvements in life engagement among patients with MDD following initiation of brexpiprazole treatment using a real-world dataset.

Patients and Methods

Information was extracted from semi-structured clinical notes of the Mental Status Examination (MSE) of patients in a real-world setting to develop an outcome measure for quantifying life engagement of psychiatric patients. Measures of life engagement and its four sub-domains (emotional, physical, social, and cognitive) were calculated at each clinical visit for 624 adult patients with MDD during the 6 months following brexpiprazole initiation. Paired t-tests assessed differences between the index event and time periods within 6 months of the index event. Kaplan-Meier survival analyses were used to quantify the improvement in life engagement scores following brexpiprazole initiation.

Results

The study identified 54 clinical features associated with life engagement. Statistically significant improvements were observed from as early as 1 month following brexpiprazole initiation, with 20.6%, 37.9%, and 53.9% of the patients demonstrating improved life engagement scores within 1, 3, and 6 months, respectively. The improvements were particularly apparent for the emotional and social sub-domains.

Conclusion

The results of this study provide evidence of improved life engagement following brexpiprazole initiation in a real-world dataset.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04 years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86-30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = -0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.

Reciprocal Associations between Depressive Symptoms, Life Satisfaction, and Eudaimonic Well-Being in Older Adults over a 16-Year Period

The dual-continua model of mental health distinguishes between mental illness (presence of mental disorders, such as depression) and mental well-being (presence of positive traits and abilities). This model also distinguishes between hedonic well-being (e.g., affect balance and life satisfaction) and eudaimonic well-being (i.e., optimal psychological and social functioning, as indicated for example by having a purpose in life). We examined the relationships between depressive symptoms (a common indicator of mental illness), life satisfaction, and eudaimonic well-being. The study used a sample of 17,056 participants from England whose data were collected at eight intervals of approximately two years over a 16-year period, from 2004 to 2019. The mean age of the sample in the first wave was 58.843 years, with a standard deviation of 12.617 years (women = 55.2%). We disentangled within- and between-person sources of variance to examine whether increases or decreases in one variable preceded changes in the other variables at the next time point. We found positive reciprocal relationships between life satisfaction and eudaimonic well-being and negative reciprocal relationships between the two well-being dimensions and depressive symptoms. These results suggest that within-person increases in well-being are followed by future decreases in depressive symptoms, and within-person increases in depressive symptoms are followed by future decreases in well-being. Therefore, low levels of mental well-being in older adults may be considered a risk factor for depression, and well-being interventions (such as those focused on meaning-making) may serve as a protective factor against depression in older adults.

Association between mental health symptoms and behavioral performance in younger vs. older online workers

Background

The COVID-19 pandemic has been associated with increased rates of mental health problems, particularly in younger people.

Objective

We quantified mental health of online workers before and during the COVID-19 pandemic, and cognition during the early stages of the pandemic in 2020. A pre-registered data analysis plan was completed, testing the following three hypotheses: reward-related behaviors will remain intact as age increases; cognitive performance will decline with age; mood symptoms will worsen during the pandemic compared to before. We also conducted exploratory analyses including Bayesian computational modeling of latent cognitive parameters.

Methods

Self-report depression (Patient Health Questionnaire 8) and anxiety (General Anxiety Disorder 7) prevalence were compared from two samples of Amazon Mechanical Turk (MTurk) workers ages 18-76: pre-COVID 2018 (N = 799) and peri-COVID 2020 (N = 233). The peri-COVID sample also completed a browser-based neurocognitive test battery.

Results

We found support for two out of three pre-registered hypotheses. Notably our hypothesis that mental health symptoms would increase in the peri-COVID sample compared to pre-COVID sample was not supported: both groups reported high mental health burden, especially younger online workers. Higher mental health symptoms were associated with negative impacts on cognitive performance (speed/accuracy tradeoffs) in the peri-COVID sample. We found support for two hypotheses: reaction time slows down with age in two of three attention tasks tested, whereas reward function and accuracy appear to be preserved with age.

Conclusion

This study identified high mental health burden, particularly in younger online workers, and associated negative impacts on cognitive function.

Meaning in Life among Older Adults: An Integrative Model

Meaning in life (MIL) among older adults has a significant physical and mental health impact. This study aimed to present an integrative model of factors that contribute to variability in MIL among older adults, including background characteristics (gender, age, employment status, religiosity), personality characteristics (locus of control, self-efficacy, optimism), and psycho-social factors (psychological distress and loneliness). Participants (751 older adults, M_age = 72.27, SD = 6.28; 446 female, 305 male) responded to a questionnaire in-person or online. Measures included: demographic variables, Short Scale for the Assessment of Locus of Control, New General Self-Efficacy Scale, Life Orientation Test-Revised, Kessler Psychological Distress Scale, and Hughes Short Scale for Measuring Loneliness. Hierarchical regression revealed that younger and religious older adults reported higher MIL levels than older and non-religious older adults. Internal locus of control, higher self-efficacy, and higher optimism were linked to higher MIL levels. Higher psychological distress and loneliness were associated with lower MIL levels, with psychological distress contributing the most of all variables in the study model to explain the variance in MIL among older adults. Employed older old adults reported lower MIL levels than those unemployed. The study emphasizes the importance of an integrative approach in the examination of MIL among older adults.

Purposeful retirement expectations and their associations with retirement planning

OBJECTIVE

Previous research has demonstrated that retirees tend to report lower levels for sense of purpose compared to working adults. However, it remains unclear whether adults show differences in the extent to which they expect to be purposeful during retirement, and what that may mean for the propensity to plan for retirement.

METHOD

The current study examined this question in a cross-sectional sample of 492 adults (Age: M = 39.28, SD = 8.35) prior to retirement. Participants completed an adapted measure to capture expected purposeful engagement during retirement, along with sense of purpose, retirement planning, and the Big Five personality traits.

RESULTS

Factor analyses and zero-order correlations suggested that purposeful retirement perceptions are related yet distinct from sense of purpose in general, and adults on average expect a moderately purposeful retirement. Purposeful retirement scores were associated with multiple retirement planning scales, and remained predictive of retirement preparation even when accounting for the Big Five and demographic factors.

CONCLUSION

Adults differ in how purposeful they expect to be during their future retirement. Moreover, these differences may be a valuable consideration when understanding how to promote retirement planning.

Self-reported sense of purpose in life and proxy-reported behavioral and psychological symptoms of dementia in the last year of life

Objectives:Behavioral and psychological symptoms of dementia (BPSD) are among the most challenging aspects of dementia for individuals living with dementia and their caregivers. Identifying factors associated with resilience to BPSD may inform interventions to reduce them. The present research examines whether purpose in life is associated with BPSD in the last year of life.Method:Participants from the Health and Retirement Study were selected if they reported on their sense of purpose, had evidence of a memory impairment, died across the follow-up, and a proxy completed the End of Life survey that included BPSD (N = 2473). Self-reported sense of purpose was tested as a predictor of the sum of symptoms and each indivdual symptom in the last year of life.Results:Purpose in life was associated with fewer BPSD overall. Of the individual symptoms, purpose was associated with less risk of psychological symptoms, specfiically less depression, periodic confusion, uncontrolled temper, but not with motor or perceptual symptoms.Conclusion: These results are consistent with growing evidence that purpose is associated with better cognitive outcomes. Purpose may be a useful target of intervention to improve outcomes across the spectrum of dementia.

Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age

Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.

Sense of Coherence Mediates the Relationship Between Cognitive Reserve and Cognition in Middle-Aged Adults

In recent years, supported by new scientific evidence, the conceptualization of cognitive reserve (CR) has been progressively enriched and now encompasses not only cognitive stimulating activities or educational level, but also lifestyle activities, such as leisure physical activity and socialization. In this context, there is increasing interest in understanding the role of psychological factors in brain health and cognitive functioning. In a previous study, we have found that these factors mediated the relationship between CR and self-reported cognitive functioning. In this study, we have confirmed an association between two important constructs included in the psychological wellbeing and salutogenic models, "purpose in life" and "sense of coherence," CR, as assessed using a questionnaire, and cognitive functioning, as evaluated using a comprehensive neuropsychological battery. Results from 888 middle-aged healthy participants from the Barcelona Brain Health Initiative indicate that both sense of coherence (SoC) and CR were positively associated with verbal memory, reasoning and attention, working memory, and global cognition. Moreover, the relation between CR and cognitive functioning in the different domains is partially mediated by SoC. When we controlled for brain integrity, introducing into the model neurofilament light chain measures, the mediator role of SoC was confirmed for reasoning and attention and global cognition. However, purpose in life was not associated with cognitive functioning. These results reveal the central role of the SoC construct, which mediates the association between classic CR estimates and cognitive functions, potentially representing a modifiable target for interventions that aim to promote brain health.

Purpose in life and personal growth: The unique and joint contribution of physical activity and basic psychological needs

This study examined if physical activity (PA) and self-determination theory's basic psychological needs directly or interactively predict older adults' eudaimonic well-being. Participants aged ≥55 years completed five online surveys. At baseline (T₁ ), participants (N = 430) reported on autonomy, competence, and relatedness experienced during PA. PA was assessed prospectively using the Physical Activity Scale for Elderly (recall period = 7 days) for four consecutive weeks (T₂ , T₃ , T₄ , and T₅ ); weekly PA scores were averaged. At T₅ , purpose in life and personal growth were measured using Ryff's scales of psychological well-being. In regression analyses, PA was associated with purpose in life for those reporting low relatedness (b = .04, p = .02). Competence was associated with purpose in life only for those high in relatedness (b = .34, p < .001). Autonomy was positively associated with personal growth for those who also reported high competence. Multiple imputation analyses (N = 430) and sensitivity analyses (n = 304) yielded findings consistent with those from complete cases (n = 182). Encouraging older people to move more may not be sufficient to confer well-being. It may be necessary to help people engage in activities that support their basic psychological needs.

Consciousness Beyond Neural Fields: Expanding the Possibilities of What Has Not Yet Happened

In the field theories in physics, any particular region of the presumed space-time continuum and all interactions between elementary objects therein can be objectively measured and/or accounted for mathematically. Since this does not apply to any of the field theories, or any other neural theory, of consciousness, their explanatory power is limited. As discussed in detail herein, the matter is complicated further by the facts than any scientifically operational definition of consciousness is inevitably partial, and that the phenomenon has no spatial dimensionality. Under the light of insights from research on meditation and expanded consciousness, chronic pain syndrome, healthy aging, and eudaimonic well-being, we may conceive consciousness as a source of potential energy that has no clearly defined spatial dimensionality, but can produce significant changes in others and in the world, observable in terms of changes in time. It is argued that consciousness may have evolved to enable the human species to generate such changes in order to cope with unprecedented and/or unpredictable adversity. Such coping could, ultimately, include the conscious planning of our own extinction when survival on the planet is no longer an acceptable option.

Psychometric properties of the Purpose in Life Scale in Brazilian older adults

Objective: This study investigated the psychometric properties of the Purpose in Life Scale in a sample of Brazilian older adults. Methods: This cross-sectional study applied the scale to 309 older adults (mean age = 69.33 ± 7.47 years) residing in the city of Maringá, Paraná, Brazil. Data analysis was conducted through confirmatory factor analysis, Cronbach’s alpha, composite reliability, and factor invariance (p < 0.05). Results: Confirmatory factor analysis revealed that items 2, 3, 5, 6, and 9 had a factor loading below 0.50 and should be excluded. The 1-factor model with 5 items showed acceptable reliability. Multigroup analysis revealed that the configurational, metric, and structural invariance of the 1-factor model with 5 items was acceptable for both men and women. Conclusion: Although the Brazilian version of Purpose in Life Scale presented acceptable psychometric properties in a reduced model with 5 items, there were limitations that should be explored in the future.

The protective effect of mindfulness and compassion meditation practices on ageing: Hypotheses, models and experimental implementation

Alzheimer's disease (AD) represents a major health and societal issue; there is no treatment to date and the pathophysiological mechanisms underlying this disease are not well understood. Yet, there is hope that AD risk factors and thus the number of AD cases can be significantly reduced by prevention measures based on lifestyle modifications as targeted by non-pharmacological preventive interventions. So far, these interventions have rarely targeted the psycho-affective risk factors related to depression, stress, anxiety, and feeling of loneliness, which are all prevalent in ageing. This paper presents the hypothesis that the regular practice of mindfulness meditation (MM) and loving-kindness and compassion meditation (LKCM) in the ageing population constitutes a lifestyle that is protective against AD. In this model, these practices can promote cognition, mental health, and well-being by strengthening attention control, metacognitive monitoring, emotion regulation and pro-social capacities. Training these capacities could reduce the risk of AD by upregulating beneficial age-related factors such as cognitive reserve, and down-regulating detrimental age-related factors, such as stress, or depression. As an illustration, we present the Medit-Ageing study (public name Silver Santé Study), an on-going European project that assesses the impact and mechanisms of non-pharmacological interventions including meditation, in the ageing population.

Association between serum sphingolipids and eudaimonic well-being in white U.S. adults

Emerging research has linked psychological well-being with many physiological markers as well as morbidity and mortality. In this analysis, the relationship between components of eudaimonic well-being and serum sphingolipids levels was investigated using data from a large national survey of middle-aged American adults (Midlife in the United States). Health behaviors (i.e., diet, exercise, and sleep) were also examined as potential mediators of these relationships. Serum levels of total ceramides-the main molecular class of sphingolipids previously associated with several disease conditions-were inversely linked with environmental mastery. In addition, significant correlations were found between specific ceramide, dihydroceramide, and hexosylceramides species with environmental mastery, purpose in life, and self-acceptance. Using hierarchical regression and mediation analyses, health behaviors appeared to mediate these associations. However, the link between ceramides and environmental mastery was partially independent of health behaviors, suggesting the role of additional mediating factors. These findings point to sphingolipid metabolism as a novel pathway of health benefits associated with psychological well-being. In particular, having a sense of environmental mastery may promote restorative behaviors and benefit health via improved blood sphingolipid profiles.

How Having a Clear Why Can Help Us Cope With Almost Anything: Meaningful Well-Being and the COVID-19 Pandemic in México

Background: Coronavirus disease 2019 (COVID-19) has resulted in an increase in known risk factors for mental health problems. Mexico adopted lockdown and physical distancing as a containment strategy with potential consequences on day to day life, such as social isolation, loss of income and loneliness that can have important consequences in terms of mental health. Objective: We aimed to examine the effect of the initial phases of the COVID-19 pandemic on psychological distress, well-being and perceived physical health among Mexican-base respondents and to examine whether coping strategies would play a potential intermediating role in relation to these variables. Under the Existential Positive Psychology perspective, an emphasis was made on meaning-centered coping. Methods: A cross-sectional study was conducted between April 30 and June 16th 2020 among 604 Mexicans-base respondents of which 471 were women and 132 men. Data was collected by using online questionnaires. Psychological distress was measured using the Depression, Anxiety, and Stress Scale (DASS-21). The Brief COPE Inventory was used to assess problem-focused and emotion-focused coping strategies. We also used the Meaning-Centered Coping Scale (MCCS). PERMA-Profiler was used to assess well-being, perceived physical health, and loneliness. Profiler and Descriptive analyses and bivariate linear regression were performed to examine the association of variables. Results: 45.9% of the participants reported moderate to extremely severe psychological distress. Our results demonstrate that problem-focused and emotion-focused coping were positively related to psychological distress, whereas meaning-centered coping was negatively associated with distress. Furthermore, psychological distress played a potential negative role in the perceived physical health, while meaning-centered coping and well-being buffered the negative influence of psychological distress on perceived physical health (completely standardized indirect effect = -0.01, SE: 0.012, 95% CI [-0.065; -0.017]. Conclusion: Meaning-centered coping was found to suppress the negative influence of psychological distress on sensation of decreased physical health corroborating the critical role of meaning in life in promoting well-being. Future studies can further examine the value of the critical role of meaning in life in promoting well-being as a protective factor against severe distress during traumatic events. Findings of this study can be used to orient policies and interventions aimed to alleviate suffering in the midst of the COVID-19 pandemic.

Trait Emotional Intelligence and Wellbeing During the Pandemic: The Mediating Role of Meaning-Centered Coping

Studies investigating the COVID-19 pandemic from a psychological point of view have mostly focused on psychological distress. This study adopts the framework of existential positive psychology, a second wave of positive psychology that emphasizes the importance of effective coping with the negative aspects of living in order to achieve greater wellbeing. Trait emotional intelligence (trait EI) can be crucial in this context as it refers to emotion-related personality dispositions concerning the understanding and regulation of one's emotions and those of others. The present study investigated the relationship between trait EI and both wellbeing and psychological distress (i.e., depression, anxiety, and stress), while exploring the mediating role of meaning-centered coping (proactive transformative strategies based on meaning in life) and maladaptive coping (i.e., behavioral disengagement and self-blame) during the first few months of the COVID-19 pandemic. A sample of 326 Lebanese adults completed measures of trait EI, wellbeing, psychological distress, coping, and meaning-centered coping. Results showed a strong positive correlation between trait EI and meaning-centered coping. Trait EI also correlated positively with wellbeing and negatively with psychological distress. Structural equation modeling showed that meaning-centered coping partially mediated the relationship between trait EI and wellbeing. Maladaptive coping fully mediated the relationship between trait EI and psychological distress. Findings indicate that trait EI is positively related to dealing with a stressful situation such as the pandemic in positive ways at both the cognitive level, by reformulating the situation to see something valuable in it, and behavioral level, by being proactive about it. Trait EI was positively linked to seeing the situation as an opportunity for personal growth, finding personal meaning in this situation, maintaining an attitude of hope and courage, and acting more responsibly with one's self and others during the current crisis. In turn, this coping formula was related to lower psychological distress and improved mental health. These results are consistent with the existential positive psychology framework and can inform implementation programs and policies aiming at raising awareness and promoting healthy and successful coping during the pandemic.

Important Correlates of Purpose in Life Identified Through a Machine Learning Approach

OBJECTIVE

A wealth of evidence has linked purpose in life (PiL) to better mental and physical health and healthy aging. Here, the authors aimed to determine important correlates of PiL using a machine learning approach.

METHODS

Participants were recruited from retirement communities by the Rush Memory and Aging Project and assessed for childhood experience, adulthood sociodemographic factors (e.g., education, income, marital status), lifestyle and health behavior (e.g., cognitively stimulating activities, exercise, social activities, social network size), psychological factors (e.g., depression, loneliness, perceived discrimination, perceived social support), personality traits (e.g., PiL, harm avoidance), and medical conditions. Elastic Net was implemented to identify important correlates of PiL.

RESULTS

A total of 1,839 participants were included in our analysis. Among the 23 variables provided to Elastic Net, 10 were identified as important correlates of PiL. In order of decreasing effect size, factors associated with lower PiL were loneliness, harm avoidance, older age, and depressive symptoms, while those associated with greater PiL were perceived social support, more social activities, more years of education, higher income, intact late-life cognitive performance, and more middle-age cognitive activities.

CONCLUSION

Our findings identify potentially important modifiable factors as targets for intervention strategies to enhance PiL.

Inner Harmony as an Essential Facet of Well-Being: A Multinational Study During the COVID-19 Pandemic

This study aimed to explore the role of two models of well-being in the prediction of psychological distress during the COVID-19 pandemic, namely PERMA and mature happiness. According to PERMA, well-being is mainly composed of five elements: positive emotions, engagement, relationships, meaning in life, and achievement. Instead, mature happiness is understood as a positive mental state characterized by inner harmony, calmness, acceptance, contentment, and satisfaction with life. Rooted in existential positive psychology, this harmony-based happiness represents the result of living in balance between positive and negative aspects of one's life. We hypothesized that mature happiness would be a more prominent protective factor during the present pandemic than the PERMA composite. A total of 12,203 participants from 30 countries responded to an online survey including the Depression Anxiety Stress Scale (DASS-21), the PERMA-Profiler, and the Mature Happiness Scale-Revised (MHS-R). Confirmatory factor analyses indicated that PERMA and mature happiness were highly correlated, but nonetheless, they represented two separate factors. After controlling for demographic factors and country-level variables, both PERMA Well-being and MHS-R were negative predictors of psychological distress. Mature happiness was a better predictor of stress, anxiety, and general distress, while PERMA showed a higher prediction of depression. Mature happiness moderated the relation between the perceived noxious effects of the pandemic and all markers of distress (depression, anxiety, stress, and total DASS-21). Instead, PERMA acted as a moderator in the case of depression and stress. These findings indicate that inner harmony, according to the mature happiness theory, is an essential facet of well-being to be taken into consideration. The results of this study can also orient policies aimed to alleviate the negative effects of the pandemic on mental health through the promotion of well-being.

The plasticity of well-being: A training-based framework for the cultivation of human flourishing

Research indicates that core dimensions of psychological well-being can be cultivated through intentional mental training. Despite growing research in this area and an increasing number of interventions designed to improve psychological well-being, the field lacks a unifying framework that clarifies the dimensions of human flourishing that can be cultivated. Here, we integrate evidence from well-being research, cognitive and affective neuroscience, and clinical psychology to highlight four core dimensions of well-being-awareness, connection, insight, and purpose. We discuss the importance of each dimension for psychological well-being, identify mechanisms that underlie their cultivation, and present evidence of their neural and psychological plasticity. This synthesis highlights key insights, as well as important gaps, in the scientific understanding of well-being and how it may be cultivated, thus highlighting future research directions.

Psychological well-being and gene expression in Korean adults: The role of age

BACKGROUND

Happiness has traditionally been thought to comprise two parts - pleasure (hedonia) and meaning (eudaimonia). Even though the two types of happiness are correlated, genomics studies have found distinct transcriptional correlates of hedonia and eudaimonia, particularly in the Conserved Transcriptional Response to Adversity (CTRA) marked by up-regulation of proinflammatory genes and down-regulation of interferon-related genes. Eudaimonia has been associated with reduced CTRA gene expression in several studies, whereas hedonia shows no consistent association with the CTRA. However, most of these social genomics studies have been conducted in Western cultures with Caucasian samples, so it is unclear if these findings extended to non-Western cultures with other ethnic groups. Moreover, it is unknown whether age might modify the association between CTRA gene expression and eudaimonia. To this end, we examined in a sample of Koreans the relationship between CTRA profiles and measures of hedonia and eudaimonia, as well as the role of age in modulating the strength of those relationships.

METHODS

Blood samples were collected from 152 healthy Korean adults (mean age = 44.64; 50 % female). Well-being was measured using the Mental Health Continuum short form (MHC-SF), Ryff Scales of Psychological Well-being (PWB), and subjective well-being (SWB) scales. RNA transcriptome profiles were obtained by RNA sequencing. Mixed effect linear model analyses examined the association between CTRA gene expression and measures of MHC-SF, SWB, PWB (total scores and six subscales) and additional analyses examined a possible moderating role of age.

RESULTS

CTRA gene expression was significantly downregulated in association with the MHC-SF eudaimonic scores as well as the PWB total scores. Among the six domains of PWB, autonomy showed the strongest inverse correlation with CTRA profiles. Moreover, the inverse association between CTRA and PWB was stronger for older participants.

CONCLUSION

Eudaimonia is associated with reduced CTRA gene expression in a Korean population, with particularly marked relationships for autonomy. Findings also suggest that aging with meaning may bring biological advantage in later life.

An Integrative Framework of Appraisal and Adaptation in Serious Medical Illness

Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care's focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients' use of active (vs. passive) and approach-oriented (vs. avoidant) coping strategies. However, without a framework outlining the process that individuals with serious medical illness and their loved ones undergo, it is challenging to discern exactly where, how, and why palliative care may affect the serious medical illness experience. To address this gap, we propose a clinically applicable framework, derived from existing theory and research in the social and behavioral sciences. This framework, called the Integrative Framework of Appraisal and Adaptation in Serious Medical Illness, describes how patients and their loved ones cognitively and emotionally process the various events that may occur as they navigate serious medical illness and the end of life. The framework also describes how individuals and their loved ones use that event processing to determine next steps, while considering the impact of their surrounding external environment, their individual social roles, and their connections on this decision making. The framework presented in this article is intended to improve our ability to understand and care for individuals with serious medical illness and their loved ones, while stimulating further discussion and research to test and refine these ideas.

Spanish adaptation of the Personal Meaning Profile-Brief: Meaning in life, psychological well-being, and distress

Background/Objective

This study aimed to adapt the Personal Meaning Profile-Brief (PMP-B) to the Spanish-speaking population and investigate its psychometric properties. The PMP-B is a 21-item instrument that assesses meaning in life through seven sources: relationship, intimacy, achievement, self-acceptance, self-transcendence, fair treatment, and religion.

Method

Participants were 546 Spanish adults comprised of a community sample (n = 171) and university students (n = 375). The PMP-B, the Ryff's Scales of Psychological Well-Being, and the Depression Anxiety Stress Scale were administrated.

Results

The PMP-B showed a bifactor structure with one general factor and seven subfactors. Measurement invariance was found across age, gender, and samples. Internal consistency and test-retest reliability were generally good. Older people showed higher PMP-B scores than younger people. The PMP-B scores, especially relational sources of meaning, were positively associated with psychological well-being and negatively related to psychological distress, mainly to depression.

Conclusions

The validity evidence gathered in this study supports the reliable use of the PMP-B to measure meaning in life. The PMP-B can be a noteworthy contribution to the meaning-centered research.

The Barcelona Brain Health Initiative: Cohort description and first follow-up

The Barcelona Brain Health Initiative is a longitudinal cohort study that began in 2017 and aims to understand and characterize the determinants of brain health maintenance in middle aged adults. A cohort of 4686 individuals between the ages of 40 and 65 years free from any neurological or psychiatric diseases was established, and we collected extensive demographic, socio-economic information along with measures of self-perceived health and lifestyles (general health, physical activity, cognitive activity, socialization, sleep, nutrition and vital plan). Here we report on the baseline characteristics of the participants, and the results of the one-year follow-up evaluation. Participants were mainly women, highly educated, and with better lifestyles compared with the general population. After one year 60% of participants completed the one-year follow-up, and these were older, with higher educational level and with better lifestyles in some domains. In the absence of any specific interventions to-date, these participants showed small improvements in physical activity and sleep, but decreased adherence to a Mediterranean diet. These changes were negatively associated with baseline scores, and poorer habits at baseline were predictive of an improvement in lifestyle domains. Of the 2353 participants who completed the one-year follow-up, 73 had been diagnosed with new neurological and neuropsychiatric diseases. Changes in vital plan at follow-up, as well as gender, sleep quality and sense of coherence at baseline were shown to be significant risk factors for the onset of these diagnoses. Notably, gender risk factor decreased in importance as we adjusted by sleep habits, suggesting its potential mediator effects. These findings stress the importance of healthy lifestyles in sustaining brain health, and illustrate the individual benefit that can be derived from participation in longitudinal observational studies. Modifiable lifestyles, specifically quality of sleep, may partially mediate the effect of other risk factors in the development of some neuropsychiatric conditions.

Psychological predictors of memory decline in a racially and ethnically diverse longitudinal sample of older adults in the United States

OBJECTIVES

In the United States, racial and ethnic disparities in memory dysfunction and Alzheimer disease are evident even after accounting for many risk factors. Psychological factors, such as psychological well-being, perceived control, depressive symptoms, and negative affect, may influence memory dysfunction, and associations may differ by race and ethnicity. This study examined whether psychological factors are differentially associated with episodic memory trajectories across racial and ethnic groups in the United States.

METHODS/DESIGN

The National Health and Aging Trends Study (NHATS), is a US-representative, longitudinal study of Medicare-eligible adults 65+ years old. Analyses of 5 years of data, included a total of 9411 participants without dementia at baseline. Adjusting for relevant covariates, a linear mixed model estimated the associations between psychological predictors and a composite of immediate and delayed trials from a word list memory test.

RESULTS

More depressive symptoms (B = -0.02), lower psychological well-being (B = 0.03), and lower perceived control (B = 0.05) were independently associated with lower initial memory. Depressive symptoms were associated with faster rate of memory decline (B = -0.01). Black (B = -0.34) and Hispanic (B = -0.28) participants evidenced lower initial memory level than whites, but only Hispanic (B = -0.04) participants evidenced faster memory decline than whites. There were no significant interactions between the psychological variables and race and ethnicity.

CONCLUSIONS

Results extend previous studies showing racial and ethnic disparities in episodic memory trajectories, and the longitudinal effects of depressive symptoms on episodic memory in US samples. Epidemiological studies of cognitive aging should incorporate more psychological factors clarify cognitive decline and disparities.

"Something to Live for": Experiences, Resources, and Personal Strengths in Late Adulthood

Due to increased life expectancy, the population segment of older adults has grown the fastest. The global phenomenon of population aging raises important questions regarding successful, positive, active, and meaningful aging. Given that aging is often characterized by declines in physical and mental health and increased risk for social isolation and depression, and given that the concept of well-being in old age is both elusive and complex, the present study explored how aging is experienced through a "bottom-up," open-ended approach. Thirty-one in-depth semi-structured personal interviews were conducted with adults aged 60 and above in order to explore the question: what concerns older adults in their day-to-day living, and what are their perceived resources? The findings illuminated three prominent themes: (1) central concerns described by the participants as characterizing their experience at this life stage; (2) strategies employed by the participants to cope with concerns and to live a meaningful life in old age; and (3) resources and character strengths that facilitate coping strategies and enable thriving. Theoretical and practical implications of the findings are discussed.

Well-Being With Soul: Science in Pursuit of Human Potential

This essay examines core contributions of a model of psychological well-being that has had widespread scientific impact. It drew on distant formulations to identify new dimensions and measures for assessing what it means to be well. Key themes among the more than 750 studies using the model are sketched, followed by reflections about why there has been so much interest in this eudaimonic approach to well-being. A final section looks to the future, proposing new directions to illuminate the forces that work against the realization of human potential as well as those that nurture human flourishing and self-realization.

The Barcelona Brain Health Initiative: A Cohort Study to Define and Promote Determinants of Brain Health

The Barcelona Brain Health Initiative (BBHI) is an ongoing prospective longitudinal study focused on identifying determinants of brain health. The main objectives are: (i) to characterize lifestyle, cognitive, behavioral and environmental markers related to a given individual's cognitive and mental functions in middle to old age, (ii) to assess the biological determinants predictive of maintenance of brain health, and (iii) to evaluate the impact of a controlled multi-dimensional lifestyle intervention on improving and maintaining brain health. The BBHI cohort consists of >4500 healthy participants aged 40-65 years followed through online questionnaires (Phase I) assessing participants' self-perceived health and lifestyle factors in seven different domains: overall health, physical exercise, cognitive activity, sleep, nutrition, social interactions, and life purpose. In Phase II a sub-group of 1,000 individuals is undergoing detailed in-person evaluations repeated at two-yearly intervals. These evaluations will provide deep phenotyping of brain function, including medical, neurological and psychiatric examinations, assessment of physical fitness, neuropsychological assessments, structural and functional brain magnetic resonance imaging, electroencephalography and perturbation-based non-invasive brain stimulation evaluations of brain activity, as well as collection of biological samples. Finally, in Phase III a further sub-group of 500 participants will undergo a similar in-person assessment before and after a multi-dimensional intervention to optimize lifestyle habits and evaluate its effects on cognitive and brain structure and function. The intervention group will receive remote supervision through an ICT-based solution, with the support of an expert in health and lifestyle coaching strategies aimed at promoting adherence. On the other hand, the control group will not have this coaching support, and will only receive education and recommendations about healthy habits. Results of this three-part initiative shall critically contribute to a better understanding of the determinants to promote and maintain brain health over the lifespan.

Semantic-cultural validation and internal consistency analysis of the Purpose in Life Scale for brazilian older adults

Purpose in life is one of the six dimensions of psychological well-being. It refers to the sense that life has meaning and direction, and that goals have been achieved or are attainable.

OBJECTIVE

To perform the semantic-cultural validation and internal consistency analysis of the 10-item Purpose in Life scale of Ryff and Keyes.

METHODS

Data were drawn from an eight-year follow-up of older adults aged ≥80 in the FIBRA Study, conducted in Campinas, Brazil.

RESULTS

The mean age of participants (N=187) was 83.81 (±3.60), mean number of years of education was 4.38 (±3.76), and mean income was 3.49 minimum wages (±2.61), comprising 125 (66.8%) females (mean purpose = 3.51 ±0.68) and 62 (33.2%) males (mean purpose = 3.58±0.60). There was no significant difference in the purpose between men and women or between educational levels. For age and income, purpose was higher in the 80- to 84-year-old group (younger age) and with income of 3-5 minimum wages (higher income). Cronbach's alpha for the scale was 0.628, indicating moderate internal consistency.

CONCLUSION

The Purpose in Life scale was translated, adapted for use in Brazil and applied in a sample of old-old adults. Purpose seemed to be influenced by age and income.

Effectiveness of an Energy Management Training Course on Employee Well-Being: A Randomized Controlled Trial

Purpose:

Programs focused on employee well-being have gained momentum in recent years, but few have been rigorously evaluated. This study evaluates the effectiveness of an intervention designed to enhance vitality and purpose in life by assessing changes in employee quality of life (QoL) and health-related behaviors.

Design:

A worksite-based randomized controlled trial.

Setting:

Twelve eligible worksites (8 randomized to the intervention group [IG] and 4 to the wait-listed control group [CG]).

Participants:

Employees (n = 240) at the randomized worksites.

Intervention:

A 2.5-day group-based behavioral intervention.

Measures:

Rand Medical Outcomes Survey (MOS) 36-item Short-Form (SF-36) vitality and QoL measures, Ryff Purpose in Life Scale, Center for Epidemiologic Studies questionnaire for depression, MOS sleep, body weight, physical activity, diet quality, and blood measures for glucose and lipids (which were used to calculate a cardiometabolic risk score) obtained at baseline and 6 months.

Analysis:

General linear mixed models were used to compare least squares means or prevalence differences in outcomes between IG and CG participants.

Results:

As compared to CG, IG had a significantly higher mean 6-month change on the SF-36 vitality scale (P = .003) and scored in the highest categories for 5 of the remaining 7 SF-36 domains: general health (P = .014), mental health (P = .027), absence of role limitations due to physical problems (P = .026), and social functioning (P = .007). The IG also had greater improvements in purpose in life (P < .001) and sleep quality (index I, P = .024; index II, P = .021). No statistically significant changes were observed for weight, diet, physical activity, or cardiometabolic risk factors.

Conclusion:

An intensive 2.5-day intervention showed improvement in employee QoL and well-being over 6 months.

Meaning in life: resilience beyond reserve

Background

The contribution of psychological factors to brain health and resilience remains poorly investigated. Furthermore, their possible interaction with ‘classical’ cognitive reserve (CR) estimates in predicting perceived mental health and cognitive status has not been specifically addressed.

Methods

We obtained data from 1081 adults responding to questionnaires on the three meaning in life (MiL) dimensions: purpose in life (PiL), sense of coherence (SoC), and engagement with life (EwL). A questionnaire on CR variables was also administered. The outcome measures were self-reported cognitive function and affective status (depression, stress, and anxiety). Multiple linear regression analyses were used to evaluate the association between sociodemographic variables, MiL dimensions, and CR with the two selected outcomes. Mediation analyses, adjusted for age and gender, were applied to determine whether the MiL dimensions mediated the putative effects of CR on self-reported mental and cognitive health.

Results

All three MiL components, but not CR estimates, correlated with the self-reported affective status of the participants. Higher CR, PiL, and SoC (but not EwL) scores significantly correlated with higher perceived cognitive function. Notably, the observed association between the CR measures and self-reported cognitive function was mediated by PiL and SoC.

Conclusions

Psychological MiL dimensions mediate the association between classic CR estimates and self-perceived cognitive function. Further studies on CR could consider including formal measures of such psychological factors to better understand their unique or synergistic contributions, as well as investigate the associated mechanisms maintaining brain function at older ages.

Electronic supplementary material

The online version of this article (10.1186/s13195-018-0381-z) contains supplementary material, which is available to authorized users.

Meaning and its association with happiness, health and healthcare utilization: A cross-sectional study

BACKGROUND

Meaning in life is not only a significant component of psychological well-being, but also a neglected issue with clinical importance that needs to be studied further, especially its association with health and healthcare utilization.

OBJECTIVE

To study the level of meaning and its association with happiness, health and healthcare utilization among the elderly in Hong Kong.

METHODS

A cross-sectional survey via telephone was conducted among 1000 elderly aged 60 years or above in Hong Kong.

RESULTS

Higher level of meaning was associated with being quite/very happy, and better health status (better self-rated health status, less chronic illnesses, lower level of frailty, no limitation of activities) before and after adjustments. It was also associated with decreased likelihood of healthcare utilization (number of medications intake, hospitalization and Acute and Emergency (A&E) admission) before and after adjusted for socio-demographics. Path analysis showed that, the association of meaning with hospitalization, A&E admission and medication use was significantly mediated by health status among the elderly.

LIMITATIONS

This cross-sectional study might not include all the potential associated factors and mediators.

CONCLUSIONS

The sense of meaning is associated with happiness and may contribute to health and healthcare utilization among the Chinese elderly. Studies are needed to further look into the potential mechanisms. Meaning in life might be a promising interventional target for successful aging of the elderly.

Persistently high psychological well-being predicts better HDL cholesterol and triglyceride levels: findings from the midlife in the U.S. (MIDUS) longitudinal study

Background

Psychological correlates of blood lipid levels have been previously evaluated mostly in cross sectional studies. However, prospectively measured psychological factors might also predict favorable blood lipid profiles, thereby indicating a healthy mind/body interplay that is associated with less disease, better health and longer lives.

Methods

This paper examined whether longitudinal profiles of psychological well-being over 9–10 years are predictors of blood lipid profiles. Using the MIDUS (Midlife in the U.S.) biological subsample (n = 1054, aged 34 to 84, 55% female), cross-time trajectories of well-being were linked with three lipid outcomes (i.e., HDL cholesterol, triglycerides, and LDL cholesterol), measured for the first time at the 2nd wave of the study.

Results

Most adults showed largely stable profiles of well-being, albeit at different levels. Some showed persistently high well-being over time, while others revealed persistently low or moderate well-being. After adjusting for the effect of demographics, health behaviors, medications, and insulin resistance, adults with persistently high levels of environmental mastery and self-acceptance—two components of psychological well-being—had significantly higher levels of HDL as well as significantly lower levels of triglycerides compared to adults with persistently low levels of well-being. Converging with prior findings, no association was found between well-being and LDL cholesterol.

Conclusions

Over 9–10 years, persistently high levels of psychological well-being measures predicted high HDL cholesterol and low triglycerides. These findings add longitudinal evidence to the growing body of research showing that positive psychological factors are linked with better lipoprotein profiles. A better blood lipid profile, particularly higher HDL-C, may be key in mediating how psychological well-being positively impacts health and length of life. Additional research is required to further validate this hypothesis as well as to establish potential underlying mechanisms.

Eudaimonic well-being, inequality, and health: Recent findings and future directions

The theoretical and philosophical underpinnings of a eudaimonic model of well-being are examined and its empirical translation into distinct dimensions of well-being is described. Empirical findings have documented aging declines in eudaimonic well-being, but there is considerable variability within age groups. Among older adults who remain purposefully engaged, health benefits (reduced morbidity, extended longevity) have been documented. Eudaimonic well-being also appears to offer a protective buffer against increased health risk among the educationally disadvantaged. Neural and genetic mechanisms that may underlie eudaimonic influences on health are briefly noted, and interventions designed to promote eudaimonic well-being are sketched. Needed future research directions include addressing problems of unjust societies wherein greed among privileged elites may be a force compromising the eudaimonic well-being of those less privileged. Alternatively, and more positive in focus, is the need to better understand the role of the arts, broadly defined, in promoting eudaimonic well-being across all segments of society.