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

A review of the literature on wellbeing and modifiable dementia risk factors

Wellbeing-defined broadly as experiencing one's life as enjoyable and fulfilling-has been associated with lower risk for Alzheimer's disease and related dementias. The mechanisms underlying this association are largely unknown. However, prior research and theory suggest that wellbeing impacts health behaviors and biological systems that are relevant to cognitive and brain health. Several of these factors have also been identified by the 2020 Lancet Commission on Dementia Prevention, Intervention, and Care as modifiable dementia risk factors. In the current review, we summarize and evaluate the evidence for associations between wellbeing and each of the 12 Lancet Commission risk factors. We found relatively consistent evidence for associations between higher wellbeing and lower levels of most of the risk factors: physical inactivity, social isolation, smoking, depression, hypertension, diabetes, hearing loss, traumatic brain injury, and air pollution. By contrast, we found evidence for only modest associations between wellbeing and education and mixed evidence for associations of wellbeing with alcohol use and body weight. Although most of the reviewed evidence was observational, longitudinal and experimental evidence suggests that many of the observed associations are likely bidirectional. These findings suggest that modifiable dementia risk factors may be mediators (i.e., intermediate steps in the causal chain) and/or confounders (i.e., variables that impact both wellbeing and dementia, and thus could induce a spurious association) of the association between wellbeing and dementia. We conclude by discussing next steps to test mediation hypotheses and to account for potential confounding in the relation between wellbeing and dementia.

Neurobehavioral Mechanisms Influencing the Association Between Generativity, the Desire to Promote Well-Being of Younger Generations, and Purpose in Life in Older Adults at Risk for Alzheimer's Disease

OBJECTIVES

Generativity, the desire and action to improve the well-being of younger generations, is associated with purpose in life among older adults. However, the neurobehavioral factors supporting the relationship between generativity and purpose in life remain unknown. This study aims to identify the functional neuroanatomy of generativity and mechanisms linking generativity with purpose in life in at-risk older adults.

METHODS

Fifty-eight older adults (mean age = 70.8, SD = 5.03, 45 females) with a family history of Alzheimer's disease (AD) were recruited from the PREVENT-AD cohort. Participants underwent brain imaging and completed questionnaires assessing generativity, social support, and purpose in life. Mediation models examined whether social support mediated the association between generativity and purpose in life. Seed-to-voxel analyses investigated the association between generativity and resting-state functional connectivity (rsFC) to the ventromedial prefrontal cortex (vmPFC) and ventral striatum (VS), and whether this rsFC moderated the relationship between generativity and purpose in life.

RESULTS

Affectionate social support mediated the association between generative desire and purpose in life. Generative desire was associated with rsFC between VS and precuneus, and, vmPFC and right dorsolateral prefrontal cortex (rdlPFC). The vmPFC-rdlPFC rsFC moderated the association between generative desire and purpose in life.

DISCUSSION

These findings provide insight into how the brain supports complex social behavior and, separately, purpose in life in at-risk aging. Affectionate social support may be a putative target process to enhance purpose in life in older adults. This knowledge contributes to future developments of personalized interventions that promote healthy aging.

Purpose in life as a resilience factor for brain health: diffusion MRI findings from the Midlife in the U.S. study

Introduction

A greater sense of purpose in life is associated with several health benefits relevant for active aging, but the mechanisms remain unclear. We evaluated if purpose in life was associated with indices of brain health.

Methods

We examined data from the Midlife in the United States (MIDUS) Neuroscience Project. Diffusion weighted magnetic resonance imaging data (n=138; mean age 65.2 years, age range 48-95; 80 females; 37 black, indigenous, and people of color) were used to estimate microstructural indices of brain health such as axonal density, and axonal orientation. The seven-item purpose in life scale was used. Permutation analysis of linear models was used to examine associations between purpose in life scores and the diffusion metrics in white matter and in the bilateral hippocampus, adjusting for age, sex, education, and race.

Results and discussion

Greater sense of purpose in life was associated with brain microstructural features consistent with better brain health. Positive associations were found in both white matter and the right hippocampus, where multiple convergent associations were detected. The hippocampus is a brain structure involved in learning and memory that is vulnerable to stress but retains the capacity to grow and adapt through old age. Our findings suggest pathways through which an enhanced sense of purpose in life may contribute to better brain health and promote healthy aging. Since purpose in life is known to decline with age, interventions and policy changes that facilitate a greater sense of purpose may extend and improve the brain health of individuals and thus improve public health.

Purpose in life and cognitive performance and informant ratings of cognitive decline, affect, and activities

OBJECTIVE

To examine (1) the association between purpose in life and multiple domains of cognitive function and informant-rated cognitive decline, affect, and activities; (2) whether these associations are moderated by sociodemographic factors, cognitive impairment, or depression; (3) whether the associations are independent of other aspects of well-being and depressive symptoms.

METHOD

As part of the 2016 Harmonized Cognitive Assessment Protocol from the Health and Retirement Study, participants completed a battery of cognitive tests and nominated a knowledgeable informant to rate their cognitive decline, affect, and activities. Participants with information available on their purpose in life from the 2014/2016 Leave Behind Questionnaire were included in the analytic sample (N = 2,812).

RESULTS

Purpose in life was associated with better performance in every cognitive domain examined (episodic memory, speed-attention, visuospatial skills, language, numeric reasoning; median β =.10, p <.001; median d =.53). Purpose was likewise associated with informant-rated cognitive decline and informant-rated affective and activity profiles beneficial for cognitive health (median β =.18, p < .001; median d =.55). There was little evidence of moderation by sociodemographic or other factors (e.g., depression). Life satisfaction, optimism, positive affect, and mastery were generally associated with cognition. When tested simultaneously with each other and depressive symptoms, most dimensions were reduced to non-significance; purpose remained a significant predictor.

CONCLUSIONS

Purpose in life is associated with better performance across numerous domains of cognition and with emotional and behavioral patterns beneficial for cognitive health that are observable by knowledgeable others. These associations largely generalize across demographic and clinical groups and are independent of other aspects of well-being.

The relationship between purpose in life and depression and anxiety: A meta-analysis

Purpose in life consists of having a sense of meaning and purpose regarding one's activities as well as an overall sense that life is meaningful. This study reports a comprehensive assessment of the relationship of purpose in life with depression and anxiety. A meta-analysis (total n = 66,468, total k = 99) investigated the association of purpose in life with depression and anxiety. Across samples, greater purpose in life was significantly associated with lower levels of depression and anxiety. The mean weighted effect size between purpose in life and depression was r = -0.49, [95% confidence intervals, CIs: -0.52, -0.45], p < 0.001. For the purpose in life and anxiety the mean weighted effect size was r = -0.36, [95% CIs: -0.40, -0.32], p < 0.001. The association of purpose in life with mental health was stronger for clinical populations, especially with regard to the relationship with anxiety. Both approach deficits and avoidance motivation are argued to play a role in the relationship between purpose and psychopathology, with greater purpose potentially limiting avoidance tendencies and reducing the effects of depression and anxiety. Understanding the role that purpose in life may play in depression and anxiety could help to inform current conceptualizations of these disorders and improve treatment outcomes.

Students' 2018 PISA reading self-concept: Identifying predictors and examining model generalizability for emergent bilinguals

Decades of research have indicated that reading self-concept is an important predictor of reading achievement. During this period, the population of emergent bilinguals has continued to increase within United States' schools. However, the existing literature has tended to examine native English speakers' and emergent bilinguals' reading self-concept in the aggregate, thereby potentially obfuscating the unique pathways through which reading self-concept predicts reading achievement. Furthermore, due to the overreliance of native English speakers in samples relating to theory development, researchers attempting to examine predictors of reading achievement may a priori select variables that are more aligned with native English speakers' experiences. To address this issue, we adopted Elastic Net, which is a theoretically agnostic methodology and machine learning approach to variable selection to identify the proximal and distal predictors of reading self-concept for the entire population; in our study, participants from the United States who participated in PISA 2018 served as the baseline group to determine significant predictors of reading self-concept with the intent of identifying potential new directions for future researchers. Based on Elastic Net analysis, 20 variables at the student level, three variables at the teacher level, and 12 variables at the school level were identified as the most salient predictors of reading self-concept. We then utilized a multilevel modeling approach to test model generalizability of the identified predictors of reading self-concept for emergent bilinguals and native English speakers. We disaggregated and compared findings for both emergent bilinguals and native English speakers. Our results indicate that although some predictors were important for both groups (e.g., perceived information and communications technologies competence), other predictors were not (e.g., competitiveness). Suggestions for future directions and implications of the present study are examined.

Sense of purpose interventions for depression and anxiety in youth: A scoping review and cross-cultural youth consultation

BACKGROUND/OBJECTIVES

To investigate the effectiveness, feasibility, and acceptability of sense of purpose (SOP) interventions in preventing or reducing anxiety or depression in youth aged 14-24 years.

METHODS

A systematic search was conducted of the academic (PubMed/MEDLINE, PsycINFO, EMBASE) and grey literature. We also consulted two SOP experts and an Australian and Indian youth advisory group with lived experience of anxiety and/or depression. Consultations focused on the feasibility and acceptability of reviewed interventions.

RESULTS

The search identified 25 studies reporting on 4408 participants from six countries (64.0 % of studies in the US). Multi-component interventions targeting several SOP components (i.e., value clarification, goal setting, gratitude enhancement) reported, on average, moderate reductions in depression and anxiety symptoms in youth. Interventions were generally more effective at reducing depression than anxiety symptoms. In terms of sub-populations or groups, there was some evidence for greater intervention effectiveness among youth with prior therapy experience, extraverted personalities, and those with already elevated anxiety/depression symptoms. Youth advisors and experts opined that group interventions were most acceptable to young people.

LIMITATIONS

This review was limited to a recent 10-year timeframe and publications in English, potentially excluding relevant studies published prior to 2011 or in other languages.

CONCLUSIONS

Fostering SOP can lead to better psychological wellbeing in youth. Potential harms resulting from interventions can occur without adequate consideration for a person's readiness for purpose discovery, environmental barriers, and familial and cultural settings. Further research in more diverse populations is required to determine who benefits and in what contexts.

Identifying significant correlates of purpose in life in older US military veterans: results from the national health and resilience in veterans study

OBJECTIVE

Perceived purpose in life (PIL) has been linked to a broad range of adverse physical, mental, and cognitive outcomes. However, limited research has examined factors associated with PIL that can be targeted in prevention and treatment efforts in aging populations at heightened risk of adverse outcomes. Using data from predominantly older US veterans, we sought to identify important correlates of PIL.

METHODS

Cross-sectional data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4069 US military veterans (Mage = 62.2). Elastic net and relative importance analyses were conducted to evaluate sociodemographic, military, health, and psychosocial variables that were strongly associated with PIL.

RESULTS

Of the 39 variables entered into an elastic net analysis, 10 were identified as significant correlates of PIL. In order of magnitude, these were resilience (18.7% relative variance explained [RVE]), optimism (12.1%), depressive symptoms (11.3%), community integration (10.7%), gratitude (10.2%), loneliness (9.8%), received social support (8.6%), conscientiousness (8.5%), openness to experience (5.4%), and intrinsic religiosity (4.7%).

CONCLUSIONS

Several modifiable psychosocial factors emerged as significant correlates of PIL in US military veterans. Interventions designed to target these factors may help increase PIL and mitigate risk for adverse health outcomes in this population.

Purpose in life as an asset for well-being and a protective factor against depression in adolescents

Purpose in life, which is a central component of the eudaimonic paradigm of well-being, has been sparsely examined in adolescence. This is unfortunate as adolescence is characterised by identity development and is a key period for the onset of mental disorders. To inform future research on well-being and purpose in life in adolescents, we drew factors from several fields of research, including mental health and psychological factors, and explored which factors were most strongly associated with purpose in life. Data were collected in a sample of 444 Italian adolescents (Mage = 16.30 [SD = 1.50], range: 14 to 20 years; 58% girls) and associations with mental health (stress, anxiety, depression, anger), psychological traits (mindfulness, self-hate, self-inadequacy, self-reassurance, isolation), and sociodemographic variables (age, sex, place of birth) were examined. Regression, dominance, and network analyses indicated that a stronger sense of purpose in life was associated with lower depressive symptoms, higher levels of self-reassurance, and being born in Italy. Our findings suggest that purpose in life is an important asset for well-being in adolescents and may protect against depression. Future longitudinal and/or experimental research should examine the potential protective role of purpose in life in relation to adolescent depression and how self-reassurance and sociodemographic factors (e.g., immigrant background) are involved.

Important Correlates of Purpose in Life in a Diverse Population-Based Cohort: A Machine Learning Approach

BACKGROUND

Purpose-in-life (PiL) refers to the tendency to derive meaning and purpose from daily life experiences. Individuals with higher PiL were more likely to have better physical, mental, and cognitive health in prospective studies. Here, we aimed to identify important correlates of PiL among people of diverse backgrounds.

METHODS

Participants were recruited by the population-based Health and Retirement Study and provided information on 34 different sociodemographic and psychosocial factors through psychometrically validated measures. To identify important correlates of PiL, we employed regularized regression implemented by Elastic Net on the entire cohort as well as among self-identified black participants only and white participants only, respectively.

RESULTS

A total of 6,620 participants were included in this study, among whom 913 were black and 5,707 were white. We identified 12 and 23 important sociodemographic and psychosocial correlates of PiL among black and white participants, respectively. Notably, all the 12 correlates in black participants were also correlates among white participants. Interestingly, when we examined both black and white participants together, being black was associated with having higher PiL. The correlates with the largest effect on PiL that were shared among black and white participants were hopelessness, perceived constraint on personal control, and self-mastery.

CONCLUSION

Several sociodemographic and psychosocial factors most strongly associated with PiL were shared among black and white participants. Future studies should investigate whether interventions targeting correlates of PiL can lead to higher sense of life purpose in participants of diverse backgrounds.

Sense of Purpose in Life and Beliefs and Knowledge of Alzheimer's Disease

OBJECTIVE

A sense of purpose in life is associated with healthier cognitive outcomes, including lower risk of Alzheimer's Disease (ad). The present research examines whether purpose is also associated with beliefs and knowledge of ad.

METHOD

A random subsample (N = 1,187) of community-dwelling participants from the Health and Retirement Study completed a module on self-reported beliefs and knowledge of ad.

RESULTS

Purpose in life was associated with lower perceived threat of ad and greater belief that modifiable factors (e.g., physical activity) decrease risk. Associations were not moderated by experience with ad or depressive symptoms. Purpose was unrelated to beliefs that genetics or stress increase risk or knowledge of ad.

CONCLUSIONS

Individuals with a sense of purpose are less concerned about risk of developing ad and believe modifiable factors reduce risk. These beliefs may support engagement in behaviors that reduce risk and be one psychological pathway through which purpose protects against ad.

Purpose in Life: Addressing Transdiagnostic Psychopathologies Concerning Patients' Sense of Purpose

ABSTRACT

Having a purpose in life is strongly associated with well-being and quality of life. Some individuals develop their sense of purpose early in life and can sustain lifelong ideals. In contrast, we identify four transdiagnostic syndromes where purpose in life is impaired: 1) deficiencies in generating purpose; 2) loss of purpose due to traumatic events such as catastrophic illnesses or bereavements; 3) conflicts due to crossed purposes; and 4) maladaptive purposes, such as life-limiting single-minded goals, dominating others, or exacting revenge. Several psychotherapies associated with positive and existential psychologies help patients construct, reconstruct, or retain a sense of purpose. However, given the strong links between a sense of purpose and beneficial health and mental health outcomes, the authors suggest that many patients in psychiatric treatment including psychotherapies will benefit from attention to these issues. This article reviews approaches for assessing and addressing purpose in life in psychiatric treatment, to enhance patients' healthy sense of purpose where this characteristic is impaired.

Biopsychosocial Factors That Influence the Purpose in Life among Working Adults and Retirees

This study aimed to identify and characterize biopsychosocial factors that impact the purpose in life (PIL) among adults that are working or already retired. This cross-sectional study includes a sample of 1330 participants, of whom 62.2% were female, with ages ranging from 55 and 84 years, with a mean of 61.93 years and a standard deviation of 7.65. Results suggest that the education level, stress, spirituality (religion) and optimism, social support from friends, and quality of life related to physical health seem to contribute positively to the PIL for both groups. However, some variables such as age, marital status and environmental quality of life help explain the PIL of retired people and the quality of life related to social support helps explain the PIL of working adults. Overall, the reported findings suggest that the purpose in life is strongly related to physical, psychological, social and environmental health factors. It is highlighted that working adults and retired people have their purpose in life related to similar factors and others specific to each life stage, suggesting the need for crucial interventions to promote a healthier and more positive aging process.

Perceived Purpose in Life, Mental Health, and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study

OBJECTIVE

To determine the current prevalence of perceived purpose in life (PIL) and its association with screening positive for mental disorders and suicidality in a nationally representative sample of predominantly older U.S. veterans.

METHODS

Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (N = 4,069; M_age = 62.2). Veterans were classified into three groups based on perceived PIL level (i.e., low, average, and high). Self-report assessments were administered to screen for mental disorders and suicidality.

RESULTS

Most veterans endorsed average PIL (71.7%), while 16.0% endorsed low PIL and 12.4% endorsed high PIL. A "dose-response" association was observed between PIL and outcomes. High PIL was associated with 42%-94% reduced odds of screening positive for major depressive, generalized anxiety, posttraumatic stress, and substance use disorders, as well as suicide attempts, ideation, and future intent.

CONCLUSION

Higher PIL is associated with lower odds of mental disorders and suicidality in U.S. veterans, underscoring the potential importance of interventions to bolster PIL in this population.

Correlated Change in Sense of Purpose and Romantic Relationship Quality

Sense of purpose, or feeling that that one has personally meaningful goals and directions guiding them through life, consistently predicts a variety of desirable well-being, health, and social outcomes. However, work has been limited with respect to evaluating it as a predictor and promoter of romantic relationships, or how purpose may develop in these contexts. For instance, healthy romantic relationships could also help individuals develop and maintain a higher sense of purpose. With cross-sectional evidence finding positive associations between sense of purpose and romantic relationship commitment and satisfaction, the current study expanded on past work by using longitudinal data with three months between two measurement occasions (Time 1: N = 2243; Time 2: N = 1284) to evaluate whether sense of purpose predicted relationship status over time and how changes in relationship quality and sense of purpose were associated. Results showed that greater sense of purpose predicted maintaining a romantic relationship, but did not predict later romantic relationship quality, while higher romantic relationship quality predicted an increase in sense of purpose. Findings are discussed regarding why people with a higher sense of purpose may be more likely to stay in relationships as well as the role that positive romantic relationships may play in helping maintain a higher sense of purpose.

Cross-national measurement invariance of the Purpose in Life Test in seven Latin American countries

The Purpose in Life Test (PIL) is a measure of purpose in life widely used in many cultures and countries; however, cross-cultural assessments are scarce. The present study aimed to evaluate the cross-cultural measurement invariance of the PIL in the general population of seven Latin American countries (Colombia, Ecuador, El Salvador, Mexico, Paraguay, Argentina, and Uruguay). A total of 4306 people participated, selected by non-probabilistic convenience sampling, where Uruguay has the highest mean age (M = 41.8; SD = 16.6 years); while Ecuador has the lowest mean age (M = 24.6; SD = 7.8 years). Furthermore, in each country, there is a higher proportion of women (>60%) than men (<40%). Using Multi-Group Confirmatory Factor Analysis, the factorial structure does not show evidence of invariance among the included countries. However, based on the Multi-Group Factor Analysis Alignment, there is evidence that a three-dimensional structure of the PIL (Meaning of existence, Freedom to make meaning in daily life and Will to find meaning in the face of future challenges) is the same in the participating countries. Results based on item response theory indicate that most PIL items can significantly differentiate responses according to the level of life purpose. In addition, people with low life purpose will tend to choose the lower response alternatives on the PIL; while people with higher life purpose will choose higher response alternatives. The findings indicate that the PIL has the potential to increase knowledge about how people conceive and experience their purpose in life in different countries.

What makes life purposeful? Identifying the antecedents of a sense of purpose in life using a lagged exposure-wide approach

Aims

Prior research documents strong associations between an increased sense of purpose in life and improved health and well-being outcomes. However, less is known about candidate antecedents that lead to more purpose among older adults.

Methods

We used data from 13,771 participants in the Health and Retirement Study (HRS) — a diverse, national panel study of adults aged >50 in the United States, to evaluate a large number of candidate predictors of purpose. Specifically, using linear regression with a lagged exposure-wide approach, we evaluated if changes in 61 predictors spanning physical health, health behaviors, and psychosocial well-being (between t₀;2006/2008 and t₁;2010/2012) were associated with purpose four years later (t₂;2014/2016) after adjustment for a rich set of baseline covariates.

Results

Some health behaviors (e.g., physical activity ≥1x/week [β = 0.14, 95% CI: 0.09, 0.19]), physical health conditions (e.g., stroke [β = −0.25, 95% CI: −0.40, −0.10]), and psychosocial factors (e.g., depression [β = −0.21, 95% CI: −0.27, −0.15]) were associated with subsequent purpose four years later. However, there was little evidence that other health behaviors, physical health conditions, and psychosocial factors such as smoking, drinking, or financial strain, were associated with subsequent purpose.

Conclusions

Several of our candidate predictors such as volunteering, time with friends, and physical activity may be important targets for interventions and policies aiming to increase purpose among older adults. However, some effect sizes were modest and contrast with prior work on younger populations, suggesting purpose may be more easily formed earlier in life.

•

Factors that lead to increased purpose in life in older adults remain unclear.

•

We leveraged a large and prospective cohort of US adults aged >50.

•

We evaluated associations between 61 predictors and subsequent purpose in life.

•

Some health/well-being factors were associated with purpose in life 4 years later, but not others.

Sense of purpose in life and concurrent loneliness and risk of incident loneliness: An individual-participant meta-analysis of 135,227 individuals from 36 cohorts

BACKGROUND

Sense of purpose, the feeling that one's life is goal-oriented and driven, tends to be protective for psychological health. Less is known about its relation with social health, particularly loneliness. We test whether the cross-sectional association between purpose and loneliness is replicable and whether purpose protects against the development of incident loneliness over time.

METHODS

Participants from 36 cohorts (total N = 135,227; age range 18-109) reported on their sense of purpose, loneliness, and psychological distress. Follow-up measures of loneliness were available in 28 cohorts that ranged from six weeks to 15 years. Prospective, random-effect meta-analysis was used to summarize the cross-sectional and longitudinal associations from each cohort.

RESULTS

Sense of purpose was associated significantly with less loneliness in all 36 cohorts, controlling for sociodemographic factors (meta-analytic mean effect estimate = -0.31, 95% CI = -0.34, -0.29, p < .001). This association was stronger among participants experiencing concurrent severe psychological distress. Sense of purpose was protective against the development of new incident loneliness (meta-analytic mean hazard ratio estimate = 0.85, 95% CI = 0.82, 0.87, p < .001). Age did not moderate any of the associations.

LIMITATIONS

Limitations include the lack of lower-income countries. The mechanisms that explain this association also need to be identified in future research.

CONCLUSIONS

Sense of purpose is associated with less loneliness and with protection against developing loneliness over time, associations that replicated across cohorts from North America, South America, Europe, and the Middle East. Sense of purpose may be a useful target of intervention to prevent or reduce loneliness, especially among individuals suffering from psychological distress.

Sense of Purpose in Life Is Associated with Lower Risk of Incident Dementia: A Meta-Analysis

BACKGROUND

A sense of purpose in life has been associated with healthier cognitive outcomes across adulthood, including risk of dementia. The robustness and replicability of this association, however, has yet to be evaluated systematically.

OBJECTIVE

To test whether a greater sense of purpose in life is associated with lower risk of dementia in four population-based cohorts and combined with the published literature.

METHODS

Random-effect meta-analysis of prospective studies (individual participant data and from the published literature identified through a systematic review) that examined sense of purpose and risk of incident dementia.

RESULTS

In six samples followed up to 17 years (four primary data and two published; total N = 53,499; n = 5,862 incident dementia), greater sense of purpose in life was associated with lower dementia risk (HR = 0.77, 95%CI = 0.73-0.81, p < 0.001). The association was generally consistent across cohorts (I2 = 47%), remained significant controlling for clinical (e.g., depression) and behavioral (e.g., physical inactivity) risk factors, and was not moderated by age, gender, or education.

CONCLUSION

Sense of purpose is a replicable and robust predictor of lower risk of incident dementia and is a promising target of intervention for cognitive health outcomes.