Sense of Purpose Promotes Resilience to Cognitive Deficits Attributable to Depressive Symptoms

Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population.

Sense of purpose in life and allostatic load in two longitudinal cohorts

OBJECTIVE

Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking sense of purpose with diverse health outcomes are unclear. Sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic load and disease risk over time. The current study examined the association between sense of purpose in life and allostatic load over time in adults over age 50.

METHODS

Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA) were used to examine associations between sense of purpose and allostatic load across 8 and 12 years of follow-up, respectively. Blood-based and anthropometric biomarkers were collected at four-year intervals and used to compute allostatic load scores based on clinical cut-off values representing low, moderate, and high risk.

RESULTS

Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS, but not in ELSA after adjusting for relevant covariates. Sense of purpose in life did not predict rate of change in allostatic load in either sample.

CONCLUSIONS

The present investigation supports sense of purpose predicting preserved differentiation of allostatic regulation, with more purposeful individuals demonstrating consistently lower allostatic load over time. Persistent differences in allostatic burden may account for divergent health trajectories between individuals low and high in sense of purpose.

Well-Being as a Protective Factor Against Cognitive Decline and Dementia: A Review of the Literature and Directions for Future Research

OBJECTIVES

Treatments that target the biological causes of dementia remain limited, making prevention critically important. Well-being-defined broadly as living in accordance with one's potential and experiencing one's life as enjoyable and satisfying-is a promising avenue for prevention. It can be targeted by large-scale, noninvasive interventions and has been linked with better cognitive health and lower dementia risk. In the current review, we begin by summarizing empirical evidence linking well-being to cognitive functioning, cognitive decline, dementia diagnosis, and dementia-related neuropathology. Then, we highlight 3 key areas for future research.

METHODS

We searched the literature on wellbeing, cognitive decline, and dementia, focusing on prospective and longitidinal evidence.

RESULTS

The research reviewed here provides consistent evidence for associations of well-being with cognitive decline, dementia risk, and cognitive resilience to neuropathology. However, several open questions remain regarding (1) causality and mechanism(s), (2) specificity versus generalizability of associations, and (3) timing.

DISCUSSION

To inform potential intervention efforts, the field must address complex open questions about whether, how, when, and for whom well-being influences dementia risk. The majority of existing research on well-being and cognitive health is correlational, and few studies have tested potential mechanisms that may explain those associations. Further, relatively little is known about the generalizability of associations across different aspects of well-being and for different sociocultural groups. Finally, we do not yet understand when in the life span and on what timescale well-being might influence cognitive health. We discuss challenges and opportunities for addressing each of these open questions, including concrete recommendations for research designs and use of open science practices.

Positive psychological constructs and cognitive function: A systematic review and meta-analysis

AIM

To synthesise evidence regarding the association between positive psychological constructs (PPCs) and cognitive function in adults aged 50 +.

METHODS

Literature searches: Medline, PsycINFO, and Scopus (inception to February 2022). Studies were included if they reported on the association between at least one PPC and one objective measure of cognitive function in people aged 50 + without cognitive impairment at baseline. Where at least two studies reported on the same PPC and cognitive outcome, estimates were pooled through meta-analysis.

FINDINGS

In total, 37 studies were included. There was evidence of cross-sectional associations for 'meaning in life' (verbal fluency: b = 0.09, 95 %CI [0.07, 0.11], p < .001; memory: b = 0.10, 95 %CI [0.08, 0.12], p < .001), 'purpose in life' (verbal fluency: b = 0.07, 95 %CI [0.05, 0.08], p < .001; memory: r = 0.13, 95 %CI [0.08, 0.18], p < .001), and positive affect (cognitive state: r = 0.25, 95 %CI [0.14, 0.36], p < .001; memory: r = 0.05, 95 %CI [0.02, 0.08], p < .001) with various domains of cognitive function. However, no significant results were found for life satisfaction (p = .13) or longitudinal studies investigating positive affect and memory (p = .48). Other PPCs were included in narrative syntheses only.

IMPLICATIONS

Purpose and meaning in life may be sensible primary targets for interventions to promote healthy cognitive aging. More longitudinal and causal inference research is needed to better understand this association and its implications for clinical practice.

Sense of purpose as a potential buffer between mental health and subjective cognitive decline

OBJECTIVES

Purposeful adults may experience greater cognitive resilience because sense of purpose may help buffer against the effects of depressive symptoms and loneliness. We also evaluated whether these associations differed by race.

DESIGN

This study uses a wave of self-report data from the SPAN study of psychosocial aging.

SETTING

Participants come from a representative sample of older adults in St. Louis.

PARTICIPANTS

Participants (N = 595) ages range from 65 to 78 (Mage = 71.46), with 18.3% of participants identifying as Black/African-American.

MEASURES

Sense of purpose was assessed with the Life Engagement Test, depressive symptoms with the Beck Depression Inventory-II, loneliness with the UCLA Loneliness Scale, and subjective cognitive decline with the AD-8.

RESULTS

Correlational analyses supported predictions that sense of purpose was negatively related to subjective cognitive decline, whereas depressive symptoms and loneliness were positively related (|r|s > .30, ps < .001). For loneliness, but not depression, this association was moderated by sense of purpose (b = -0.43, p < .001). A relatively high sense of purpose attenuated associations between loneliness and subjective cognitive decline. A three-way race × purpose × loneliness interaction (b = -0.25, p = .021) revealed that the buffering effects of sense of purpose on subjective cognitive decline were stronger for Black adults.

DISCUSSION

This study provided partial support for the buffering hypothesis, showing that sense of purpose may help mitigate the cognitive decrements associated with loneliness. Future research needs to consider how purpose-promoting programs may support healthy cognitive aging, particularly among Black older adults and those who experience greater social isolation.

Addressing Psychosocial Factors in Cognitive Impairment Screening from a Holistic Perspective: The DeCo-Booklet Methodology Design and Pilot Study

Cognitive impairment (CI), an intermediate phase between the decline in physiological cognition and dementia, is known to be mediated by a variety of risk and protective factors, with age being the most influential of these. The multifactorial nature of CI and the worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging (HA) a matter of major interest. Focusing on psychosocial variables and psychological constructs, here we designed and piloted a data collection booklet (DeCo-B) to assess CI and HA from a holistic perspective. The DeCo-B comprises six sections: sociodemographic factors, CI, meaning in life, psychosocial factors, health problems, and lifestyle. The estimated prevalence of CI and HA in our cohort were 24.4% and 6.6%, respectively. Spearman correlations mainly identified pairwise associations between the meaning in life domains and psychosocial variables. Moreover, age, marital status, purpose in life, resilience, chronic pain, cognitive reserve, and obstructive sleep apnea were significantly associated with an increased risk of CI. Our results showed that DeCo-B is a suitable tool for researching how modifiable risk and protective factors influence cognitive status. The complex interrelationships between variables should be further investigated and, for practical reasons, the questionnaire should be optimized in future work.

A prospective study of college student depressive symptoms, sense of purpose, and response to a COVID-19 campus shutdown

Individual differences can shape the way major life events are experienced. In this study, we explored the unique and interactive effects of depressive symptoms and sense of purpose on downstream appraisals of a COVID-19 college campus shutdown. Data were from a sample of U.S. college students (n = 152) surveyed prior to widespread COVID-19 transmission (Time 1; early fall 2019), and again just after their university closed as a protective measure (Time 2; mid-spring 2020). Depressive symptoms were positively associated, whereas sense of purpose was negatively associated, with cross-sectional reports of social status change due to shutdown. Depressive symptoms at Time 1 positively predicted perceived external control of the situation at Time 2, and sense of purpose at Time 1 positively predicted changes to worldview at Time 2. Purpose and depressive symptoms evidenced high rank-order stability from Time 1 to Time 2. This study represents a rare documentation of college students' feelings and experiences before, and during, a historical moment. The implications of these findings for future research are discussed.