Several years before a diagnosis of moderate cognitive impairment, older people may experience a lessened sense of purpose along with a sense of pessimism about their personal growth, a new study has found.
The study subjects were part of the Rush Memory and Aging Project, a long-term effort that began in 1997 at Rush University in Chicago to identify genetic and environmental factors in the development of Alzheimer’s disease. Their data has been used in more than 300 studies looking at aspects of aging, ranging from an investigation into the effects of egg consumption on dementia risk to a study of the relationship between loneliness and physical activity in older adults.
Changes Precede Cognitive Decline
This latest study was published online in the Journal of Neurology Neurosurgery & Psychiatry.
Researchers in China, Sweden, and Chicago conducted the long-term investigation involving 910 people with an average age of 79. Over a 14-year period, the participants underwent annual evaluations for moderate cognitive impairment and dementia. The researchers measured six components of the subjects’ psychological well-being:
- Self-acceptance
- Autonomy
- Environmental mastery
- Purpose in life
- Positive relationships with others
- Personal growth
By the end of the study, 265 of the subjects (29 percent) had developed moderate cognitive impairment, and of this group, 89 (34 percent) had gone on to develop dementia. Compared to subjects who did not show cognitive decline, those who developed cognitive impairment experienced a faster decline in psychological wellbeing two years prior to diagnosis. But changes began earlier than that; this group began reporting lower levels of purpose in life three years before diagnosis, and lower levels of personal growth beginning six years before.
The four other measures of wellbeing did not decline in the group that developed impairment, the researchers found. They hypothesized that this may indicate that personal growth and purpose in life “may be more cognitively demanding than other components of wellbeing, and therefore may serve as more sensitive indicators of cognitive aging.”
These sensitive indicators are important, as dementia’s “long preclinical stage may provide a critical time window for implementing preventions to prevent or delay its onset,” they wrote, and so early identification of people at high risk “is crucial to implement preventive measures and reduce dementia incidence and associated burdens.”
Cautions and Limitations
Bolstering one’s sense of purpose and growth may not necessarily prevent or delay cognitive decline, the researchers cautioned. Although the findings indicate that lowered psychological well-being may predict future cognitive impairment, the study did not show a causal relationship, Jie Guo, who has a doctorate in human nutrition and is a co-author of the study, told The Epoch Times.
“Given that this study is an observational study,” she said, “we could not conclude causal associations that maintaining a sense of purpose and working on one’s personal growth may stave off moderate cognitive impairment and dementia.”
Also, the study did not measure the effects of the subjects’ fitness and nutrition levels, Guo added. These factors may play a role in staving off cognitive impairment and Alzheimer’s, and are the topic of ongoing research on aging, she noted.
A recent report on dementia published by the Lancet Commission, a series of independent, high-level expert groups convened by The Lancet medical journal, found 14 dementia risk factors that range from lifestyle choices such as physical inactivity and smoking to health conditions such as obesity and hearing loss.
Almost half of all dementia cases could be delayed or prevented by eliminating these risk factors, according to the Lancet report.
Research into the many factors—physical, environmental, social, and psychological—that contribute to cognitive decline and dementia is ongoing and international.
“Further research is needed to investigate whether and to what extent interventions targeting [psychological] well-being components may benefit cognitive function and help prevent the development of dementia,” Guo and colleagues wrote.