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

Dynamic influence of mood on subjective cognitive complaints in mild cognitive impairment: A time series network analysis approach

OBJECTIVES

Subjective cognitive complaints (SCC) are common and clinically relevant in mild cognitive impairment (MCI) but are intertwined with mood states. Using Ecological Momentary Assessment (EMA) of SCC and network analyses we sought to uncover the links between mood and SCC and how these links may vary by the presence or absence of MCI.

DESIGN

We used EMA to collect intensive longitudinal data. In addition to analyzing the data at an aggregate level to estimate between-person associations of affect and SCC variables, we used time series analyses to estimate contemporaneous and time-lagged relations between the variables.

SETTING

EMA survey and mobile cognitive testing in subjects' natural environments.

PARTICIPANTS

The sample included 100 participants, 48 with Normal Cognition (NC), and 52 with MCI.

MEASUREMENTS

Participants completed 30-day EMA protocols in which surveys sampling SCC and moods were delivered 3 times per day.

RESULTS

The association between SCC (as measured by EMA) and standard in-lab measures of SCC was significant in MCI, but not in NC. Despite no average level differences in severity of SCC, there was a strong association between negative affect (as measured by EMA) with SCC in NCs compared to MCI.

CONCLUSIONS

EMA maybe a useful and valid approach to measuring SCCs in MCI. Network analyses indicated that negative affect was linked with later SCCs. This finding was strong in persons with NC than in persons with MCI. The basis of the attenuated association between negative affect and SCCs in MCI deserves further study.

Longitudinal association between creative arts participation with cognitive function in late life

OBJECTIVES

Examine relationships between arts participation in high school and later life, cognition, and cognitive change among older adults in the United States.

DESIGN

Longitudinal retrospective SETTING: Health and Retirement Survey (HRS) including the Life History Mail Surveys (LHMS) and Consumption and Activities Mail Survey (CAMS).

PARTICIPANTS

A sample of HRS respondents with cognition data from Wave 3 (1996) through Wave 14 (2018). We merged LHMS and CAMS responses (2017 and 2019) about high school arts participation, eliminating respondents < 50 years of age, without cognitive data in the last three waves, or with normal cognition following previously reported dementia.

MEASUREMENTS

Respondents were categorized into 4 groups for musical and for visual arts): (1) lifelong learners; (2) high school learners; (3) current learners; and (4) no interest. Cognitive function was measured as a continuous summary score on a 27-point cognitive battery of items in the Langa-Weir Classification total Telephone Interview for Cognitive Status, TICS.

RESULTS

Musical arts participation at time of the survey was associated with a slower rate of cognitive decline in the entire sample (3505 participants in musical and 3507 in visual arts) and the War Babies cohort. Those who participated in musical arts at the time of the survey and while in high school experienced a slower rate of cognitive decline in the AHEAD-CODA cohort only. No relationships were found between cognition and times of visual arts participation.

CONCLUSIONS

Some types of arts participation at different periods of life may benefit cognition later in life.

The Mediating Role of Meaning and Purpose in Life in the Relationship Between Spiritual Well-Being and Depressive Symptoms Among Older Adults in Türkiye

This study aimed to examine the relationship between depressive symptoms and spiritual well-being in older adults, with a particular focus on the mediating role of meaning and purpose of life in this relationship. This research used a correlational and cross-sectional design and was conducted with 148 older adults between May and August 2023. Data were collected face-to-face using a personal information form, the Geriatric Depression Scale-15 (short form), the Spiritual Well-Being Scale, and the Meaning and Purpose of Life Scale. The mean age of the participants in the study was 75.69 years. Initial analysis revealed that the transcendence, anomie, and harmony with nature sub-factors of the Spiritual Well-being Scale explained depressive symptoms at a rate of 50.4%. However, when meaning and purpose in life were included in the model as a mediator variable, the explained variance ratio increased to 63.0%. In the SEM testing, it was found that meaning and purpose in life fully mediated the correlation between the anomie, the sub-factor of the Spiritual Well-Being Scale, and depressive symptoms. These findings suggest that healthcare providers should incorporate interventions aimed at reducing anomie, improving harmony with nature, and fostering a sense of meaning and purpose in life, as part of early intervention and preventive measures to mitigate depressive symptoms and promote mental health in this population.

Purpose in life moderates the relationship between perceived discrimination and cognitive functioning in midlife and older adults

OBJECTIVES

Discrimination is associated with worse cognitive outcomes, but research is urgently needed to identify modifiable psychosocial resources that may buffer the impact of discrimination on cognition. Purpose in life is one such resource associated with positive health outcomes. However, it is unclear whether purpose in life may buffer the relationship between discrimination and cognition among older adults.

METHOD

We drew a sample of 22,369 adults aged 51 and older in the 2006 to 2020 waves of the nationally-representative Health and Retirement Study (HRS). Multilevel mixed models assessed whether (1) measures of everyday discrimination and purpose in life and (2) a purpose in life x discrimination interaction term were associated with cognition.

RESULTS

Discrimination was associated with poorer cognitive functioning, both on its own and when controlling for purpose in life. Likewise, purpose in life was significantly associated with better cognitive functioning, with and without controlling for discrimination. Results also indicated that purpose in life significantly moderated the association between discrimination and cognitive functioning (b = 0.05, p = 0.01).

CONCLUSION

Findings underscore the importance of psychosocial resources that may serve as stress-buffering mechanisms and protect older adults' cognitive health. Future research is needed to clarify the biobehavioral mechanisms that may underlie this association.

Purpose in life and stress: Momentary associations from a micro-longitudinal study

Purpose in life is an aspect of well-being associated with less subjective stress. The present research sought to expand this literature by testing the association between both dispositional and momentary purpose with stress in daily life using a micro-longitudinal study design. Participants (N = 303) reported their dispositional purpose at baseline and reported their momentary purpose and stress three times a day for 8 days. Between-person, dispositional purpose was associated with less momentary stress across the 8 days tested with linear regression (β = -0.29, 95% CI = -0.39, -18, p < 0.001); it was unrelated to variability in stress (β = 0.05, 95% CI = -0.05, 0.14, p = 0.310). In contrast, the within-person analysis tested with multilevel modelling indicated that in moments when participants felt more purpose-driven than their average, they felt more stressed (b = 0.09, 95% CI = 0.06, 0.12, SE = 0.01, p < 0.001). This association was slightly stronger among participants with relatively lower dispositional purpose (binteraction = -0.04, SE = 0.02, 95% CI = -0.08, -0.01, p = 0.032). This study replicated the negative association between dispositional purpose and subjective stress when stress was measured at moments in daily life. It also found that feeling more purpose-driven than usual in the moment is stressful, a counterintuitive finding that, if replicated, suggests that striving for purpose can be stressful in the moment, even if feeling more purposeful in general is associated with lower stress.

Personality traits moderate associations between word recall and subjective memory

Cognitive gerontology research requires consideration of performance as well as perceptions of performance. While subjective memory is positively associated with memory performance, these correlations typically are modest in magnitude, leading to the need to consider whether certain people may show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood and memory decline) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Extraversion and conscientiousness held the most consistent associations with the cognitive variables of interest, as both traits were positively associated with metamemory and word recall, but negatively associated with subjective decline. Moreover, extraversion moderated associations between word recall and both memory capacity and complaints, insofar that objective-subjective associations were weaker for those adults higher in extraversion. These findings highlight the need to understand how personality influences the sources of information employed for subjective cognitive beliefs.

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.

When mind and measurement diverge; the interplay between subjective cognitive complaints (SCCs), objective cognition, age, and depression in autistic adults

While the increased incidence of dementia and subjective cognitive complaints (SCCs) suggests that autistic adults may face cognitive challenges at older age, the extent to which SCCs predict (future) cognitive functioning remains uncertain. This uncertainty is complicated by associations with variables like depression. The current study aims to unravel the interplay of age, depression, cognitive performance, and SCCs in autism. Using a large cross-sectional cohort of autistic (n=202) and non-autistic adults (n=247), we analyzed associations of SCCs with age, depression, and cognitive performance across three domains (visual memory, verbal memory, and fluency). Results showed a strong significant association between depression and SCCs in both autistic and non-autistic adults. Cognitive performance was not significantly associated with SCCs, except for a (modest) association between visual memory performance and SCCs in autistic adults only. Follow-up regression tree analysis indicated that depression and being autistic were considerably more predictive of SCCs than objective cognitive performance. Age nor sex was significantly associated with SCCs. These findings indicate that self-reported cognitive functioning does not equal cognitive performance, and should be interpreted with care, especially in individuals with high rates of depression. Longitudinal investigations are needed to understand SCCs' role in dementia and cognitive health in autism.

The effect of self-disclosure on loneliness among patients with coronary heart disease: The chain mediating effect of social support and sense of coherence

BACKGROUND

Loneliness is prevalent in patients with coronary heart disease (CHD). It has a serious impact on the physical and mental health and the quality of life of patients with CHD. However, what factors contribute to loneliness and the mechanism of action still need to be explored.

OBJECTIVES

To explore the chain mediating effect among self-disclosure, social support, sense of coherence and loneliness in patients with CHD through a chain mediating model.

METHODS

This cross-sectional study included 248 patients with CHD from three tertiary hospitals in Shiyan, Hubei Province, China. Self-reported scales were used to assess feelings of loneliness, self-disclosure, social support and sense of coherence. The Amos 26.0 software was used to construct the chain mediating effect.

RESULTS

Self-disclosure cannot directly affect patients' loneliness (β = -0.60, P>0.05). Social support and sense of coherence play a significant complete mediating role between self-disclosure and loneliness, with an overall mediating effect value of -0.479.

CONCLUSION

Self-disclosure in CHD patients indirectly affect loneliness through social support and sense of coherence (β = -0.479, P = 0.001). Improving patient self-disclosure and modulation of social support and sense of coherence help reduce in loneliness.

Beyond Finding Purpose: Motivating a Translational Science of Purpose Acquisition

A broad interest in finding purpose is understandable, as having purpose is situated in notions of "the good life" and is linked in studies to greater health and wellbeing. Yet, the empirical basis for whether purpose is truly findable is inadequate, lacking guidance from theories predicting behavioral capacities that drive its acquisition. If feeling purposeful is as favorable as studies suggest, then more transparent and precise explanations of how it is derived are needed; otherwise, the field risks illuminating this resource while leaving the pathways to it unlit. Here, I call for a translational science of purpose acquisition directed at gathering and disseminating evidence of the processes by which this sense can be cultivated. I introduce a minimal viable framework for integrating basic and applied investigations into purpose by bridging laboratory research, intervention and implementation efforts, community-engaged practices, and policies to accelerate testing and strategies for enhancing this salubrious sense in people's lives.

Network of mental activities, cognitive function and depression in older men and women

BACKGROUND

Evidence suggests that lifestyle activities impact cognitive and mental health in older populations. However, how lifestyle factors are associated with one another, and which factors are most important for cognitive function and mental health has received comparatively little attention.

DESIGN

Bayesian-Gaussian network analysis was used to investigate unique associations between mental activities (MA; i.e., activities involving cognitive engagement), global cognition, and depression at three time-points in a large sample of older adults (baseline, 2 years, and 4 years follow-up).

SETTING

This study used longitudinal data from participants living in Australia and participating in the Sydney Memory and Ageing Study.

PARTICIPANTS

The sample included 998 participants (55% female) aged between 70 and 90, without a diagnosis of dementia at baseline.

MEASUREMENTS

Neuropsychological assessment of global cognition, self-reported depressive symptoms, and self-reported information about daily MA.

RESULTS

Cognitive functioning was positively associated with playing tabletop games and using the internet in both sexes at all time-points. MA were differentially linked in men and women. Depression was not consistently associated with MA in men across the three time-points; women who visited artistic events consistently had lower depression scores.

CONCLUSIONS

Engaging with tabletop games and using the internet was associated with better cognition in both sexes, however sex acted as a modifier for other associations. These findings are useful for future investigations that consider interactive associations between MA, cognition, and mental health in older adults, and their possible roles in promoting healthy aging.

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.