Feeling a lack of purpose and personal growth in older ages may be a very early warning sign of dementia later in life, new research suggests. The findings add to a growing body of evidence that psychological well-being and memory decline are intimately linked.
More than 5 million Americans over 65 live with dementia, according to 2014 data from the U.S. Centers for Disease Control and Prevention. Dementia comes in different forms—the most common form is Alzheimer's disease—and is characterized by an impaired ability to remember, think and make decisions.
Exactly what causes dementia isn't entirely clear, but a range of genetic and environmental risk factors have been associated with the condition.
Previous research has identified links between depression, poor psychological well-being and memory decline, suggesting that each might affect the others. Now, scientists from China Agricultural University, Sweden's Karolinska Institutet and Chicago's Rush University Medical Center have explored how psychological well-being changes over the course of cognitive decline and dementia development.
The study involved 910 cognitively intact older adults involved in the Rush Memory and Aging Project, who were followed up annually over 14 years. Six components of psychological well-being—self-acceptance, autonomy, environmental mastery, purpose in life, positive relations with others and personal growth—were measured at each evaluation, along with signs of mild cognitive impairment and dementia.
The researchers found that compared with participants who remained cognitively intact throughout the study period, those who went on to develop mild cognitive impairment had a faster decline in psychological well-being. In particular, levels of purpose in life and personal growth appeared to decline as early as three and six years, respectively, before cognitive decline became apparent.
The study concluded that reduced psychological well-being, even in the absence of evident cognitive impairment, may serve as an early-warning sign of future impairment in brain function.
"Our findings 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 ageing," the study's authors write.
Of course, these studies are purely associative, and the mechanisms that might be underlying these associations are still unclear. However, the factors appear to be bidirectional—it is known that depression and stress can cause changes in brain structure in areas of the brain critical for memory formation and retrieval. And feeling as if you are losing cognitive function may aggravate feelings of helplessness and isolation.
More work is needed to fully understand these associations and develop effective interventions to help slow, or even stop, cognitive decline.
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References
Yin J, John A, Cadar D. Bidirectional Associations of Depressive Symptoms and Cognitive Function Over Time. JAMA Netw Open. 2024;7(6).
Guo, J., Wang, J., Dove, A., Bennett, D. A., & Xu, W. (2024). Psychological well-being trajectories preceding incident mild cognitive impairment and dementia. Journal of Neurology Neurosurgery & Psychiatry, 95(9).
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