Negative and Positive Psychosocial Factors in Relation to Cognitive Health in Older African Americans

Abstract

Background and Objectives Identifying potential intervention strategies to reduce cognitive decline, particularly among older African Americans at high risk for Alzheimer's dementia, is critical. This study aimed to investigate whether depressive symptoms, purpose in life, and their inter-relations are associated with cognitive decline in older African Americans. Research Design and Methods We included older African Americans from the Minority Aging Research Study (n=748) and Rush Memory and Aging Project (n=109), without dementia at baseline. We assessed associations of depressive symptoms, purpose in life, and their inter-relations, with baseline levels and change in global cognition using linear mixed-effects models. Results At baseline, each unit increment in depressive symptoms was related to worse initial global cognition (mean difference=-0.03 standard unit; P=.003), while higher purpose in life was related to better cognition (mean difference=0.12; P=.002). Further, participants with ≥1 depressive symptom who had a purpose in life score above the median appeared to have better global cognition (mean difference=0.10; P=.01), compared to those with depressive symptoms but lower levels of purpose in life. However, we did not find relations of depressive symptoms or purpose in life with rates of cognitive decline over time, likely due to the modest follow-up. Discussion and Implications In older African Americans, we found that lower depressive symptoms and greater purpose in life were independently related to higher initial levels of global cognition, but not cognitive decline. Preliminary findings of higher global cognition in individuals with depressive symptoms but greater purpose in life merit further investigation if purpose may eventually be considered as an intervention.

Psychosocial factors associated with 7‐year change in cognition among middle‐aged and older Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA) and Sociocultural ancillary studies

“…Our findings on the lack of an association between purpose in life and change in global cognition disagree with previous studies 2,4,5,48 that reported an association between greater purpose in life and slower global cognitive decline and less perceived cognitive decline in non‐Hispanic white and African American adults. Given the limited research on purpose in life and cognition in Hispanic/Latino adults, additional research is needed to confirm our findings and to further elucidate whether a longer follow‐up time is needed to observe an association.…”

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

“…Previous research has found consistent associations between purpose in life and cognitive status, episodic memory, and verbal fluency (Boyle et al, 2010; Sutin et al, 2022; Windsor et al, 2015). The association between purpose and other cognitive domains has been more inconsistent, with some studies finding positive associations (Estrella et al, 2021; Wagner et al, 2022) and other studies finding no relation (Cattaneo et al, 2022; Zahodne et al, 2018). The present study found that purpose was associated with better performance in every domain measured, as well as global cognitive function.…”

“…For example, the association between purpose and cognitive decline over time is apparent across races but is stronger among Black than White adults (Kim et al, 2019). Studies with samples from specific populations, such as Black (Wagner et al, 2022) and Hispanic (Estrella et al, 2021) adults, also tend to find similar associations as studies with predominately White samples (Lewis et al, 2017). This evidence suggests that the association between purpose and healthier cognition may generalize across sociodemographic groups.…”

“…Most work on purpose and cognitive function has focused on global cognitive function, episodic memory, and verbal fluency (Boyle et al, 2010; Sutin et al, 2022; Windsor et al, 2015). Some work has also found the positive association between purpose and cognition extends to other cognitive functions, including visuospatial ability, verbal learning, perceptual speed, processing speed, and working memory (Estrella et al, 2021; Wagner et al, 2022). Yet, other studies have found that purpose is unrelated to performance in specific cognitive domains (Cattaneo et al, 2022; Zahodne et al, 2018).…”

Fulfilled Mind, Healthy Gut? Relationships of Eudaimonic Psychological Well-Being With the Gut Microbiome in Postmenopausal Women

“…Two theoretical dimensions have been proposed as ways of understanding and characterizing PWB: the hedonic dimension, which defines well-being according to pursuing and attaining pleasure and happiness (e.g., experiencing positive emotions), and the eudaimonic dimension, which defines well-being according to one’s ability to identify meaningful life pursuits and striving to achieve one’s best (8). Past work reliably shows that facets of eudaimonic PWB such as purpose in life (i.e., the extent to which individuals see their lives as having a sense of direction, and goals to live for) or having a sense of mastery (i.e., the extent to which individuals perceive life as being under their control) are linked with indicators of healthy aging including better cognitive function (9,10), along with reduced risk of age-related health conditions such as cardiovascular disease (11), diabetes (12), neurodegenerative disease (13), frailty (14), and premature mortality (15). Moreover, other studies suggest that eudaimonic PWB may buffer potentially toxic effects of stress (16), thereby reducing the impact of deteriorative biologic and behavioral processes that may contribute to stress-related aging (17).…”