Sense of purpose in life and extending the cognitive healthspan: evidence from multistate survival modeling

ABSTRACT

Having a sense of purpose in life predicts better maintenance of cognitive function in older adulthood and reduced risk of mild cognitive impairment (MCI) and dementia. However, little research has examined its influence on the rate of cognitive decline and length of cognitive healthspan. This study evaluated the role of sense of purpose on the risk and timing of transitions between normal cognition, MCI, and dementia. Older adults from the Memory and Aging Project (MAP; n = 1821) and the Health and Retirement Study (HRS; n = 10,542) were followed annually for 19 years and biennially for 12 years, respectively. Multistate survival models assessed whether sense of purpose predicted transitions across normal cognition, MCI, dementia, and death. More purposeful older adults had lower risk of developing MCI (HR = 0.82 in MAP; HR = 0.93 in HRS), higher likelihood of cognitive improvement, and longer cognitively healthy life expectancies. Results suggest sense of purpose may extend the cognitive healthspan.

KEYWORDS:

• Cognition
• cognitive reserve
• dementia
• well-being
• sense of purpose in life

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data and material availability

Data and materials from the Health and Retirement Study are publicly available through the HRS website (https://hrs.isr.umich.edu/data-products). Data from the Memory and Aging Project can be requested and accessed via the Rush Alzheimer’s Disease Center Resource Sharing Hub (https://www.radc.rush.edu). This study was not preregistered, but analysis code has been made publicly available via OSF and can be accessed at https://osf.io/znvwc/.

Supplementary data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13825585.2024.2373846.

Additional information

Funding

This work was supported by the Alzheimer Society of Canada [ASRP 20-17 to N.A.L.]. The Memory and Aging Project was supported by the National Institutes of Health [R01AG17917 and R01AG33678]. The Health and Retirement Study is sponsored by the National Institute on Aging [NIA U01AG009740] and is conducted by the University of Michigan.