Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-19T01:39:23.130Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  16 September 2022

Gabrielle N. Pfund Open the ORCID record for Gabrielle N. Pfund [Opens in a new window] ,
Isaiah Spears ,
Sara A. Norton ,
Ryan Bogdan ,
Thomas F. Oltmanns  and
Patrick L. Hill
Gabrielle N. Pfund*
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
Isaiah Spears
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
Sara A. Norton
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
Ryan Bogdan
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
Thomas F. Oltmanns
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
Patrick L. Hill
Affiliation:
Department of Psychological and Brain Sciences, Washington University, St. Louis, MO, USA
*
Correspondence should be addressed to: Gabrielle N. Pfund, Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA. Email: gabrielle.pfund@northwestern.edu.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Purposeful adults may experience greater cognitive resilience because sense of purpose may help buffer against the effects of depressive symptoms and loneliness. We also evaluated whether these associations differed by race.

Design:

This study uses a wave of self-report data from the SPAN study of psychosocial aging.

Setting:

Participants come from a representative sample of older adults in St. Louis.

Participants:

Participants (N = 595) ages range from 65 to 78 (Mage = 71.46), with 18.3% of participants identifying as Black/African-American.

Measures:

Sense of purpose was assessed with the Life Engagement Test, depressive symptoms with the Beck Depression Inventory-II, loneliness with the UCLA Loneliness Scale, and subjective cognitive decline with the AD-8.

Results:

Correlational analyses supported predictions that sense of purpose was negatively related to subjective cognitive decline, whereas depressive symptoms and loneliness were positively related (|r|s > .30, ps < .001). For loneliness, but not depression, this association was moderated by sense of purpose (b = −0.43, p < .001). A relatively high sense of purpose attenuated associations between loneliness and subjective cognitive decline. A three-way race × purpose × loneliness interaction (b = −0.25, p = .021) revealed that the buffering effects of sense of purpose on subjective cognitive decline were stronger for Black adults.

Discussion:

This study provided partial support for the buffering hypothesis, showing that sense of purpose may help mitigate the cognitive decrements associated with loneliness. Future research needs to consider how purpose-promoting programs may support healthy cognitive aging, particularly among Black older adults and those who experience greater social isolation.

Keywords

cognitive impairmentdepressionlonelinesshealth aging
Type
Original Research Article
Information
International Psychogeriatrics , Volume 34 , Special Issue 12: Issue Theme: Subjective Cognitive Complaints: What Do They Predict? , December 2022 , pp. 1045 - 1055
Copyright
© International Psychogeriatric Association 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aftab, A. et al. (2019). Meaning in life and its relationship with physical, mental, and cognitive functioning: a study of 1,042 community-dwelling adults across the lifespan. The Journal of Clinical Psychiatry, 81, 11357.CrossRefGoogle ScholarPubMed
Bauer, D. J. and Curran, P. J. (2005). Probing interactions in fixed and multilevel regression: inferential and graphical techniques. Multivariate Behavioral Research, 40, 373–400.CrossRefGoogle ScholarPubMed
Bergman, Y. S. and Segel-Karpas, D. (2018). Future time perspective, loneliness, and depressive symptoms among middle-aged adults: a mediation model. Journal of Affective Disorders, 241, 173–175.CrossRefGoogle ScholarPubMed
Best, R. D., Cruitt, P. J., Oltmanns, T. F. and Hill, P. L. (2021). Neuroticism predicts informant reported cognitive problems through health behaviors. Aging & Mental Health, 25, 2191–2199.CrossRefGoogle ScholarPubMed
Bogg, T. and Roberts, B. W. (2004). Conscientiousness and health-related behaviors: a meta-analysis of the leading behavioral contributors to mortality. Psychological Bulletin, 130, 887–919.CrossRefGoogle ScholarPubMed
Bondevik, M. and Skogstad, A. (2000). Loneliness, religiousness, and purpose in life in the oldest old. Journal of Religious Gerontology, 11, 5–21.CrossRefGoogle Scholar
Boyle, P. A., Barnes, L. L., Buchman, A. S. and Bennett, D. A. (2009). Purpose in life is associated with mortality among community-dwelling older persons. Psychosomatic Medicine, 71, 574–579. DOI 10.1097%2FPSY.0b013e3181a5a7c0 CrossRefGoogle ScholarPubMed
Boyle, P. A., Buchman, A. S., Barnes, L. L. and Bennett, D. A. (2010). Effect of a purpose in life on risk of incident alzheimer disease and mild cognitive impairment in community-dwelling older persons. Archives of General Psychiatry, 67, 304–310. DOI 10.1001/archgenpsychiatry.2009.208.CrossRefGoogle ScholarPubMed
Boyle, P. A., Buchman, A. S., Wilson, R. S., Yu, L., Schneider, J. A. and Bennett, D. A. (2012). Effect of purpose in life on the relation between alzheimer disease pathologic changes on cognitive function in advanced age. Archives of General Psychiatry, 69, 499–504.Google ScholarPubMed
Burrow, A. L., Hill, P. L. and Sumner, R. (2016). Leveling mountains: purpose attenuates links between perceptions of effort and steepness. Personality and Social Psychology Bulletin, 42, 94–103.CrossRefGoogle ScholarPubMed
Cacioppo, J. T. et al. (2006). Loneliness within a nomological net: an evolutionary perspective. Journal of Research in Personality, 40, 1054–1085.CrossRefGoogle Scholar
Cacioppo, J. T. and Hawkley, L. C. (2009). Perceived social isolation and cognition. Trends in Cognitive Sciences, 13, 447–454.CrossRefGoogle ScholarPubMed
Cohen, R., Bavishi, C. and Rozanski, A. (2016). Purpose in life and its relationship to all-cause mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine, 78, 122–133. DOI 10.1097/PSY.0000000000000274.CrossRefGoogle ScholarPubMed
Cruitt, P. J., Hill, P. L. and Oltmanns, T. F. (2021). Personality pathology predicts increased informant-reported, but not performance-based, cognitive decline: findings from two samples. Personality Disorders: Theory, Research, and Treatment, 13, 30–40.CrossRefGoogle Scholar
Cruitt, P. J. and Oltmanns, T. F. (2018). Age-related outcomes associated with personality pathology in later life. Current Opinion in Psychology, 21, 89–93.CrossRefGoogle ScholarPubMed
Dewitte, L., Lewis, N. A., Payne, B. R., Turiano, N. A. and Hill, P. L. (2021). Cross-lagged relationships between sense of purpose in life, memory performance, and subjective memory beliefs in adulthood over a 9-year interval. Aging & Mental Health, 25, 2018–2027.CrossRefGoogle Scholar
Donovan, N. J., Wu, Q., Rentz, D. M., Sperling, R. A., Marshall, G. A. and Glymour, M. M. (2017). Loneliness, depression and cognitive function in older US adults. International Journal of Geriatric Psychiatry, 32, 564–573.CrossRefGoogle Scholar
Erzen, E. and Çikrikci, Ö. (2018). The effect of loneliness on depression: a meta-analysis. International Journal of Social Psychiatry, 64, 427–435.CrossRefGoogle ScholarPubMed
Folstein, M. F., Robins, L. N. and Helzer, J. E. (1983). The mini-mental state examination. Archives of general psychiatry, 40, 812.CrossRefGoogle ScholarPubMed
Funder, D. C. and Ozer, D. J. (2019). Evaluating effect size in psychological research: sense and nonsense. Advances in Methods and Practices in Psychological Science, 2, 156–168.CrossRefGoogle Scholar
Galvin, J. E. et al. (2005). The AD8: a brief informant interview to detect dementia. Neurology, 65, 559–564.CrossRefGoogle ScholarPubMed
Galvin, J. E., Roe, C. M., Coats, M. A. and Morris, J. C. (2007). Patient's rating of cognitive ability: using the AD8, a brief informant interview, as a self-rating tool to detect dementia. Archives of neurology, 64, 725–730.CrossRefGoogle ScholarPubMed
Hampson, S. E. (2012). Personality processes: mechanisms by which personality traits “get outside the skin”. Annual Review of Psychology, 63, 315–339.CrossRefGoogle Scholar
Hawkley, L. C. and Cacioppo, J. T. (2010). Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40, 218–227.CrossRefGoogle ScholarPubMed
Hedberg, P., Brulin, C., Aléx, L. and Gustafson, Y. (2011). Purpose in life over a five-year period: a longitudinal study in a very old population. International Psychogeriatrics, 23, 806–813.CrossRefGoogle Scholar
Hill, P. L., Edmonds, G. W. and Hampson, S. E. (2019). A purposeful lifestyle is a healthful lifestyle: linking sense of purpose to self-rated health through multiple health behaviors. Journal of Health Psychology, 24, 1392–1400.CrossRefGoogle ScholarPubMed
Hill, P. L. and Pfund, G. N. (2021). Purposeful retirement expectations and their associations with retirement planning. Aging & Mental Health, 22, 1–7.Google Scholar
Hill, P. L. and Pfund, G. N. (in press). Purposeful Living as an Essential Ingredient to a Healthy Life. In: Sirois, F. M. (Ed.), Palgrave Handbook of Positive Psychology and Health. Springer Nature.Google Scholar
Kaup, A. R. et al. (2015). Cognitive resilience to apolipoprotein E ϵ4: contributing factors in black and white older adults. JAMA Neurology, 72, 340–348.CrossRefGoogle ScholarPubMed
Kim, E. S., Delaney, S. W. and Kubzansky, L. D. (2019). Sense of purpose in life and cardiovascular disease: underlying mechanisms and future directions. Current Cardiology Reports, 21, 1–11.CrossRefGoogle ScholarPubMed
Kim, E. S., Shiba, K., Boehm, J. K. and Kubzansky, L. D. (2020). Sense of purpose in life and five health behaviors in older adults. Preventive Medicine, 139, 106172.CrossRefGoogle ScholarPubMed
Kim, G., Shin, S. H., Scicolone, M. A. and Parmelee, P. (2019). Purpose in life protects against cognitive decline among older adults. The American Journal of Geriatric Psychiatry, 27, 593–601.CrossRefGoogle ScholarPubMed
Lara, E. et al. (2019). Are loneliness and social isolation associated with cognitive decline? International Journal of Geriatric Psychiatry, 34, 1613–1622.CrossRefGoogle ScholarPubMed
Lewis, N. A. (2020). Purpose in life as a guiding framework for goal engagement and motivation. Social and Personality Psychology Compass, 14, 1–11.CrossRefGoogle Scholar
Lewis, N. A. and Hill, P. L. (2020). Does being active mean being purposeful in older adulthood? Examining the moderating role of retirement. Psychology and Aging, 35, 1050–1057.CrossRefGoogle ScholarPubMed
Lewis, N. A. and Hill, P. L. (2021). Sense of purpose promotes resilience to cognitive deficits attributable to depressive symptoms. Frontiers in Psychology, 12, 2517.CrossRefGoogle ScholarPubMed
Lewis, N. A., Turiano, N. A., Payne, B. R. and Hill, P. L. (2017). Purpose in life and cognitive functioning in adulthood. Aging, Neuropsychology, and Cognition, 24, 662–671.CrossRefGoogle ScholarPubMed
McKnight, P. E. and Kashdan, T. B. (2009). Purpose in life as a system that creates and sustains health and well-being: an integrative, testable theory. Review of General Psychology, 13, 242–251.CrossRefGoogle Scholar
Neville, S. et al. (2018). Loneliness in men 60 years and over: the association with purpose in life. American Journal of Men’s Health, 12, 730–739.CrossRefGoogle ScholarPubMed
Nygren, B., Aléx, L., Jonsén, E., Gustafson, Y., Norberg, A. and Lundman, B. (2005). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging & Mental Health, 9, 354–362.CrossRefGoogle ScholarPubMed
Oltmanns, T. F., Rodrigues, M. M., Weinstein, Y. and Gleason, M. E. J. (2014). Prevalence of personality disorders at midlife in a community sample: disorders and symptoms reflected in interview, self, and informant reports. Journal of Psychopathology and Behavioral Assessment, 36, 177–188.CrossRefGoogle Scholar
Ownby, R. L., Crocco, E., Acevedo, A., John, V. and Loewenstein, D. (2006). Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Archives of General Psychiatry, 63, 530–538.CrossRefGoogle ScholarPubMed
Passler, J. S. et al. (2021). The relationship of cognitive change over time to the self-reported Ascertain Dementia 8-item Questionnaire in a general population. Archives of Clinical Neuropsychology, 36, 243–252.CrossRefGoogle Scholar
Pfund, G. N. and Hill, P. L. (2018). The multifaceted benefits of purpose in life. The International Forum for Logotherapy, 41, 27–37.Google Scholar
Pfund, G. N., Hofer, M., Allemand, M. and Hill, P. L. (2021). Being social may be purposeful in older adulthood: a measurement burst design. The American Journal of Geriatric Psychiatry, 30, 777–786.CrossRefGoogle ScholarPubMed
Pfund, G. N. and Lewis, N. A. (2020). Aging with purpose: developmental changes and benefits of purpose in life throughout the lifespan. In: G. N. Pfund and M. Allemand (Eds.), Personality and Healthy Aging in Adulthood (pp 27–42). Cham: Springer.CrossRefGoogle Scholar
Pfund, G. N. and Miller-Perrin, C. (2019). Interaction and harmony in faith communities: predicting life purpose, loneliness, and well-being among college students. Journal of College and Character, 20, 234–253.CrossRefGoogle Scholar
Pfund, G. N., Ratner, K., Allemand, M., Burrow, A. L. and Hill, P. L. (2022). When the end feels near: sense of purpose predicts well-being as a function of future time perspective. Aging & Mental Health, 26, 1178–1188.CrossRefGoogle ScholarPubMed
Pinquart, M. (2002). Creating and maintaining purpose in life in old age: a meta-analysis. Ageing International, 27, 90–114.CrossRefGoogle Scholar
Power, M. C. et al. (2021). Trends in relative incidence and prevalence of dementia across non-Hispanic Black and White individuals in the United States, 2000-2016. JAMA Neurology, 78, 275–284.CrossRefGoogle ScholarPubMed
R Core Team (2021). R: A Language and Environment for Statistical Computing. Vienna, Austria: R Core Team.Google Scholar
RStudio Team (2020). RStudio: Integrated Development for R. Boston, MA: RStudio, PBC.Google Scholar
Russell, D., Peplau, L. A. and Cutrona, C. E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39, 472–480.CrossRefGoogle ScholarPubMed
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57, 1069–1081.CrossRefGoogle Scholar
Scheier, M. F. et al. (2006). The life engagement test: assessing purpose in life. Journal of Behavioral Medicine, 29, 291–298.CrossRefGoogle ScholarPubMed
Smith, G. E. (2016). Healthy cognitive aging and dementia prevention. American Psychologist, 71, 268–275.CrossRefGoogle ScholarPubMed
Smith, T. W. (2006). Personality as risk and resilience in physical health. Current Directions in Psychological Science, 15, 227–231.CrossRefGoogle Scholar
Sutin, A. R., Luchetti, M., Stephan, Y., Strickhouser, J. E. and Terracciano, A. (2022). The association between purpose/meaning in life and verbal fluency and episodic memory: a meta-analysis of > 140,000 participants from up to 32 countries. International Psychogeriatrics, 34, 263–273.CrossRefGoogle ScholarPubMed
Van As, B. A. L., Imbimbo, E., Franceschi, A., Menesini, E. and Nocentini, A. (2021). The Longitudinal Association between Loneliness and Depressive Symptoms in the Elderly: A Systematic Review. International Psychogeriatrics, 1–13.Google ScholarPubMed
Weston, S. J., Lewis, N. A. and Hill, P. L. (2021). Building sense of purpose in older adulthood: examining the role of supportive relationships. The Journal of Positive Psychology, 16, 398–406.CrossRefGoogle Scholar
Wilson, R. S. et al. (2002). Depressive symptoms, cognitive decline, and risk of AD in older persons. Neurology, 59, 364–370.CrossRefGoogle ScholarPubMed
Wilson, R. S. et al. (2007). Loneliness and risk of Alzheimer disease. Archives of General Psychiatry, 64, 234–240.CrossRefGoogle ScholarPubMed
Wilson, R. S. et al. (2021). Relationship of purpose in life to dementia in older Black and White Brazilians. Journal of the International Neuropsychological Society, 1-6, 1–6.Google Scholar
Windsor, T. D., Curtis, R. G. and Luszcz, M. A. (2015). Sense of purpose as a psychological resource for aging well. Developmental Psychology, 51, 975–986.CrossRefGoogle ScholarPubMed
Yaffe, K., Blackwell, T., Gore, R., Sands, L., Reus, V. and Browner, W. S. (1999). Depressive symptoms and cognitive decline in nondemented elderly women: a prospective study. Archives of General Psychiatry, 56, 425–430.CrossRefGoogle ScholarPubMed
Zahodne, L. B., Manly, J. J., Smith, J., Seeman, T. and Lachman, M. E. (2017). Socioeconomic, health, and psychosocial mediators of racial disparities in cognition in early, middle, and late adulthood. Psychology and Aging, 32, 118–130.CrossRefGoogle ScholarPubMed
Zahodne, L. B., Morris, E. P., Sharifian, N., Zaheed, A. B., Kraal, A. Z. and Sol, K. (2020). Everyday discrimination and subsequent cognitive abilities across five domains. Neuropsychology, 34, 783–790.CrossRefGoogle Scholar
Zaslavsky, O. et al. (2014). Association of the selected dimensions of eudaimonic well-being with healthy survival to 85 years of age in older women. International Psychogeriatrics, 26, 2081–2091.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Pfund et al. supplementary material

Pfund et al. supplementary material

Download Pfund et al. supplementary material(PDF)
PDF 427.9 KB