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Cited by 580Dementia and Cognitive Impairment ResearchAging and Gerontology ResearchAlzheimer's disease research and treatments

Effect of a Purpose in Life on Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-Dwelling Older Persons

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Boyle, Patricia A., Buchman, Aron S., Barnes, Lisa L., Bennett, David A.·2010·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2009.208PMC PMC2897172
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Abstract

CONTEXT: Emerging data suggest that psychological and experiential factors are associated with risk of Alzheimer disease (AD), but the association of purpose in life with incident AD is unknown. OBJECTIVE: To test the hypothesis that greater purpose in life is associated with a reduced risk of AD. DESIGN: Prospective, longitudinal epidemiologic study of aging. SETTING: Senior housing facilities and residences across the greater Chicago metropolitan area. PARTICIPANTS: More than 900 community-dwelling older persons without dementia from the Rush Memory and Aging Project. MAIN OUTCOME MEASURES: Participants underwent baseline evaluations of purpose in life and up to 7 years of detailed annual follow-up clinical evaluations to document incident AD. In subsequent analyses, we examined the association of purpose in life with the precursor to AD, mild cognitive impairment (MCI), and the rate of change in cognitive function. RESULTS: During up to 7 years of follow-up (mean, 4.0 years), 155 of 951 persons (16.3%) developed AD. In a proportional hazards model adjusted for age, sex, and education, greater purpose in life was associated with a substantially reduced risk of AD (hazard ratio, 0.48; 95% confidence interval, 0.33-0.69; P < .001). Thus, a person with a high score on the purpose in life measure (score = 4.2, 90th percentile) was approximately 2.4 times more likely to remain free of AD than was a person with a low score (score = 3.0, 10th percentile). This association did not vary along demographic lines and persisted after the addition of terms for depressive symptoms, neuroticism, social network size, and number of chronic medical conditions. In subsequent models, purpose in life also was associated with a reduced risk of MCI (hazard ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .02) and a slower rate of cognitive decline (mean [SE] global cognition estimate, 0.03 [0.01], P < .01). CONCLUSION: Greater purpose in life is associated with a reduced risk of AD and MCI in community-dwelling older persons.

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  • Existing meta-analyses are limited by the use of aggregated data from studies that adjust differently for potential confounders.

    “Existing meta-analyses are limited by the use of aggregated data from studies that adjust differently for potential confounders (eg, one study did not adjust for confounders9 and another study adjusted for only demographic variables and baseline cognition10).”

    From Associations between social connections and cognition: a global collaborative individual participant data meta-analysis (2022) · cites this paper as [9]

    The Methods (Data Analysis; page unavailable) say the cognitive-decline models adjusted for age, sex, education, and baseline cognition. But the Results (Purpose in Life and Risk of AD; page unavailable) report an Alzheimer disease model that also controlled for depressive symptoms, neuroticism, social networks, and chronic medical conditions. Thus, describing this study as adjusting for *only* demographic variables and baseline cognition overstates the limitation; the paper does not itself assess the limitations of meta-analyses. (LLM, conf=0.86)

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  • A growing body of findings from longitudinal epidemiological studies shows that purpose predicts reduced morbidity (including reduced risk of Alzheimer's disease, mild cognitive impairment, stroke, and myocardial infarction) and extended longevity.

    “A growing body of findings from longitudinal epidemiological studies show that purpose predicts reduced morbidity (e.g., reduced risk of Alzheimer ' s disease and mild cognitive impairment, as well as reduced risk of stroke and myocardial infarction) and extended longevity (10, 16 -21).”

    From Purpose in life and use of preventive health care services (2014) · cites this paper as [16]

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  • Higher PIL is associated with less dementia and Alzheimer's disease.

    “In numerous prospective research studies, higher PIL has been associated with better self-rated health,22 fewer chronic diseases (eg, stroke,8,19 myocardial infarctions9), reduced pain,11 less disability,7,10,11 less dementia and Alzheimer's disease,23 and reduced mortality.6,10,11”

    From Purpose in Life and Positive Health Outcomes Among Older Adults (2018) · cites this paper as [23]

  • There were minimal demographic differences with the exception of those 80 years of age and older having lower PIL.

    “As in other studies, there were minimal demographic differences with the exception of those 80 years of age and older having lower PIL.”

    From Purpose in Life and Positive Health Outcomes Among Older Adults (2018) · cites this paper as [23]

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Authors
Boyle, P. A., Buchman, A. S., Barnes, L. L., & Bennett, D. A.
Affiliations
Rush University Medical Center (US)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2010-03-01
Volume
67
Issue
3
Pages
304
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2009.208
PMC
PMC2897172
OpenAlex
W2129597363
Cited by
580
References
33
Citations by year
2026: 29 · 2025: 35 · 2024: 38 · 2023: 89 · 2022: 56 · 2021: 47 · 2020: 45 · 2019: 29 · 2018: 41 · 2017: 39 · 2016: 32 · 2015: 28 · 2014: 23 · 2013: 20 · 2012: 15
FWCI
10.71
Type
journal article
Language
en
Open access
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Aging (R01AG017917, R01-AG-24480, R01‐AG17917, K23 AG 23040, K23AG023040, R01AG024480, R01AG034374)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Aging and Gerontology Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
meaning of life, Alzheimer's disease, mild cognitive impairment, cognitive decline, community-dwelling older adults, dementia risk, psychological factors
MeSH terms
Age Factors, Aged, Aged, 80 and over, Aging, Alzheimer Disease, Chicago, Cognition Disorders, Data Collection, Female, Goals, Humans, Life Style, Longitudinal Studies, Male, Prospective Studies, Psychometrics, Quality of Life, Risk Factors, Severity of Illness Index, Urban Population, Proportional Hazards Models, Housing for the Elderly, Intention

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