Greater Sense of Purpose May Protect the Aging Brain

Megan Brooks

March 24, 2015

Having a purpose in life — the sense that life has meaning and direction — may help guard against cerebral infarcts in older individuals, suggest new findings from the Rush Memory and Aging Project.

Participants who reported a greater sense of purpose in life had a lower risk of having cerebral infarcts on neuropathologic examination.

"Mental health, in particular positive psychological factors such as having a purpose in life, are emerging as very potent determinants of health outcomes," Patricia Boyle, PhD, study coauthor and associate professor of behavioral sciences at the Rush Alzheimer's Disease Center of Rush University Medical Center in Chicago, Illinois, notes in a statement.

"Clinicians need to be aware of patients' mental state and encourage behaviors that will increase purpose and other positive emotional states," she advised.

"Purpose in life differs for everyone, and it is important to be thoughtful about what motivates you (such as volunteering, learning new things, or being part of the community) so you can engage in rewarding behaviors," added Lei Yu, PhD, study lead author and assistant professor of neurological sciences at the Rush Alzheimer's Disease Center.

The study appeared online March 19 in Stroke.

Do What Motivates You

Prior research from the Rush team showed that elderly people with a strong sense of purpose in life are almost 2.5 times less likely to develop Alzheimer's disease. Their latest study suggests it might also protect against cerebral infarcts.

They studied 453 participants in the Rush Memory and Aging Project. All participants underwent annual physical and psychological evaluations, including a standard assessment of purpose in life, and were followed until they died, at an average age of 90. All of the participants were free of dementia when they entered the study.

A total of 114 participants (25.3%) had clinically diagnosed stroke. At autopsy, macroscopic infarcts were observed in 154 individuals (34.0%) and microinfarcts were found in 128 (28.3%).

The average score on the measure of purpose of life was 3.5 (range, 2.1 to 5.0). According to the researchers, participants showing a greater purpose in life had a lower odds of having more macroscopic infarcts (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.346 - 0.826; P = .005).

The association with macroscopic infarcts was driven by lacunar infarcts, independent of cerebral large or small vessel disease, they note.

There was no association between purpose in life and microinfarcts (OR, 0.78; 95% CI, 0.495 - 1.229; P = .283).

Mechanism Unclear

Having purpose in life may reduce the risk for cerebral infarcts by promoting healthy lifestyles, the authors note. Prior research has shown that purpose correlates with lower risk for cardiovascular disease. However, they note that their findings remained "robust" after adjustment for vascular risk factors of body mass index, history of smoking, diabetes mellitus, and blood pressure, as well as measures of negative affect, physical activity, and clinical stroke.

Having purpose in life might also directly influence neuroendocrine function. Some studies have suggested that psychological well-being correlates with many biological markers, such as salivary cortisol level, epinephrine, and norepinephrine. Further work is needed to study these and other possible mechanistic pathways, the authors say.

The current study has several strengths, the researchers say. Purpose in life was documented in community-dwelling people without dementia. Participants were followed for more than 5 years and underwent neuropathologic examination after death. In addition, the association of life purpose with reduced risk for infarct pathology was robust against confounding variables.

Among the limitations of these data is that the study included a cohort that was older than age 80 years at baseline and had higher levels of education compared with the general population. "Therefore, results may not generalize to other groups. Our finding that the association of purpose in life is primarily driven by lacunar infarcts requires replication from other studies," they note.

The study was supported by the National Institute on Aging; the National Heart, Lung, and Blood Institute; and the Illinois Department of Public Health. One author disclosed receiving consulting fees or sitting on paid advisory boards for AVID Radiopharmaceuticals, Eli Lilly Inc, and GE Healthcare. A complete list of author disclosures appears with the original article.

Stroke. Published online March 19, 2015. Abstract

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