HEALTH NEWS

Study Title:

Effect of Purpose Alzheimer Disease

Study Abstract

Context Purpose in life is associated with a substantially reduced risk of Alzheimer disease (AD), but the neurobiologic basis of this protective effect remains unknown.

Objective To test the hypothesis that purpose in life reduces the deleterious effects of AD pathologic changes on cognition in advanced age.

Design A longitudinal, epidemiologic, clinicopathologic study of aging was conducted that included detailed annual clinical evaluations and brain autopsy.

Participants Two hundred forty-six community-based older persons from the Rush Memory and Aging Project participated.

Main Outcome Measures Purpose in life was assessed via structured interview, and cognitive function was evaluated annually and proximate to death. On postmortem examination, 3 indexes of AD pathologic features were quantified: global AD pathologic changes, amyloid, and tangles. The associations of disease pathologic changes and purpose in life with cognition were examined using linear regression and mixed models.

Results Purpose in life modified the association between the global measure of AD pathologic changes and cognition (mean [SE] parameter estimate, 0.532 [0.211]; P = .01), such that participants who reported higher levels of purpose in life exhibited better cognitive function despite the burden of the disease. Purpose in life also reduced the association of tangles with cognition (parameter estimate, 0.042 [0.019]; P = .03), and the protective effect of purpose in life persisted even after controlling for several potentially confounding variables. Furthermore, in analyses examining whether purpose in life modified the association between AD pathologic effects and the rate of cognitive decline, we found that higher levels of purpose in life reduced the effect of AD pathologic changes on cognitive decline (parameter estimate, 0.085 [0.039]; P = .03).

Conclusion Higher levels of purpose in life reduce the deleterious effects of AD pathologic changes on cognition in advanced age.

From press release:

Greater purpose in life may help stave off the harmful effects of plaques and tangles associated with Alzheimer's disease, according to a new study by researchers at Rush University Medical Center.


The study is published in the May issue of the Archives of General Psychiatry.

"Our study showed that people who reported greater purpose in life exhibited better cognition than those with less purpose in life even as plaques and tangles accumulated in their brains," said Patricia A. Boyle, PhD.

"These findings suggest that purpose in life protects against the harmful effects of plaques and tangles on memory and other thinking abilities. This is encouraging and suggests that engaging in meaningful and purposeful activities promotes cognitive health in old age."

Boyle and her colleagues from the Rush Alzheimer's Disease Center studied 246 participants from the Rush Memory and Aging Project who did not have dementia and who subsequently died and underwent brain autopsy. Participants received an annual clinical evaluation for up to approximately 10 years, which included detailed cognitive testing and neurological exams.

Participants also answered questions about purpose in life, the degree to which one derives meaning from life's experiences and is focused and intentional. Brain plaques and tangles were quantified after death. The authors then examined whether purpose in life slowed the rate of cognitive decline even as older persons accumulated plaques and tangles.

While plaques and tangles are very common among persons who develop Alzheimer's dementia (characterized by prominent memory loss and changes in other thinking abilities), recent data suggest that plaques and tangles accumulate in most older persons, even those without dementia. Plaques and tangles disrupt memory and other cognitive functions.

Boyle and colleagues note that much of the Alzheimer's research that is ongoing seeks to identify ways to prevent or limit the accumulation of plaques and tangles in the brain, a task that has proven quite difficult. Studies such as the current one are needed because, until effective preventive therapies are discovered, strategies that minimize the impact of plaques and tangles on cognition are urgently needed.

"These studies are challenging because many factors influence cognition and research studies often lack the brain specimen data needed to quantify Alzheimer's changes in the brain," Boyle said. "Identifying factors that promote cognitive health even as plaques and tangles accumulate will help combat the already large and rapidly increasing public health challenge posed by Alzheimer's disease."

The Rush Memory and Aging Project, which began in 1997, is a longitudinal clinical-pathological study of common chronic conditions of aging. Participants are older persons recruited from about 40 continuous care retirement communities and senior subsidized housing facilities in and around the Chicago Metropolitan area. More than 1,500 older persons are currently enrolled in the study.

Study Information

Patricia A. Boyle, PhD; Aron S. Buchman, MD; Robert S. Wilson, PhD; Lei Yu, PhD; Julie A. Schneider, MD; David A. Bennett, MD
Effect of Purpose in Life on the Relation Between Alzheimer Disease Pathologic Changes on Cognitive Function in Advanced Age
Arch Gen Psychiatry
2012 May
Rush Alzheimer's Disease Center