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Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons.
Arch Gen Psychiatry 2010; 67(3):304-10AG

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.

Authors+Show Affiliations

Rush Alzheimer's Disease Center, 600 S Paulina, Ste 1020B, Chicago, IL 60612, USA. patricia_boyle@rush.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20194831

Citation

Boyle, Patricia A., et al. "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, vol. 67, no. 3, 2010, pp. 304-10.
Boyle PA, Buchman AS, Barnes LL, et al. Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. Arch Gen Psychiatry. 2010;67(3):304-10.
Boyle, P. A., Buchman, A. S., Barnes, L. L., & 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(3), pp. 304-10. doi:10.1001/archgenpsychiatry.2009.208.
Boyle PA, et al. Effect of a Purpose in Life On Risk of Incident Alzheimer Disease and Mild Cognitive Impairment in Community-dwelling Older Persons. Arch Gen Psychiatry. 2010;67(3):304-10. PubMed PMID: 20194831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of a purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons. AU - Boyle,Patricia A, AU - Buchman,Aron S, AU - Barnes,Lisa L, AU - Bennett,David A, PY - 2010/3/3/entrez PY - 2010/3/3/pubmed PY - 2010/3/18/medline SP - 304 EP - 10 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 67 IS - 3 N2 - 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. SN - 1538-3636 UR - https://www.unboundmedicine.com/medline/citation/20194831/Effect_of_a_purpose_in_life_on_risk_of_incident_Alzheimer_disease_and_mild_cognitive_impairment_in_community_dwelling_older_persons_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=20194831.ui DB - PRIME DP - Unbound Medicine ER -