The benefits of a sense of purpose in life for healthier cognitive aging.
The benefits of a sense of purpose in life for healthier cognitive aging.
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DOI：
10.1017/s1041610222000837
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发表时间：
2022-12
影响因子：
7
通讯作者：
Terracciano, Antonio
中科院分区：
文献类型：
--
作者：
Sutin, Angelina R. R.;Luchetti, Martina;Terracciano, Antonio
Pfund等人（2022）最近的研究结果指出，生活目标感对于更健康的认知衰老结果至关重要。具体来说，Pfund及其同事报告说，在595名老年人的不同样本中，更强的目标感与更少的自我报告认知抱怨相关，这是一种常用的痴呆症筛查工具。这种对认知的主观感知很重要，因为它们不仅对个人来说是负担，而且还能预测未来客观认知障碍的风险。这些发现表明目标与认知结果的相关性，更广泛地符合在整个生命周期中关于目标感和更健康的认知衰老结果的新兴文献。生活的目的感是一种感觉，一个人的生活是目标导向的，有一个方向（McKnight和Kashdan， 2009）。目的正在成为一种强有力的保护因素，可以促进从临床前阶段到生命末期痴呆风险范围内更好的认知结果（Sutin et al., 2021 c）。例如，在认知障碍之前，目的与更好的语言流畅性和情景记忆功能（Sutin et al., 2022 b）以及较少的与年龄相关的认知衰退（Kim et al., 2019 b）有关。有更多目标的个体也不太可能患有运动认知风险（MCR）综合征，这是一种预示痴呆症发展的痴呆症前期综合征，随着时间的推移，他们不太可能发生偶发MCR （Sutin等人，2021 b）。较高的生活目标同样与较低的轻度认知障碍风险相关（MCI; Boyle et al., 2010, Wilson et al., 2021）。生活目标与更健康的行为和临床特征进一步相关（Kim et al., 2019 a），这些特征可以预防痴呆症。因此，目标感较高的人患老年痴呆症的风险较低也就不足为奇了。在对六项前瞻性研究（N= 53,499； N= 5,862例痴呆事件）的荟萃分析中，研究人员发现，在基线认知健康的参与者中，在长达17年的随访期内，目标感较高的参与者发生痴呆事件的风险降低了约30% (HR= 0.77, 95% CI= 0.73-0.81, p< 0.001)，这种保护性关联在六个样本中都得到了复制（Sutin等人，2021 a）。即使在痴呆症发作后，有目的性的感觉仍然具有保护作用。据一位知识渊博的代理人（Sutin et al., 2022 c）报道，在痴呆症之前测量的更大的目标感与生命最后一年痴呆症的行为和心理症状（也称为神经精神症状）较少相关。Pfund和他的同事们目前的工作是在这一文献的基础上建立和扩展的，他们探讨了目标作为一种缓冲，以抵御孤独感和抑郁症状对认知抱怨的有害影响，以及这些联系是否会因种族而有所缓和。他们发现，更高的目标改善了孤独（而不是抑郁）与认知抱怨之间的联系，这种相互作用进一步受到种族的缓和。Pfund和他的同事们的发现很有趣，并且至少在三个方面增加了关于目标和认知老化的文献：首先，研究结果表明，生活目标可能是一种心理资源，可以减少其他风险因素（如孤独）对认知结果（如认知抱怨）的有害影响。大多数关于目标和认知健康的研究都集中在目标对认知结果的主要影响上，但目标也可能减轻其他有害因素的风险。例如，目的可以防止认知能力低下。
The recent findings reported by Pfund et al.(2022) point to the importance of a sense of purpose in life for healthier cognitive aging outcomes. Specifically, Pfund and colleagues report that in a diverse sample of 595 older adults, a greater sense of purpose is associated with fewer self-reported cognitive complaints as measured by the AD8, a frequently used screening tool for dementia. Such subjective perceptions of cognition are important because not only are they burdensome for individuals, but they also predict the risk of future objective cognitive impairments. These findings show the relevance of purpose for this cognitive outcome, which fits more broadly with the burgeoning literature on sense of purpose and healthier cognitive aging outcomes across the lifespan. A sense of purpose in life is the feeling that one’s life is goal-oriented and has a direction (McKnight and Kashdan, 2009). Purpose is emerging as a robust protective factor that promotes better cognitive outcomes across the spectrum of dementia risk, from the preclinical phase to the end of life (Sutin et al., 2021 c). Prior to cognitive impairment, for example, purpose is associated with better verbal fluency and episodic memory function (Sutin et al., 2022 b) and less age-related cognitive decline (Kim et al., 2019 b). Individuals with more purpose are also less likely to have motoric cognitive risk (MCR) syndrome, a pre-dementia syndrome that predicts developing dementia, and over time they are less likely to develop incident MCR (Sutin et al., 2021 b). Higher purpose in life has likewise been associated with a lower risk of mild cognitive impairment (MCI; Boyle et al., 2010, Wilson et al., 2021). Purpose in life is further associated with healthier behavioral and clinical profiles (Kim et al., 2019 a) that are protective against dementia. It is not surprising, then, that individuals with a higher sense of purpose have a lower risk of incident dementia. In a meta-analysis of six prospective studies (N= 53,499; n= 5,862 incident dementia), it was found that among participants with healthy cognition at baseline, those with a higher sense of purpose had an approximately 30% lower risk of developing incident dementia over an up to 17-year follow-up period (HR= 0.77, 95% CI= 0.73–0.81, p< 0.001), a protective association that replicated in each of the six samples (Sutin et al., 2021 a). Feeling purposeful continues to be protective even after dementia onset. A greater sense of purpose measured prior to dementia is associated with fewer behavioral and psychological symptoms of dementia (also known as neuropsychiatric symptoms) in the last year of life, as reported by a knowledgeable proxy (Sutin et al., 2022 c). The present work by Pfund and colleagues builds and expands on this literature by addressing purpose as a buffer against the harmful effects of loneliness and depressive symptoms on cognitive complaints, and whether these associations are moderated by race. They found that higher purpose ameliorates the association between loneliness (but not depression) on cognitive complaints and that this interaction is further moderated by race. Pfund and colleagues’ findings are intriguing and add to the literature on purpose and cognitive aging in at least three ways: First, the findings suggest that purpose in life may be a psychological resource that reduces the harmful effects of other risk factors (eg loneliness) on cognitive outcomes (eg cognitive complaints). Most research on purpose and cognitive health has focused on the main effect of purpose on a cognitive outcome, but the purpose may also alleviate the risk of other harmful factors. Purpose, for example, may be protective against poor cognitive …