Purpose in life: Mechanisms to support healthier cognitive aging and reduce risk of Alzheimer's disease

项目摘要 人生的目的是相信一个人的生活和活动是有目标的，有方向的，有价值的。这种信念是 与更好的结果一致，包括更多地参与健康促进行为（例如， 少吸烟，多运动），少患慢性病（如，心血管疾病、糖尿病），以及 最终更长寿。独立于行为和临床因素，生活目的与 更好的认知结果，包括降低阿尔茨海默病和相关痴呆症（ADRD）的风险。ADRD 仍然是一个重大的挑战，病人，他们的家人，和医疗保健系统，因为它是一个领先的 缺乏改善疾病的治疗或治愈的死亡原因。越来越多的文献表明， 生活中的目的是保护整个ADRD疾病谱的弧：它与更好的 在认知任务上的表现和痴呆症发作前的认知下降较少， 轻度和重度的认知障碍，即使在诊断后， 以及痴呆症的心理症状在平行文献中，有一致的证据表明， 对照试验表明，生活的目的是可塑的，可以通过干预来增加。人生的目的就是这样 准备成为一个强大的干预目标，以改善认知结果，从维持认知功能， 来改善痴呆症护理的结果。干预发展的下一步是 确定假定的作用机制，假设其在干预后发生变化，并解释 目的和更好的认知结果之间的关系。一旦确定了这些机制， 可以开发和测试增加改善认知结果的目的的干预措施。的方向迈出了一步 为了实现这一长期目标，本研究将使用生态瞬时评估（EMA）来确定 负责生活目的和健康认知结果之间联系的日常机制。在 特别是，我们将测试的假设，即生活的目的是与更大的瞬间参与， 更好的瞬时认知，这将随着时间的推移支持更健康的认知功能。我们将解决这些问题 三组被认为是干预的关键人群的相关性： 有健康认知的老年人和中年人。这项研究将提供急需的 关于解释目的如何保护认知的假定作用机制的信息。该等资料不 关键是要制定有目的的干预措施，促进更健康的认知老化。

Project Summary Purpose in life is the belief that one’s life and activities are goal-oriented, directed, and worthwhile. This belief is associated consistently with better outcomes, including greater engagement in health promoting behavior (e.g., less smoking, more physical activity), fewer chronic diseases (e.g., cardiovascular disease, diabetes), and ultimately greater longevity. Independent of behavioral and clinical factors, purpose in life is associated with better cognitive outcomes, including lower risk of Alzheimer’s disease and related dementias (ADRD). ADRD remains a significant challenge to patients, their families, and the healthcare system, as it is one of the leading causes of death that lacks disease-modifying treatments or cures. There is a growing literature that shows that purpose in life is protective across the arc of the ADRD disease spectrum: It is associated with better performance on cognitive tasks and less cognitive decline prior to dementia onset, it is protective against cognitive impairments, both mild and severe, and, even after diagnosis, it is associated with fewer behavioral and psychological symptoms of dementia. In a parallel literature, there is consistent evidence from randomized controlled trials that purpose in life is malleable and can be increased through intervention. Purpose in life is thus poised to be a powerful target of intervention to improve cognitive outcomes, from maintaining cognitive function in middle adulthood to improving outcomes in dementia care. The next step in intervention development is to identify the putative mechanisms of action hypothesized to change in response to the intervention and explain the relation between purpose and better cognitive outcomes. Once these mechanisms are identified, interventions that increase purpose to improve cognitive outcomes can be developed and tested. As a step toward this long-term goal, the present study will use ecological momentary assessments (EMA) to identify the daily mechanisms responsible for the association between purpose in life and healthier cognitive outcomes. In particular, we will test the hypothesis that purpose in life is associated with greater momentary engagement and better momentary cognition, which will support healthier cognitive function over time. We will address these associations in three groups considered critical populations for intervention: older adults with subjective cognitive impairment, older adults with healthy cognition, and middle-aged adults. This research will provide much needed information on putative mechanisms of action that explain how purpose protects cognition. Such information is critical to develop purpose interventions that promote healthier cognitive aging.