Purpose in life is a robust protective factor of reported cognitive decline among late middle-aged adults: The Emory Healthy Aging Study

J Affect Disord. 2020 Feb 15:263:310-317. doi: 10.1016/j.jad.2019.11.124. Epub 2019 Nov 30.


Background: Cognitive abilities tend to decline in advanced age. A novel protective factor of cognitive decline in advanced age is purpose-in-life (PiL), a trait-like tendency to derive life meanings and purpose. However, whether PiL protects against cognitive decline in late-middle-age is unclear. Hence, we examined the association between PiL and perceived cognitive decline, one of the earliest detectable cognitive symptoms before the onset of cognitive impairment. Furthermore, we used a machine learning approach to investigate whether PiL is a robust predictor of cognitive decline when considered with the known protective and risk factors for cognition.

Methods: PiL was assessed with a 10-item questionnaire and perceived cognitive decline with the Cognitive Function Instrument among 5,441 Emory Healthy Aging Study participants, whose mean age was 63 and 51% were employed. Association between PiL and perceived cognitive decline was examined with linear regression adjusting for relevant confounding factors. Elastic Net was performed to identify the most robust predictors of cognitive decline.

Results: Greater PiL was associated with less perceived cognitive decline after adjusting for the relevant factors. Furthermore, Elastic Net modeling suggested that PiL is a robust predictor of cognitive decline when considered simultaneously with known protective (education, exercise, enrichment activities) and risk factors for cognition (depression, anxiety, diagnosed medical, mental health problems, smoking, alcohol use, family history of dementia, and others).

Limitation: This is a cross-sectional study.

Conclusions: PiL is a robust protective factor of perceived cognitive decline observed as early as middle age. Thus, interventions to enhance PiL merit further investigation.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Cognition
  • Cognitive Dysfunction*
  • Cross-Sectional Studies
  • Female
  • Healthy Aging*
  • Humans
  • Middle Aged
  • Protective Factors