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

人生目标：支持更健康的认知衰老和降低阿尔茨海默病风险的机制

• 批准号: 10471946
• 负责人: Angelina R Sutin
• 金额: $ 74.95万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10471946
• 关键词: Address; Adult; Affect; Affective; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Attention; Basic Science; Behavior; Behavioral; Behavioral Symptoms; Belief; Buffers; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic Disease; Clinical; Cognition; Cognitive; Cognitive aging; Dementia; Development; Diabetes Mellitus; Diagnosis; Disease; Ecological momentary assessment; Education; Elderly; Emotional; Ethnic Origin; Family; Feeling; Financial cost; Goals; Health Promotion; Healthcare Systems; Impaired cognition; Income; Individual; Intervention; Life; Literature; Longevity; Mediating; Meta-Analysis; Modeling; Outcome; Patients; Performance; Physical activity; Population Heterogeneity; Population Intervention; Prevention; Public Health; Race; Randomized Controlled Trials; Research; Resources; Risk; Smoking; Syndrome; Testing; Time; Variant; cognitive function; cognitive performance; cognitive task; critical period; dementia care; dementia risk; effective intervention; evidence base; improved; improved outcome; middle age; mild cognitive impairment; neuropathology; premature; prevent; protective effect; protective factors; psychologic; psychological symptom; reduce symptoms; resilience; response; therapy development

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.

项目摘要 生活中的目的是相信一个人的生活和活动是面向目标，指导和值得的。这种信念是 与更好的结果相关联，包括更多参与健康促进行为（例如， 更少的吸烟，更多的体育锻炼），更少的慢性疾病（例如心血管疾病，糖尿病）和 最终更长寿。独立于行为和临床因素，生活的目的与 更好的认知结果，包括较低的阿尔茨海默氏病风险和相关痴呆症（ADRD）。 adrd 对于患者，他们的家人和医疗保健系统仍然是一个重大挑战，因为它是领先的 缺乏改良疾病的治疗或治疗的死亡原因。越来越多的文献表明 生命的目的在ADRD疾病谱系的弧线中受到保护：它与更好的相关 在痴呆发作之前的认知任务和认知能力下降较少的表现，它受到保护 认知障碍，轻度和严重，即使在诊断后，它也会与较少的行为相关 和痴呆症的心理症状。在平行文献中，有随机的证据一致 人生目的的对照试验是可延展的，可以通过干预来增加。因此生活的目的是 被毒化为通过维持认知功能而成为改善认知结果的干预措施的有力目标 在成年中期，改善痴呆症护理的结果。干预开发的下一步是 确定假设为响应干预而改变的推定的作用机制，并解释 目的与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。作为一步 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 每日机制，负责生命目的与更健康的认知结果之间的关联。在 特别是，我们将检验以下假设：生活中的目的与更大的瞬时参与和 更好的瞬时认知将随着时间的流逝支持更健康的认知功能。我们将解决这些 三组的关联被认为是干预的关键人群：主观认知的老年人 障碍，具有健康认知的老年人和中年成年人。这项研究将提供急需的 有关推定的作用机制的信息，这些机制解释了目的如何保护认知。这样的信息是 制定目的干预措施至关重要，以促进更健康的认知衰老。