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.

项目概要 人生目标是指相信一个人的生活和活动是有目标的、有方向的、有价值的。 始终与更好的结果相关，包括更多地参与健康促进行为（例如， 减少吸烟、增加体力活动）、减少慢性疾病（例如心血管疾病、糖尿病），以及 最终，与行为和临床因素无关，生活目标与更长的寿命有关。 更好的认知结果，包括降低患阿尔茨海默病和相关痴呆症 (ADRD) 的风险。 对于患者、其家人和医疗保健系统来说，这仍然是一个重大挑战，因为它是领先的疾病之一 缺乏疾病缓解治疗或治愈方法的死亡原因越来越多的文献表明。 生活目标对 ADRD 疾病谱的各个方面都有保护作用：它与更好的生活目标相关 认知任务的表现以及痴呆症发作前认知能力下降较少，它可以预防 认知障碍，无论是轻度还是严重，即使在诊断后，它也与较少的行为相关 在平行文献中，有一致的随机证据。 对照试验表明，生活目的是可塑的，并且可以通过干预来增加。 有望成为通过维持认知功能来改善认知结果的干预的强大目标 干预措施发展的下一步是改善老年痴呆症护理的结果。 确定为响应干预而改变而制定的假定行动机制并解释 一旦确定了这些机制，目的和更好的认知结果之间的关系 作为一个步骤，可以开发和测试增强目的以改善认知结果的干预措施。 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 负责生活目的和更健康的认知结果之间联系的日常机制。 特别是，我们将检验这样一个假设，即生活的目的与更大的瞬时投入和 更好的瞬时认知，随着时间的推移，这将支持更健康的认知功能，我们将解决这些问题。 三组被认为是干预关键人群的关联：具有主观认知的老年人 这项研究将提供急需的信息。 有关假定的行动机制的信息，这些信息解释了目的如何保护认知。 制定有目的的干预措施以促进更健康的认知衰老至关重要。