Here is a sign of future cognitive decline.
Individuals with mild cognitive impairment exhibited lower scores in terms of purpose in life and personal growth three and six years prior to their diagnosis, respectively, compared to participants who maintained cognitive integrity, according to one on Tuesday in a study published in the Journal of Neurology, Neurosurgery & Psychiatry. Mild cognitive impairment refers to a condition where individuals begin to experience memory loss or other cognitive difficulties but can still carry out most activities of daily living independently. It is often seen as a precursor to dementia.
The study “provides a compelling examination of the changes in psychological well-being that may occur in the initial stages of cognitive impairment,” Dr. Angelina Sutin, a behavioral sciences and social medicine professor at Florida State University College of Medicine, stated via email. Sutin was not part of the research team.
Globally, over 55 million individuals suffer from dementia, which is a leading cause of death and is projected to affect nearly three times as many people by 2050. Although there is no cure for the disease, the authors believe that the extended period between the onset of illness and the appearance of symptoms could offer “a crucial window of opportunity for implementing measures to prevent or delay its onset.”
To date, lower psychological well-being has been linked to a higher risk of dementia; however, the precise nature of well-being changes throughout the disease progression and which specific aspects of well-being have the greatest impact remains ambiguous. Understanding these elements could be useful in managing risks or symptoms post-diagnosis.
The research team analyzed data from 910 cognitively intact older adults from the Illinois-based Rush Memory and Aging Project (MAP), an ongoing study initiated in 1997. Between 2008 and 2014, participants—primarily women and white individuals—were regularly evaluated for neurological, cognitive, medical, and mental health conditions. Psychological well-being was assessed based on six components: self-acceptance, autonomy, purpose in life, personal growth, positive relationships with others, and the ability to cope with one’s environment.
When compared to participants who remained cognitively intact, psychological well-being deteriorated more swiftly among older adults who eventually developed cognitive impairment, and their well-being was significantly lower two years prior to diagnosis. This suggests that poorer well-being, especially concerning life purpose and personal growth, may signal future cognitive impairment, according to the authors.
Positive relationships with others rapidly declined after diagnosis, while declines in other aspects of well-being remained consistent before and after diagnosis.
Although “not unexpected,” the study emphasizes the significance of well-being as a potential preventive measure against dementia, as well as its possible indication of the disease’s progression, noted Dr. Glen R. Finney, director of the Geisinger Memory and Cognition Program in Pennsylvania, in an email. Finney was not involved in the research.
Well-being and cognitive decline
Further research is necessary as the study has limitations regarding the lack of participant diversity, as subjects were recruited from communities with higher educational backgrounds.
“However, since the findings are similar to those from a few other studies employing more representative samples, I am not overly concerned about these limitations,” Sutin stated.
It is plausible that poor well-being leads to cognitive impairment and vice versa. On one hand, improved well-being could diminish the risk of cognitive impairment and dementia by alleviating the effects of Alzheimer’s disease processes on cognition. Positive well-being has been correlated with lower inflammatory cytokines and reduced cardiovascular risk, potentially decreasing the likelihood of cognitive impairment.
Conversely, there may exist a “vicious cycle” in which neurodegenerative conditions, such as Alzheimer’s disease, begin years or even decades before cognitive symptoms manifest, impair the functioning of brain networks that support well-being and initiative, which could lead to apathy and decreased motivation. This study indicates that such phenomena could transpire even prior to observable cognitive changes, despite ongoing monitoring for such alterations.
Compared to those who remained cognitively intact, individuals who developed cognitive impairment were older and displayed lower BMI and psychological well-being. Those diagnosed with dementia were also older and possessed the APOE ε4 allele, a gene associated with an increased risk of Alzheimer’s disease.
Enrich your life, protect your brain
Maintaining well-being, discovering purpose in life, and pursuing personal growth are always essential for enhancing overall quality of life, but these efforts are particularly crucial as we age, Finney noted.
“Engage in socialization to keep your brain healthy and support your well-being, and seek meaningful activities that you can participate in while also exploring new opportunities for personal growth and learning,” he added.
These activities need not be new or complex to be beneficial or significant, Sutin explained. They can include strategic games, challenging literature, or discovering innovative ways to accomplish daily tasks, as advised by the Alzheimer’s Association, which provides resources for maintaining brain health. Formal education is another avenue to stay cognitively and socially active, and some educational institutions offer scholarships for older students.
Moreover, you can form new friendships (or nurture old ones) by participating in clubs, volunteering, or joining fitness groups within your community.
If you find it challenging to remain socially or mentally active, consult your doctor to determine if this might indicate a neurodegenerative disease, Finney recommends.
“Proactively addressing risk factors can help lower the risk of dementia, preserve functionality if dementia does emerge, and may at least partially aid in reversing mild symptoms before dementia sets in,” he stated.
The authors propose that the lengthy period between the onset of the disease and the appearance of symptoms in mild cognitive impairment could represent a critical window for initiating interventions to prevent or delay the onset of dementia, given the association between poorer mental health and heightened dementia risk. Engaging in activities that promote purpose, personal growth, and social interaction may be advantageous for maintaining brain health and well-being, according to the Alzheimer’s Association.
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Here is a Sign of Future Cognitive Decline
Understanding Mild Cognitive Impairment
People with mild cognitive impairment had lower scores on purpose in life and personal growth three and six years before their diagnosis, as found in a study published in the Journal of Neurology, Neurosurgery & Psychiatry. Mild cognitive impairment (MCI) is characterized by early signs of memory loss or other cognitive abilities while allowing individuals to perform daily activities independently. It often serves as a precursor to more severe conditions such as dementia.
The Significance of the Study
This groundbreaking study highlights critical changes in psychological well-being that can arise during the initial stages of cognitive impairment development. Dr. Angelina Sutin, a renowned professor at Florida State University College of Medicine, noted the importance of this research, stating it paints a “powerful” picture of the psychological shifts that can occur early on.
Current Statistics on Dementia
As of now, over 55 million people globally are living with dementia, recognized as a leading cause of death, with expectations to triple by the year 2050. Unfortunately, no curative measures exist, but the research highlights a potential for prevention, given the significant time lapse between the onset of cognitive decline and the manifestation of recognizable symptoms.
Psychological Well-Being as a Risk Factor
Previous findings demonstrate an association between poor psychological well-being and increased dementia risk. This study delves into how well-being fluctuates throughout the journey of cognitive decline and identifies the most impactful aspects of well-being. Understanding these elements could empower individuals to manage risks or symptoms effectively after diagnosis.
Well-Being and Cognitive Decline
Research Methodology
The research utilized data from 910 cognitively intact older adults participating in the Illinois-based Rush Memory and Aging Project (MAP). Commencing in 1997, the project involves ongoing assessments of neurological, cognitive, medical, and mental health every year. Psychological well-being was evaluated based on six components: self-acceptance, autonomy, life purpose, personal growth, positive relationships, and the ability to cope with one’s environment.
Findings of the Study
Participants who eventually developed cognitive impairment exhibited a more rapid decline in psychological well-being compared to their cognitively intact counterparts. Notably, their well-being declined two years before diagnosis, suggesting poorer levels of life purpose and personal growth as potential precursors to cognitive impairment.
- Positive Relationships: A significant drop occurred after diagnosis.
- Overall Well-Being: Other aspects remained stable before and after diagnosis.
The Interplay of Well-Being and Cognitive Health
While the study revealed insightful patterns, it also acknowledged limitations, including a lack of demographic diversity. Though the study’s sample primarily consisted of older white adults with higher education levels, the findings align with broader research trends.
There’s a bidirectional relationship between well-being and cognitive impairment. Enhanced well-being may help mitigate dementia risks by limiting the effects of Alzheimer’s disease on cognition. Positive well-being correlates with reduced inflammation and cardiovascular risks, both of which may diminish cognitive impairment chances.
Conversely, neurodegenerative diseases like Alzheimer’s could impair brain network functionality—essential for maintaining well-being—potentially leading to apathy. This interplay suggests both disorders could simultaneously influence each other long before noticeable cognitive changes arise.
Enrich Your Life, Protect Your Brain
Fostering well-being, finding a life purpose, and pursuing personal growth become increasingly critical with age. Dr. Glen R. Finney, a director at the Geisinger Memory and Cognition Program, underscores the necessity of socialization and meaningful activities for cognitive health.
Practical Tips for Enhancing Well-Being
- Engage in Social Activities: Community clubs, volunteer work, and fitness groups can foster connections.
- Seek New Learning Opportunities: Explore educational courses or workshops suited for older adults.
- Play Mind-Challenging Games: Engage in strategic games and reading to keep the mind active.
- Maintain Relationships: Stay in touch with friends and make new friendships to strengthen your social circle.
When to Consult a Doctor
If experiencing difficulties maintaining social or mental activity, it is advisable to consult a healthcare professional. Proactively addressing these factors aids in reducing dementia risks, preserving function, and potentially reversing mild symptoms emerging before dementia onset.
The Critical Window for Intervention
The study posits that the substantial interval between the onset of cognitive impairment and visible symptomology presents a pivotal opportunity for interventions aimed at preventing or delaying dementia’s development. Engaging in purpose-driven, socially enriching, and personal growth-oriented activities may help sustain brain health.
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