Significant link found between determination and dementia

New research shows that a person’s sense of purpose declines in the lead-up to and after a diagnosis of dementia or cognitive decline. Accordingly, the more purposeful a person is, the less risk he has of developing Alzheimer’s disease and similar diseases.

“Purpose in life is the feeling that one’s life has purpose and direction. It’s an important component of wellness,” said Dr. Angelina Sutin, lead author of the study published Wednesday in the journal JAMA Network Open.

Researchers now know that a sense of purpose is an important factor in good health in adulthood, added Dr. Sutin, a professor of behavioral sciences and social medicine at Florida State University College of Medicine in Tallahassee.

“Previous studies have shown that motivated people are less likely to develop Alzheimer’s disease and other dementias,” says Angelina Sutin. “Here we look at the relationship between sense of purpose and cognitive impairment from a different perspective: Does impairment affect feelings of sense of purpose?”

To explore this question, researchers looked at data from more than 30,000 people in two studies: the Health and Retirement Study from 2006 to 2021 and the National Health and Aging Trends Study from 2011 to 2021.

According to the study, study participants were assessed several times over several years for cognitive impairment and their sense of purpose.

While there was some evidence of a decline in sense of purpose in the years leading up to cognitive impairment, the decline was more rapid once it was identified, Dr. Sutin said.

The results were not surprising given what scientists know about declines in mental health after diagnosis, said Dr. Sam Fazio, senior director of quality care and psychosocial research at the Alzheimer’s Association.

The impairment was identified as a result of performance on cognitive tasks rather than as a result of diagnosis by a health care professional. But the results are reliable because they use estimates over a period of more than a decade, and the trends were replicated in both groups, explains Angelina Sutin.

“Goal may be a target for intervention following cognitive impairment to maintain well-being and reduce or delay the onset of behavioral symptoms associated with the low goal,” the study states.

According to Angelina Sutin, the degree to which each person lost their sense of purpose varied from person to person—for some it decreased quickly, while for others it did not decrease at all. Future research should examine these patterns to determine who is most at risk, she added.

But it is critical for everyone to maintain a sense of purpose later in life, Dr. Soutine emphasizes.

“The opposite of purpose in life—apathy—is a major problem in dementia. People with dementia lose their desire to participate in life, she said. “It is critical for people to maintain their purpose in life to prevent or at least delay this apathy that can reduce quality of life.”

According to Sam Fazio, caregivers—whether professionals or loved ones—play an important role in helping a person with cognitive impairment stay engaged. This is especially true as dementia progresses, making it more difficult for someone to initiate activities on their own.

The key, he said, is to find ways to help engage the person with cognitive impairment and involve them in activities, but not take on so much that they don’t have a sense of independence and involvement.

The best support is centered on the person and not just about their illness, Fazio said.

Good care involves taking the time to learn more about the person and helping them reconnect with that person, Fazio added. This could mean talking about their previous careers or baking their famous cookies with them.