Sense of purpose emerges as key predictor of cognitive functioning in older adults

A large, decade-long study of older adults has found that those with higher levels of well-being—especially a strong sense of purpose—also tended to show better cognitive functioning and less cognitive decline over time. The study, published in Psychological Science, suggests that well-being and cognitive health are closely linked in later life, with each influencing the other in a dynamic and reciprocal relationship.

As the global population ages, the burden of cognitive decline and dementia is expected to increase dramatically. Efforts to identify modifiable factors that can help maintain cognitive function into older age have become a top priority. One area of growing interest is the role of psychological well-being. While earlier research has shown links between well-being and cognition, most studies could not determine whether changes in well-being led to changes in cognition or the reverse.

The current study, led by Gabrielle Pfund of Auburn University and colleagues from Rush University and Washington University in St. Louis, aimed to clarify these relationships by using advanced statistical techniques to track both well-being and cognitive function in the same individuals over time.

“I have been interested in the construct of sense of purpose since early in my graduate school experience,” said Pfund, an assistant professor of human development and family science. “As I continued throughout graduate school, I came across more and more research that highlighted the predictive power of purpose, particularly for healthy aging. Like many, I’ve personally experienced the pain of losing a loved one to dementia. With pharmacological interventions still nascent, establishing nonpharmacological opportunities to combat the development of dementia and slow cognitive decline is imperative.”

The research team analyzed data from 1,702 adults over the age of 65 who participated in two large studies based in the Chicago area: the Memory and Aging Project and the Minority Aging Research Study. Participants were racially diverse, with about three-quarters identifying as White and nearly a quarter identifying as Black.

Each participant completed annual assessments of their cognitive abilities and self-reported levels of well-being for up to 10 years. Cognitive function was measured using a comprehensive battery of 19 tests covering memory, processing speed, verbal ability, and spatial reasoning. Well-being was assessed using several measures, including the Psychological Well-Being Scale (which reflects eudaimonic well-being, such as autonomy and personal growth), a separate measure of sense of purpose, and the Satisfaction With Life Scale.

“This study focuses on the reciprocal relationship between cognitive function with three domains of well-being: (1) sense of purpose (the extent to which one feels they have personally meaningful goals and activities), (2) eudaimonic well-being (one’s sense of autonomy, personal growth, purpose, and connection to others), and (3) life satisfaction (one’s sense of contentment with their life),” Pfund explained.

To explore the long-term patterns between well-being and cognition, the researchers used bivariate latent growth curve models. These models showed that people who started out with higher levels of well-being also tended to have higher levels of cognitive function. More importantly, participants who experienced steeper declines in well-being also tended to show steeper cognitive declines. These findings held even after accounting for factors such as age and sex.

The researchers also applied a second type of statistical model, known as random-intercept cross-lagged panel models, which allowed them to examine how changes in one variable predicted changes in the other over time. These analyses revealed that changes in well-being predicted subsequent changes in cognition—and vice versa. In other words, having a better-than-usual year in terms of well-being was followed by a better-than-usual year in cognitive performance. Similarly, declines in cognition predicted future declines in well-being.

“We found that as cognition function declined, so did participants’ levels of well-being,” Pfund told PsyPost. “We also found that declines in well-being at one time point predicted times in cognitive function at the next (and vice versa). These patterns remained when accounting for age, sex, race, APoE genotype (i.e., gene for Alzheimer’s risk), education, depressive symptoms, and neuroticism. This means that intervention efforts focused on the development, maintenance, and promotion of well-being could be a promising pathway to support healthy cognitive aging.”

The researchers found that these effects were not equally strong across all forms of well-being. Eudaimonic well-being and sense of purpose had a stronger and more consistent relationship with cognitive health than life satisfaction did. People with a strong sense of purpose were more likely to maintain their cognitive abilities, and cognitive declines had a more pronounced impact on this form of well-being than on general life satisfaction.

“One of my main interests in the current work was to see whether these different elements of well-being were all associated with cognitive decline equally,” Pfund said. “I expected the findings to be stronger for sense of purpose than life satisfaction, and that ended up being the case. This means this finding was not a surprise for me, but sometimes psychologists outside of the well-being research field consider these different domains of well-being consider them fairly synonymous, so I think this finding will likely be a surprise to others.”

The study’s large sample size, long follow-up period, and racially diverse cohort strengthen the reliability of the findings. The researchers also took steps to control for many factors that might influence the results. However, as with any observational study, the results cannot prove causality. It is still possible that other unmeasured factors influence both well-being and cognition, or that some of the observed links are due to shared lifestyle or health-related variables.

The authors also note that their findings may not apply equally across all populations. For instance, participants were primarily drawn from an urban region with relatively high access to health care and community resources.

“Overall, the current study was quite well-suited to the current question given the large number of assessments and racially diverse sample,” Pfund said. “However, one question I have growing interest in is whether these findings would extend to more rural populations, who are at higher risk for cognitive decline, its risk factors (e.g., diabetes), and protective factors (e.g., access to medical care). Understanding whether these associations are consistent, stronger, or weaker in higher risk populations with less access to other medical support provides context for the generalizability of these findings and future intervention efforts.”

“My main goal is to understand daily processes and mechanisms that link these long-term relationships,” Pfund continued. “Why is sense of purpose associated with cognitive function? Is it because purposeful people have better social relationships, engage in more cognitive activities, are more physically active, or is there something unique about feeling purposeful? This approach is necessary for establishing what factors are most necessary to intervene upon in daily life to promote healthy cognitive aging.”

The study, “Bidirectional Relationships Between Well-Being and Cognitive Function,” was authored by Gabrielle N. Pfund, Bryan D. James, and Emily C. Willroth.