Declining psychological well-being: A red flag for cognitive impairment
The study followed 910 older adults in the US, with an average age of 79 years, over a period of more than 10 years. These participants were cognitively intact at the start of the research, undergoing annual assessments of brain function, cognition, and psychological well-being. Over the course of the study, 29% of the participants developed MCI, and of these, 34% progressed to dementia.
Researchers found that individuals who developed MCI exhibited noticeable declines in psychological well-being two to six years before their diagnosis. This decline was characterised by lower levels of purpose in life and personal growth, beginning three and six years before the onset of MCI, respectively. This decline in well-being occurred even in the absence of overt cognitive symptoms, suggesting that these psychological changes could serve as early warning signs of cognitive impairment.
What is the link between psychological well-being and dementia?
Previous research has established a connection between psychological well-being and brain health, particularly in relation to dementia. Much of this research has focused on a sense of purpose in life, with less attention given to other components of well-being, such as personal growth. This new study emphasises that personal growth, which involves a sense of ongoing development and fulfilment, maybe a more sensitive indicator of cognitive ageing than other aspects of psychological well-being.
The researchers suggest that personal growth and purpose in life are cognitively demanding, making them more vulnerable to decline as brain function deteriorates. This finding highlights the importance of maintaining psychological well-being as we age, not only for emotional health but also as a potential protective factor against cognitive decline.
What is an observational study?
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While the study’s findings are compelling, it is important to note that this was an observational study. As such, the researchers caution against drawing firm conclusions about cause and effect. For example, it is unclear whether a decline in psychological well-being causes cognitive impairment, or whether the two are mutually reinforcing. It is possible that poorer cognition influences psychological well-being, or that both factors share common protective mechanisms.
The study’s participants were also predominantly white, female, and well-educated, which may limit the generalisability of the findings to other populations. Despite these limitations, the research offers insights into the relationship between psychological well-being and cognitive health.
Social connections and cognitive health
One of the key findings of the study was the rapid decline in positive relationships with others following an MCI diagnosis. People with impaired cognitive function were found to be less likely to engage in social and leisure activities, which in turn negatively impacted their relationships. This finding suggests that maintaining social connections may be crucial in preserving cognitive health.
The researchers advocate for psychological support for individuals diagnosed with dementing disorders, emphasizing the importance of fostering social and emotional well-being alongside medical treatment.
Implications for early detection and prevention
The findings of this study have significant implications for the early detection and prevention of dementia. Recognising changes in psychological well-being, particularly in areas such as personal growth and purpose in life, could help identify individuals at risk of developing cognitive impairment before more severe symptoms appear.