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Meaning in life: resilience beyond reserve.

ABSTRACT: BACKGROUND:The contribution of psychological factors to brain health and resilience remains poorly investigated. Furthermore, their possible interaction with 'classical' cognitive reserve (CR) estimates in predicting perceived mental health and cognitive status has not been specifically addressed. METHODS:We obtained data from 1081 adults responding to questionnaires on the three meaning in life (MiL) dimensions: purpose in life (PiL), sense of coherence (SoC), and engagement with life (EwL). A questionnaire on CR variables was also administered. The outcome measures were self-reported cognitive function and affective status (depression, stress, and anxiety). Multiple linear regression analyses were used to evaluate the association between sociodemographic variables, MiL dimensions, and CR with the two selected outcomes. Mediation analyses, adjusted for age and gender, were applied to determine whether the MiL dimensions mediated the putative effects of CR on self-reported mental and cognitive health. RESULTS:All three MiL components, but not CR estimates, correlated with the self-reported affective status of the participants. Higher CR, PiL, and SoC (but not EwL) scores significantly correlated with higher perceived cognitive function. Notably, the observed association between the CR measures and self-reported cognitive function was mediated by PiL and SoC. CONCLUSIONS:Psychological MiL dimensions mediate the association between classic CR estimates and self-perceived cognitive function. Further studies on CR could consider including formal measures of such psychological factors to better understand their unique or synergistic contributions, as well as investigate the associated mechanisms maintaining brain function at older ages.

SUBMITTER: Bartres-Faz D

PROVIDER: S-EPMC5968537 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Meaning in life: resilience beyond reserve.

Bartrés-Faz David D Cattaneo Gabriele G Solana Javier J Tormos Josep M JM Pascual-Leone Alvaro A

Alzheimer's research & therapy 20180524 1

<h4>Background</h4>The contribution of psychological factors to brain health and resilience remains poorly investigated. Furthermore, their possible interaction with 'classical' cognitive reserve (CR) estimates in predicting perceived mental health and cognitive status has not been specifically addressed.<h4>Methods</h4>We obtained data from 1081 adults responding to questionnaires on the three meaning in life (MiL) dimensions: purpose in life (PiL), sense of coherence (SoC), and engagement with ...[more]

PMID: 29793549

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Project description:Health-promoting initiatives incorporating meaning-making to enhance the well-being of people in late adulthood are important, particularly as the number of older people is increasing. Resilience and sources of meaning may be related to individuals' experience of meaningfulness and satisfaction with life. However, few studies have investigated these relations among people in late adulthood. In the present exploratory study, we asked the following questions: What are the differences regarding scores on sources of meaning, resilience, meaningfulness, and satisfaction between people in late adulthood (≥65) and other adults (18-64)? What is the association between sources of meaning and meaningfulness, and between resilience and meaningfulness? What is the association between sources of meaning and satisfaction with life, and between resilience and satisfaction with life? A cross-sectional design was used. A population-based sample of 925 participants (aged 18-91 years) was recruited from the National Population Register in Norway. Of these, 219 participants were 65 years old and older (mean age 73 years). Additionally, sub-analyses for the age-group ≥ 75 (N = 71) were performed. Independent-samples t-tests, chi-square tests, one-way ANOVA, and linear regressions adjusted for demographics, anxiety, and depression were performed utilizing standardized questionnaires. It was found that people in late adulthood (≥65 years) scored significantly higher on meaningfulness compared to younger adults (18-64). Of the sources of meaning, vertical self-transcendence, including explicit religiosity and spirituality, had the strongest relation to meaningfulness for people in late adulthood, after adjusting for demographics, anxiety, and depression. For the same group, accomplishment, including generativity and unselfish engagement with the surroundings and future generations, also stood out as a prominent source of meaning when related to meaningfulness. No sources of meaning were associated with satisfaction with life in the older group. No associations between resilience and meaningfulness, nor between resilience and satisfaction with life, were found among people in late adulthood. However, positive associations were found between resilience and meaningfulness, as well as between resilience and satisfaction with life, in the 18-64 age group. Longitudinal research and interventional studies are needed to confirm whether the designated sources contribute to meaningfulness in a Norwegian context. The implications of the findings are discussed.

Project description:We explored the presence of both reserve and resilience in late-converter mild cognitive impairment due to Alzheimer's disease (MCI-AD) and in patients with slowly progressing amyloid-positive MCI by assessing the topography and extent of neurodegeneration with respect to both "aggressive" and typically progressing phenotypes and in the whole group of patients with MCI, grounding the stratification on education level.We analyzed 94 patients with MCI-AD followed until conversion to dementia and 39 patients with MCI who had brain amyloidosis (AMY+ MCI), all with available baseline 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) results. Using a data-driven approach based on conversion time, patients with MCI-AD were divided into typical AD and late-converter subgroups. Similarly, on the basis of annual rate of Mini Mental State Examination score reduction, AMY+ MCI group was divided, obtaining smoldering (first tertile) and aggressive (third tertile) subgroups. Finally, we divided the whole group (MCI-AD and AMY+ MCI) according to years of schooling, obtaining four subgroups: poorly educated (Low-EDUC; first quartile), patients with average education (Average-EDUC; second quartile), highly educated (High-EDUC; third quartile), and exceptionally educated (Except-EDUC; fourth quartile). FDG-PET of typical AD, late converters, and aggressive and smoldering AMY+ MCI subgroups, as well as education level-based subgroups, were compared with healthy volunteer control subjects (CTR) and within each group using a two-samples t test design (SPM8; p < 0.05 family-wise error-corrected).Late converters were characterized by relatively preserved metabolism in the right middle temporal gyrus (Brodmann area [BA] 21) and in the left orbitofrontal cortex (BA 47) with respect to typical AD. When compared with CTR, the High-EDUC subgroup demonstrated a more extended bilateral hypometabolism in the posterior parietal cortex, posterior cingulate cortex, and precuneus than the Low- and Average-EDUC subgroups expressing the same level of cognitive impairment. The Except-EDUC subgroup showed a cluster of significant hypometabolism including only the left posterior parietal cortex (larger than the Low- and Average-EDUC subgroups but not further extended with respect to the High-EDUC subgroup).Middle and inferior temporal gyri may represent sites of resilience rather than a hallmark of a more aggressive pattern (when hypometabolic). These findings thus support the existence of a relatively homogeneous AD progression pattern of hypometabolism despite AD heterogeneity and interference of cognitive reserve. In fact, cortical regions whose "metabolic resistance" was associated with slower clinical progression had different localization with respect to the regions affected by education-related reserve.

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Meaning in life: resilience beyond reserve.

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Meaning in life: resilience beyond reserve.

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