Date Published: May 24, 2018
Publisher: BioMed Central
Author(s): David Bartrés-Faz, Gabriele Cattaneo, Javier Solana, Josep M. Tormos, Alvaro Pascual-Leone.
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.
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.
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.
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.
The online version of this article (10.1186/s13195-018-0381-z) contains supplementary material, which is available to authorized users.
Largely influenced by the ‘cognitive reserve’ (CR) theory [73, 74], research on factors accounting for interindividual differences in cognitive and brain function in older populations has been dominated by the study of the roles of education, occupation, and social and leisure activities . Recently, with the introduction of broader umbrella terms like ‘lifestyle’ and ‘resilience’, the field has expanded, acknowledging the potential relevance of specific cognitive components such as bilingualism , as well as factors like physical activity (e.g., ), sleep (e.g., ), and diet (e.g., ). Particular mental and bodily practices (i.e., meditation; e.g., ), and their interactions with both nonmodifiable (e.g., genetic background) and modifiable (e.g., ) risk factors, have also been explored. However, psychological factors, including personal resources (e.g., motivational and personality traits, coping strategies or attitude toward life and the future), have received less attention even though they may contribute to late-life health, brain resilience, and the capacity for functional restoration.
The present study, conducted in a relatively large sample of adults, revealed positive associations amongst the MiL dimensions as well as with CR measures. However, not all of the studied variables explained the self-reported health outcomes to a similar degree. Negative affectivity, including depression, anxiety, and stress, only showed an association with the MiL dimensions. By contrast, self-perceived cognitive function also presented an association with CR that was partially mediated by PiL and SoC. In the following sections we discuss these findings in the light of previous literature and highlight its relevance for further studies in the CR field.
In summary, our results suggest that future research on CR, in which cognitive measures are key outcomes, should consider introducing formal ratings and analyzing the impact of MiL components. Some functional neuroimaging data suggest overlapping engagements of particular brain systems and areas for MiL and CR, such as the default-mode network and the anterior cingulate cortex, as well as the dorso and ventrolateral prefrontal regions (reviewed in [3, 13, 66]). Thus, further research is needed to increase our understanding of how MiL and CR components operate through specific or common neural bases to promote brain health. Finally, it should be noted that CR components (cognitive, physical training, and social engagement; reviewed in ) and different dimensions of meaning and well-being (e.g., [82, 88]) are amenable to behavioral interventions. Moreover, intervening in one of the components may have an effect on the other dimensions, as has been recently reported in elderly adults in whom physical activity exerted a positive effect on SoC scores . Hence, understanding how such dimensions interact and potentiate one another in response to experimental manipulations could have an impact on the implementation and refinement of future health-promoting multidomain intervention programs.