Clinical Manifestations

Purpose-in-life (PiL) refers to the tendency to derive purpose and meaning in life. Higher PiL was associated with lower risk for developing Alzheimer's dementia in older white participants (age 70s-80s). It is unclear, however, whether the protective effect of PiL can be observed as early as in the 50s and 60s, and whether PiL is associated with a delay in onset age of cognitive impairment. Here, we investigated these questions in the population-based cohort of diverse participants recruited by the Health and Retirement Study. 13,689 participants (10,114 White, 1837 Black, 1335 Hispanic, 405 Other) with normal cognitive status at baseline, PiL assessment, longitudinal depression and cognitive test scores, and genetic data were included. Cognitive performance was assessed biennially with the modified Telephone Interview for Cognitive Status (mTICS) over 15 follow-up years. The mTICS includes immediate and delay recall, working memory, attention, and processing speed. Cognitive impairment was defined as having mTICS