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Posted: April 4, 2010 12:00 a.m.

To avoid dementia - live with purpose

As our population ages, dementia becomes a more frequent diagnosis. Alzheimer's is the most common type of dementia, and is characterized by a global loss of intellectual functioning. A person who has dementia has cognitive problems with memory, reasoning, perception and motor skills that gets worse as they get older. There is not a cure for it, and little is known about its causes.

The incentive to understand the causes of the disease, and its precursor - mild cognitive impairment, increases as the numbers of people with dementia rises. Aron S. Buchman is an associate professor in the department of neurological sciences at Rush University Medical Center in Chicago who seeks to uncover the risk factors for dementia and how to prevent it. In this effort, he is looking at personality and social factors that may be involved. "There has been a lot of interest in psychosocial factors and their association with cognitive decline and dementia in later life," he stated.

His current course of study looks how the positive aspects of life may keep dementia at bay. He explained that his researchers are, "looking at happiness, purposefulness in life, well-being and whether those kind of concepts are associated with a decreased risk of dementia." Buchman and his colleagues collected data on 951 people without dementia who participated in the Rush Memory and Aging Project, and they were asked to respond to statements such as, "I feel good when I think of what I have done in the past and what I hope to do in the future," and "I have a sense of direction and purpose in life."

On follow-up about 4 years later, 16.3 percent of the study participants developed Alzheimer's disease. Accounting for other factors that may contribute to the development of Alzheimer's, the researchers found that those that responded most positively to statements about their lives were the least likely to develop dementia.

Those who stated that they had more purposeful lives were less likely to develop mild cognitive impairment and had a slower rate of cognitive decline.

What is not known is if there is a biological explanation for the study results. Buchman speculates that those with high purpose in life are at a lower risk of developing dementia because of what is involved in a purposeful life. "More social activity, more physical activity, higher cognitive activities, high purpose in life - all these psychosocial factors seem to be linked with longer life, decreased mortality, decreased disability and provide important clues to a public health approach to try to increase independence in older people in later life," Buchman said.

Buchman's work contributes to a body of knowledge that indicates a linkage between behavior and disease. There is some conjecture, particularly by Greg M. Cole, a neuroscientist at the Greater Los Angeles VA Healthcare System, that what Buchman is measuring in his purpose-in-life measures is really depression. There may be a distinction, but depression has been repeatedly associated with increased risk for Alzheimer's disease.

"One wonders whether this is a treatable psychiatric condition contributing to risk or an early symptom of decline," Cole speculated.

So one question that Buchman's research generates is whether there is more Alzheimer's disease because more people have a decreased sense of purpose, or is a lower sense of purpose in life an early, subtle sign of dementia? These are such important questions because their answers may suggest where intervention can take place to avoid this devastating disease.

Dr. C. Kirven Weekley is a clinical psychologist with offices in Covington and Norcross. He specializes in the evaluation and treatment of adults for depression, anxiety, relationship problems and medical issues. He can be reached at (770) 441-9244.

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