Thinking positive about age may help conquer mild cognitive impairment

Having a positive attitude about aging can go a long way in helping people recover from mild cognitive impairment (MCI). Generally, it is assumed that older people who develop MCI won’t recover, yet studies show that close to half of people with MCI regain normal cognition, according to Becca Levy, who coauthored a study in JAMA Network Open, investigating whether positive age-beliefs contributed to recovery from MCI. Dr. Levy is a professor of epidemiology and psychology at the Yale School of Public Health. In psychology, “age belief is standard term that includes the images of aging we take in from our culture which starts in childhood,” she told the Medical Post in an email. Other studies have shown that positive age beliefs are associated with reducing stress caused by cognitive challenges, increased self-confidence about cognition, and improved cognitive performance. But the question remained as to whether positive age beliefs played a role in MCI recovery. Participants for the study were recruited from the Health and Retirement Study (HRS), a national longitudinal survey in the U.S.. Inclusion criteria were age 65 years or older who had presented with MCI and had at least one follow-up cognition assessment and a positive age-belief measure. To determine the age belief of participants, the Attitude toward Aging subscale of the Philadelphia Geriatric Morale Scale was used. It included phrases such as “the older I get, the more useless I feel.” Respondents rated how much they agree or disagree with the statements. A total of 1,716 participants were included and consisted of 953 women (55.5%) and 763 men (44.5%) with a mean age of 77.8 years. They all had baseline MCI, ranging from mild to severe. Details such as self-reported race, education, marital status, smoking history, apolipoprotein E status, depression, cardiovascular and/or diabetes diagnosis, social isolation, sleep issues, and physical inactivity were all taken into account in the analyses. There were seven data collection performed (every second year from 2008 through 2020) in the HRS. The overall cohort was split into two groups. “We split the group at the average score into those who have taken in more positive views of aging from their culture and those who have taken in more negative views of aging,” Dr. Levy said. A total of 609 people were ranked as having positive age beliefs and 1,107 with negative age beliefs. It was found that those with greater age positive beliefs at baseline had a 30.2% greater likelihood of recovery than those who had negative age-beliefs. “This recovery advantage persisted regardless of baseline MCI severity,” the study said. The two groups were similar in terms of other potentially confounding factors such as depression, feelings of isolation, the presence of chronic disease and other issues. But “We did find that those with negative age beliefs were less likely to be physically active so we adjusted for this and found above and beyond this the age beliefs predicted cognitive recovery,” Dr. Levy said. She noted that while the study participants had MCI at baseline, the causes for it weren’t part of this study. “We started the main analysis with a group that had MCI at baseline. In a secondary analysis we found that those who had normal cognition were more likely to develop MCI if they had negative age beliefs than if they had taken in more positive age beliefs.” Researchers concluded in the paper “The findings of this cohort study suggest the importance of considering the role of culture, expressed here through age beliefs, in MCI development and reversal.” In general, other studies have confirmed the deleterious effects of anxiety. One such is a recent study in the International Journal of Geriatric Psychiatry in which researchers confirmed an association between perceived stress, anxiety and MCI—though it did not look specifically at attitudes around aging. Here, researchers conducted a longitudinal study of 368 adults over the age of 65 and performed annual measures of anxiety symptoms, perceived stress and dementia. They noted that, generally, the prevalence of anxiety disorders in older adults are estimated to be from 3.2% to 14.2%, and range from 5% to 21% in adults with MCI. The study used a population cohort in Pennsylvania where recruitment started in 2006 to 2008 with more recruited 2016 to 2019. Analyses were done of 368 people who had full assessments at three different points during the study period. The results found that perceived stress was a significant mediator of MCI—both in the pathways from MCI to anxiety, and from anxiety to incident MCI. “Perceived stress mediated 37.14% of the anxiety effect on incident MCI, and 27.13% effect on anxiety symptoms,” the paper said. “Our results indicate that the bidirectional pathway between anxiety and incident MCI is mediated in both directions by perceived stress.” They also noted that “Both anxiety and cognitive impairment may share common pathophysiologic pathways in the brain.”

Thinking positive about age may help conquer mild cognitive impairment

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