There is a growing literature that feeling that one’s life is goal-oriented and directed – that is, feeling that one’s life is purposeful – is associated with healthier cognitive outcomes. Purpose in life, for example, is protective against Alzheimer’s disease (Boyle, Buchman, Barnes, & Bennett, 2010) and dementia (Sutin, Stephan, & Terracciano, 2018). Prior to dementia, it is associated with healthier cognitive function (Lewis, Turiano, Payne, & Hill, 2017) and less cognitive decline over time (G. Kim, Shin, Scicolone, & Parmelee, 2019). These protective benefits are thought to be related to the healthier lifestyles and health profiles of individuals higher in purpose (E. S. Kim, Delaney, & Kubansky, 2019; E. S. Kim, Shiba, Boehm, & Kubzansky, 2020). Less research has addressed whether purpose in life continues to be protective later in the dementia disease process. Although purpose in life is protective, individuals high in purpose still can develop dementia. One of the most difficult aspects of the disease for caregivers is the behavioral and psychological symptoms of dementia (BPSD). BPSD are heterogenous and cover a wide range of symptoms and include disturbances across a number of domains. These domains include psychological (e.g., depression, apathy, elation, delusions), perceptual (e.g., hallucinations), motor function (e.g., wandering, repetitive purposeless behaviors), circadian rhythm (e.g., changes in sleep patterns), and eating behavior (e.g., loss or increase in appetite) (Cerejeira, Lagarto, & Mukaetova-Ladinska, 2012). BPSD can be challenging for caregivers to manage (Black & Almeida, 2004). They have also been associated with faster progression of the disease (Geda et al., 2013) and are a strong predictor of institutionalization (Gaugler, Yu, Krichbaum, & Wyman, 2009). The purpose of this project is to examine whether self-reported purpose in life is associated prospectively (up to 10 years later) with BPSD in the last year of life, as reported by a knowledgeable observer.
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