Abstract
Studies show the importance of the personal experience of meaning in life for older adults, but adults with dementia have been largely excluded from this research. The current study examined the longitudinal predictive effect of meaning in life for the psychological and cognitive functioning of older adults with Alzheimer’s disease and whether cognitive decline predicted presence of meaning in life. On three yearly measurement occasions, presence of meaning in life, depressive symptoms, life satisfaction, and cognitive functioning were assessed in structured interviews with a convenience sample of 140 older adults with Alzheimer’s disease from nine nursing homes in Belgium. Cross-lagged panel and latent growth curve models were used to analyze the longitudinal relationships between the variables. Over the three measurement waves, participants with higher presence of meaning reported lower depressive symptoms one year later. Presence of meaning and life satisfaction predicted each other over time, but only between the first and second wave. The analyses showed no strong evidence for a longitudinal association between meaning in life and cognitive functioning in either direction. The findings emphasize the importance of the experience of meaning in life for the psychological functioning of older adults with Alzheimer’s disease. The lack of evidence for associations between meaning and cognitive functioning questions the prevailing view that intact cognitive abilities are a necessity for experiencing meaning. More attention to the potential of meaning interventions for persons with dementia is warranted.
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Notes
Main deviations: level of education was not mentioned as covariate in the pre-registration but was included as control because of its association with cognitive functioning (inclusion did not alter main conclusions). Separate models 2–4 were not specified in the pre-registration but were added because of more acceptable parameters-observations ratio.
Crosstabs showed that those with missing data on PoMT1 also had a higher rate of dropping out of the study due to death (47%) than those with PoMT1 data available (27%). However, when drop-out due to death was investigated as outcome in a logistic regression, PoMT1 missingness was not predictive of drop-out over and above the predictive effect of age, which suggests that the association between PoM missingness and dropout due to death is likely attributable to participant age (i.e., older participants are more likely to have missing PoMT1 data and are more likely to drop out due to death). Full crosstabs and logistic regression output can be found on OSF (osf.io/czvhb).
While the longitudinal associations between SWLS and MMSE and between GDS and MMSE were not the main focus of this manuscript, we tested these separate cross-lagged models as well for exploratory purposes. We found no significant cross-lagged relationships between SWLS and MMSE or between GDS and MMSE.
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Acknowledgements
We wish to thank the participating residential care settings and residents. We thank Lotte Van Looy and Tine Schellekens for their help in collecting the data.
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This work was supported by the Research Foundation Flanders under grant 1109417 N (to LD).
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L. Dewitte, M. Vandenbulcke, and J. Dezutter designed the study and formulated the research questions. P.L Hill and L. Dewitte designed the analysis plan. L. Dewitte collected and analyzed the data and wrote the manuscript. J. Dezutter and M. Vandenbulcke supervised the data collection and provided critical feedback on the manuscript. P.L. Hill assisted with the analyses and writing of the manuscript.
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Dewitte, L., Hill, P.L., Vandenbulcke, M. et al. The longitudinal relationship between meaning in life, depressive symptoms, life satisfaction, and cognitive functioning for older adults with Alzheimer’s disease. Eur J Ageing 19, 1155–1166 (2022). https://doi.org/10.1007/s10433-022-00689-z
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DOI: https://doi.org/10.1007/s10433-022-00689-z