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Well-Being and Cognitive Resilience to Dementia-Related Neuropathology

Emily C. Willroth¹; Bryan D. James^2,3; Eileen K. Graham¹; Alifiya Kapasi^3,4; David A. Bennett^3,5; Daniel K. Mroczek^1,6

¹ Department of Medical Social Sciences, Northwestern University · ² Department of Internal Medicine, Rush Medical College, Rush University · ³ Rush Alzheimer’s Disease Center, Rush University · ⁴ Department of Pathology, Rush Medical College, Rush University · ⁵ Department of Neurological Sciences, Rush Medical College, Rush University · ⁶ Department of Psychology, Northwestern University

Not all older adults with dementia-related neuropathology in their brains experience cognitive decline or impairment. Instead, some people maintain relatively normal cognitive functioning despite neuropathologic burden, a phenomenon called cognitive resilience. Using a longitudinal, epidemiological, clinical-pathologic cohort study of older adults in the United States ( N = 348), the present research investigated associations between well-being and cognitive resilience. Consistent with preregistered hypotheses, results showed that higher eudaimonic well-being (measured via the Ryff Psychological Well-Being Scale) and higher hedonic well-being (measured via the Satisfaction with Life Scale) were associated with better-than-expected cognitive functioning relative to one’s neuropathological burden (i.e., beta-amyloid, neurofibrillary tangles, Lewy bodies, vascular pathologies, hippocampal sclerosis, and TDP-43). The association of eudaimonic well-being in particular was present above and beyond known cognitive resilience factors (i.e., socioeconomic status, education, cognitive activity, low neuroticism, low depression) and dementia risk factors (i.e., apolipoprotein E [ ApoE] genotype, medical comorbidities). This research highlights the importance of considering eudaimonic well-being in efforts to prevent dementia.

DOI

10.1177/09567976221119828

Volume

34 (3)

Pages

283-297

Language

en

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