An international study published in the journal
Nature Mental Health has identified three psychological profiles associated with different patterns of cognitive and brain decline in ageing. The study, which analysed more than 1,000 middle-aged and older adults, shows that the specific psychological characteristics of each profile may influence the risk of developing dementia, as well as aspects such as the speed of brain decline and sleep quality. These findings open new perspectives for the design of more personalized prevention strategies.
According to the research team, the results highlight “the need for comprehensive psychological assessments of patients to identify different psychological profiles and thus enable more specific and individually tailored behaviour change strategies to be implemented”.
The study is led by David Bartrés-Faz, a researcher at the Faculty of Medicine and Health Sciences and the Institute of Neurosciences (UBneuro) of the University of Barcelona. He is also a member of the August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and principal researcher at the Institut Guttmann Barcelona Brain Health Initiative (BBHI), which aims to find and understand how to maintain the brain’s health.
Risk and protective factors for cognitive decline
Recent studies identified psychological characteristics that may be associated with increased risk or protection against cognitive decline, neurodegeneration and clinical dementia. For example, having repetitive negative thoughts, a tendency to experience distress and perceived stress are associated with more risk, while having a sense of purpose in life or self-reflection would be protective factors against such decline.
In this study, conducted on data from more than 1,000 volunteers of the BBHI and the Medit-Ageing international study, the research team examined whether these factors — protective and risk factors — combine in similar psychological profiles in two independent cohorts of middle-aged adults and older people without cognitive impairment.
Bartrés-Faz stresses that “to date, psychological risk and protective factors have been examined almost exclusively independently: this approach is limiting, as psychological characteristics do not exist in isolation”.
The team then analysed how belonging to each of these profiles is related to indicators of mental health, cognition, lifestyle and brain integrity — measured by cortical thickness — as well as cognitive evolution and brain atrophy over time. “The aim was to elucidate how various combinations of psychological characteristics are related to mental, cognitive and brain health”, notes the UB and Gutmann Institut researcher.
Mental and cognitive health implications
The results show that having a “well-balanced” psychological profile, with moderately high protective factors and moderately low-risk factors, is associated with better cognitive and mental health in all indicators measured. “These associations were observed in all age groups studied, which reinforces the relevance of considering the balance of a wide range of psychological aspects as determinants of mental, cognitive and brain health in adulthood and older age”, says Bartrés-Faz.
On the other hand, a psychological profile with low levels of protective characteristics — such as a sense of purpose, extraversion or openness to new experiences — was associated with poorer cognition (especially in older people), more pronounced brain atrophy (already observable in middle-aged adults) and lower adherence to healthy lifestyles.
Finally, the third profile identified, characterized by high levels of negative or risky psychological traits, such as a high propensity for distress and negative thoughts, “may increase the risk of cognitive impairment and dementia through a psycho-affective pathway, including the expression of symptoms such as depression, anxiety, cognitive complaints, loneliness and sleep disorders”, says the researcher.
Future prevention interventions
Once validated in larger-sample studies, these results could have important implications for the development of future preventive interventions designed to modify psychological factors and lifestyles. “For instance, people with traits compatible with the psychological profile with low levels of protective factors may benefit more from psychological therapies that include the identification or re-identification of valued behaviours and life purposes, such as acceptance and commitment therapy”, Bartrés-Faz notes.
However, “people who meet the criteria of the third profile identified may have a better response to therapies aimed at reducing distress-related symptoms, which have also recently been shown to have potential benefit”, the researcher states. The expert stresses the importance of conducting “comprehensive psychological assessments, including analysis of both risk and protective factors, in order to more accurately estimate each person’s risk profile”.