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After the age of 45, more than 90% of the population shows structural brain changes that lead to a decline in different cognitive functions, especially those related to the speed at which we do things. This is a natural consequence of ageing and “we accumulate them just as we accumulate wrinkles,” explains Kilian Abellaneda, PhD in Neurosciences and researcher at the Institut Guttmann. However, in some cases these lesions can lead to severe cognitive impairment, so identifying mechanisms that can promote resilience in the face of this damage is an essential objective in an increasingly ageing society. Now, a study of the Barcelona Brain Health Initiative (BBHI) shows for the first time in healthy people that purpose in life promotes resilience to brain damage caused by ageing, and identifies differences in the functioning of brain networks between people with greater or lesser life purpose.

“Purpose in life has been identified as a protective factor in pathological conditions, such as Alzheimer's disease, but it had not been investigated whether it promotes resilience in healthy middle-aged adults,” explains David Bartrés-Faz, principal investigator of the BBHI, professor of Medical Psychology at the Faculty of Medicine and Health Sciences of the University of Barcelona and last author of the article, published in the journal Alzheimer's Research & Therapy.

The term “resilience” refers to the brain's ability to maintain good functioning despite ageing and disease. Given the lack of effective therapeutic interventions against pathologies that lead to cognitive decline, identifying which modifiable factors can promote this resilience is essential. Some of these factors are physical exercise, diet, cognitive training and, as the article states, psychological factors, including life purpose (LP), understood as having a full life, with goals and a directionality in line with our values. “In other words, it is what Japanese call 'ikigai', which is the reason why we get up every morning,” says Abellaneda, first author of the article.

A measure to prevent cognitive impairment

The study selected 624 healthy people –without neurological or psychiatric pathologies– from the BBHI, an initiative of the Guttmann Institute, in collaboration with the University of Barcelona and the Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School (Boston, USA), which aims to learn and understand how we can maintain brain health over time. People with a higher LP index were studied, as opposed to those with a lower index. “In people with less vital purpose, it is very clearly detected that the more lesions they have, the greater the impairment of executive functions, while in people with more purpose, the same lesions did not cause cognitive impairment,” Abellaneda explains. “This is relevant because the fact of having a vital purpose can be worked on through psychological interventions, which means that it could become a measure to prevent cognitive deterioration,” adds Bartrés-Faz.

The second aim of the study was to identify the biological mechanisms underlying the differences in LP between people. Using functional neuroimaging techniques, the researchers found that participants with higher LP have a slightly different configuration of brain networks. Specifically, they have differential connectivity in the so-called “default-mode network”, a brain system sometimes referred to as the “self network” that has been associated with, among other things, autobiographical memory and self-thought. "We have seen that some specific connections involving this network are associated with better cognitive performance, becoming a possible brain reserve mechanism that could be at the basis of the fact that people with more life purpose have greater resilience” Abellaneda explains.