Midlife Psychological Well-Being and its Impact on Cognitive Functioning Later in Life: An Observational Study Using a Female British Birth Cohort.

Abstract

There is growing interest in public health strategies to modify dementia risk in midlife to reduce the burden of cognitive impairment in subsequent decades. Risk reduction messages should include key recommendations for women in response to the high prevalence of dementia observed in this population. Midlife is a critical period for dementia-related brain changes and psychosocial crises. Psychological well-being can improve resilience to crises, yet it is not well understood with respect to dementia risk reduction. This study aimed to examine the association between midlife psychological well-being and cognitive function in later life in women. The study included 703 women from the British 1946 birth cohort in the Medical Research Council's National Survey of Health and Development. Psychological well-being at 52 years was assessed using the Ryff Scales of Psychological Well-being over six dimensions: autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance. Cognitive function at 69 years was measured using the Addenbrooke's Cognitive Examination, Third Edition. After controlling for cognitive ability at eight years, educational attainment by 26 years, occupational attainment and marital status by 53 years, depression, smoking, and physical exercise at 60-64 years, there was a significant association between greater personal growth and lower self-acceptance at 52 years, and better cognition at 69 years. However, there was no association between cognition and the other four Ryff scales. Most aspects of midlife psychological well-being, except for personal growth and self-acceptance, were not prospectively associated with cognition.